Interaction between physical frailty and sleep quality on risk of migraine in later life: a cohort study of over 350,000 participants
Abstract
Frailty was associated with neurological disorders, but has not been extrapolated to migraine. It’s unclear whether maintaining healthy sleep mitigates this association. We examined the independent, joint, and interactive relationships between frailty status and sleep quality and migraine risk. 356,326 participants from the UK Biobank without migraine at baseline were included. The five-component Fried phenotype was used to assess frailty status and categorized participants as non-frail, pre-frail, and frail. A five-factor sleep questionnaire was employed to quantify sleep quality and categorize individuals into poor, intermediate, and healthy sleep. Cox proportional hazard models were applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). Their interactions on the multiplicative and additive scales were also assessed. During a median follow-up of 13.6 years, 4,641 (1.3%) participants experienced migraine. Compared with non-frail individuals, the HRs (95% CIs) for migraine were 1.149 (1.079–1.222) and 1.413 (1.225–1.630) for those with pre-frailty and frailty. Individuals with intermediate (HR = 1.170; 95% CI: 1.101–1.243) and poor (HR = 1.353; 95% CI: 1.146–1.598) sleep showed an increased risk of migraine compared to those with healthy sleep. The joint test suggested that frail individuals with poor sleep faced the highest migraine risk (HR = 1.897; 95% CI: 1.339–2.687), with evidence of an additive interaction. Also, healthy sleep weakened the…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 356,326 participants or records.
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