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Management of headache in the elderly
Matthew S Robbins1, Richard B Lipton
1The Montefiore Headache Center, Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, 1575 Blondell Avenue, Bronx, NY 10461, USA. marobbin@montefiore.org
Drugs & Aging
|May 11, 2010
Summary
Managing headaches in older adults is complex, requiring careful diagnosis of secondary causes and primary headache disorders like migraine and hypnic headache. Effective treatment involves multifaceted approaches, considering polypharmacy and comorbidities for optimal relief.
Area of Science:
- Geriatric Medicine
- Neurology
- Headache Medicine
Background:
- Headache diagnosis and management in the elderly present unique challenges.
- Evaluation requires differentiating secondary causes from primary headache disorders.
- Primary headaches like tension-type, migraine, and hypnic headache can manifest or persist in older adults.
Purpose of the Study:
- To review the complexities in diagnosing and managing headache disorders in the elderly population.
- To highlight the importance of identifying secondary causes before diagnosing primary headache disorders.
- To discuss current and emerging therapeutic strategies for primary headaches in older individuals.
Main Methods:
- Comprehensive review of literature on headache diagnosis and management in the elderly.
- Analysis of primary headache disorders prevalent in older adults, including tension-type, migraine, and hypnic headache.
- Examination of treatment modalities, considering polypharmacy, drug interactions, and comorbidities.
Main Results:
- Tension-type headache is common, but migraine and hypnic headache also occur in the elderly.
- Primary chronic daily headache is more prevalent than episodic forms in this age group.
- Treatment requires careful consideration of drug interactions, comorbidities, and patient tolerance.
Conclusions:
- Despite complexities, effective relief for elderly patients with primary headache disorders is achievable with current therapies.
- Addressing modifiable risk factors is crucial for managing headache progression.
- New acute, prophylactic, and interventional treatments are anticipated to improve care for older adults with headaches.
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