Decreased risk of dementia in migraine patients with traditional Chinese medicine use: a population-based cohort study

// Chun-Ting Liu 1, * , Bei-Yu Wu 1, * , Yu-Chiang Hung 1, 2, * , Lin-Yi Wang 3 , Yan-Yuh Lee 3 , Tsu-Kung Lin 4 , Pao-Yen Lin 5 , Wu-Fu Chen 6 , Jen-Huai Chiang 7, 8 , Sheng-Feng Hsu 9, 10 and Wen-Long Hu 1, 11, 12, * 1 Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan 2 School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan 3 Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan 4 Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan 5 Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan 6 Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan 7 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan 8 College of Medicine, China Medical University, Taichung, Taiwan 9 Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan 10 Department of Chinese Medicine, China Medical University Hospital, Taipei Branch, Taipei, Taiwan 11 Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan 12 Fooyin University College of Nursing, Kaohsiung, Taiwan * These authors contributed equally to this work Correspondence to: Wen-Long Hu, email: oolonghu@gmail.com Keywords: dementia, migraine, pharmaco-epidemiology, national health insurance research database, Chinese herbal product Received: February 27, 2017      Accepted: June 28, 2017      Published: July 08, 2017 ABSTRACT Patients with migraine are reportedly at increased risk of developing dementia. We aimed to investigate the association between traditional Chinese medicine (TCM) use and dementia risk in migraine patients. This longitudinal cohort study used the Taiwanese National Health Insurance Research Database to identify 32,386 diagnosed migraine patients aged 20 years and above who received treatment from 1997 to 2010. To balance comparability between TCM users and non-TCM users, we randomly selected equal numbers from each group, and compared subgroups compiled based on combinations of age, sex, index year, and year of migraine diagnosis. All enrollees received follow-up until the end of 2013 to measure dementia incidence. We identified 1,402 TCM users and non-TCM users after frequency matching. A total of 134 subjects were newly diagnosed with dementia during the follow-up period. TCM users were significantly less likely to develop dementia than non-TCM users. The most frequently prescribed formulae and single Chinese herbal products were Jia-Wei-Xiao-Yao-San and Yan-Hu-Suo, respectively. This population-based study revealed a decreased dementia risk in migraine patients with TCM use. These findings may provide a reference for dementia prevention strategies, and help integrate TCM into clinical intervention programs that provide a favorable prognosis for migraine patients.