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[Headache in the elderly].

V M Reinisch1, C J Schankin, J Felbinger

  • 1Oberbayerisches Kopfschmerzzentrum, Neurologische Klinik und Poliklinik, Klinikum Grosshadern der Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377, München, Germany. veronika.reinisch@med.uni-muenchen.de

Schmerz (Berlin, Germany)
|January 30, 2008
PubMed
Summary
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Chronic headaches are common in older adults, with secondary headaches increasing with age. Treatment requires careful consideration of multiple medications and comorbidities in the elderly.

Area of Science:

  • Geriatrics
  • Neurology
  • Pain Medicine

Background:

  • Chronic headache affects approximately 10% of women and 5% of men over 70.
  • Primary headache incidence declines with age, while secondary headaches increase.
  • Age-related changes alter migraine presentation, with less prominent vegetative symptoms and neck pain.

Purpose of the Study:

  • To review the epidemiology and clinical characteristics of headaches in the elderly.
  • To identify common causes of secondary headaches in older adults.
  • To highlight challenges and considerations in managing headaches in elderly patients with multimorbidity.

Main Methods:

  • Literature review of epidemiological data and clinical presentations of headaches in the elderly.
  • Analysis of age-related changes in primary and secondary headache syndromes.

Related Experiment Videos

  • Discussion of common etiologies including space-occupying lesions, ophthalmological issues, autoimmune diseases, medication effects, and comorbidities.

    • Main Results:

    • Secondary headaches, often mimicking tension-type headaches, become more prevalent in the elderly.
    • Intracranial lesions, ophthalmological problems, giant cell arteritis, medication side effects, and withdrawal are frequent causes.
    • Conditions like sleep apnea, hypertension, and hypothyroidism can cause headaches due to disturbed homeostasis.
    • Facial neuralgias, such as trigeminal neuralgia, increase with age.

    Conclusions:

    • Headache management in the elderly necessitates careful attention to polypharmacy and drug interactions.
    • Comorbidities like depression, anxiety, and cognitive impairment require integrated, interdisciplinary treatment plans.
    • Multimodal therapeutic approaches are essential for effectively managing headaches in older adults.