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Older Adults with New Onset Migraine 3 Times More Likely to Have Motor Vehicle Accident
Older adults with a history of migraine, in contrast, were at no greater risk of an automotive crash than those without prevalent migraine, according to new study results.
Older adults who drive and have recently been diagnosed with migraine headaches were found 3 times as likely to be involved in a motor vehicle crash (MVC),1 according to new study findings from researchers at the University of Colorado (UC) Anschutz Medical Campus.
The investigators also found, however, that older adult drivers who reported ever having migraine in the past were at no greater risk for a motor vehicle accident than contemporaries who reported no history of migraine. The results were published online December 22, 2023, in the Journal of the American Geriatric Society.1
“Migraine headaches affect more than 7% of U.S. adults over the age of 60,” Carolyn DiGuiseppi, MPH, PhD, MD, professor with the Colorado School of Public Health and study lead author said in a UC statement.2 “The US population is aging, which means increasing numbers of older adult drivers could see their driving abilities affected by migraine symptoms previously not experienced.”2 DiGiuseppi described disturbing symptoms that include drowsiness, poor concentration, dizziness, severe head pain, and more.2
To learn more about the impact of newly diagnosed migraine on older adults’ driving ability DiGiuseppi and colleagues conducted a longitudinal prospective cohort study of active drivers aged 65 to 79 years at 5 US sites.1 Study participants were categorized as having prevalent migraine (ie, ever had migraine, reported at enrollment), having incident migraine (diagnosis first reported at a study follow-up visit), or never having had migraine. Participants who used medications listed those typically used for migraine prevention and treatment.1
“The US population is aging, which means increasing numbers of older adult drivers could see their driving abilities affected by migraine symptoms previously not experienced.”
Over 2 years of follow-up researchers tracked MVCs reported directly by participants and in-vehicle GPS devices were used to track individual driving habits. They used multivariable mixed models to estimate associations between prevalent migraine with driving outcomes. Associations of incident migraine with MCVs in the year following diagnosis were estimated with conditional logistic regression using a matched design, according to the study.
FINDINGS1
The final cohort for analysis comprised 2589 drivers (53% women) of which 12.5% reported prevalent migraine and 1.3% developed symptoms during study follow-up leading to a migraine diagnosis. The investigators reported no association between having a history of migraine headache and MVCs in the 2 years following study enrollment (adjusted OR [aOR] 0.98; 95% CI, 0.72-1.35). However, they found that the odds of having an MCV within 1 year of migraine diagnosis (incident migraine) were increased significantly by more than 3 (aOR 3.27; 95% CI, 1.21- 8.82.) Further analysis of GPS-recorded driving data indicated that drivers with prevalent migraine while not involved in actual accidents were involved in more hard braking events compared to participants who had never experienced migraine.
When DiGiuseppi et al assessed associations between commonly prescribed migraine medications and MVCs, they found no statistically significant interactions between migraine and either crashes or driving habits in any of the models.
"These results have potential implications for the safety of older patients that should be addressed," DiGuiseppi said. "Patients with a new migraine diagnosis would benefit from talking with their clinicians about driving safety, including being extra careful about other risks, such as distracted driving, alcohol, pain medication and other factors that affect driving." The investigators also recommend additional research to examine “timing, frequency, and severity of migraine diagnosis and symptoms, and use of medications specifically prescribed for migraine, in relation to driving outcomes.”
