Headache in the elderly: a retrospective study in a tertiary headache center

Area of Science:

• Neurology
• Geriatrics
• Headache Medicine

Background:

• Primary headaches, especially migraine, are prevalent neurological disorders.
• A comprehensive understanding of headache in the aging population is needed.
• This study evaluates headache and migraine across different age groups in a specialized center.

Purpose of the Study:

• To analyze and compare headache and migraine characteristics in young adults, adults, middle-aged, and elderly patients.
• To identify age-related differences in headache presentation, symptoms, and comorbidities.
• To emphasize the need for age-tailored diagnostic and therapeutic approaches.

Main Methods:

• Retrospective analysis of 3023 patients from a tertiary Headache Center (2017-2025).
• Patients categorized into four age groups: young adults (18-30), adults (31-45), middle-aged (46-59), and elderly (≥60).
• Data included headache features, symptoms, disability, allodynia, fatigue, anxiety, depression; analyzed using chi-square and Kruskal-Wallis tests.

Main Results:

• Elderly patients (13.4%) were more prone to tension-type, other primary, and secondary headaches.
• Chronic migraine was more prevalent in the elderly (40.3%) compared to younger groups.
• Older adults reported longer disease duration, longer attacks, increased fatigue, and higher rates of medication overuse.

Conclusions:

• Headache and migraine presentations significantly vary by age.
• Elderly patients exhibit distinct patterns, including predominant chronic migraine, less autonomic symptoms, prolonged attacks, and increased fatigue.
• Medication overuse is a notable issue in older individuals, underscoring the necessity for age-specific management strategies.