Primary Headaches in an Elderly Population Seeking Medical Care for Cognitive Decline

Headache. 2017 Feb;57(2):209-216. doi: 10.1111/head.13003. Epub 2016 Dec 9.

Abstract

Objectives: To assess the prevalence of specific headache disorders in a population older than 65 years seeking consultation due to memory problems or cognitive impairment.

Methods: We verified the occurrence of headache symptoms and the impact of headaches on daily life. Headaches were classified as per the International Classification of Headache Disorders, 2nd edition (ICHD-2). All patients were screened with the Mini-Mental State Examination (MMSE), followed by the Selective Reminding Test and neuroimaging. Participants with severe cognitive impairment or dementia were excluded.

Results: A total of 1,237 patients (51.6% women), with mean age of 75.6 years (SD = 6.9) were screened from January 2006 to December 2014. Of them, 302 (24.4%) patients suffered from headaches. Most common individual diagnoses were probable migraine (13.8%), episodic tension-type headache (3.4%), and episodic migraine (3.0%). Chronic migraine or probable chronic migraine happened in 3.5%, while chronic tension-type headache affected 0.6%. Most patients with headaches routinely used symptomatic medications (55.6%). Mean MMSE scores were similar in patients with or without headaches, or with different headache diagnoses.

Conclusions: Headache disorders overall, frequent headaches, and headaches requiring treatment are commonly seen in the elderly seeking care for cognitive decline and should be properly assessed and managed.

Keywords: elderly; frequent headaches; mild cognitive impairment.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cognitive Dysfunction / epidemiology*
  • Cognitive Dysfunction / therapy
  • Cross-Sectional Studies
  • Disability Evaluation
  • Female
  • Headache Disorders, Primary / diagnosis
  • Headache Disorders, Primary / drug therapy
  • Headache Disorders, Primary / epidemiology*
  • Headache Disorders, Primary / psychology
  • Humans
  • Interviews as Topic
  • Male
  • Mental Status Schedule
  • Oxazines
  • Patient Acceptance of Health Care
  • Prevalence
  • Sex Factors

Substances

  • Oxazines
  • 3-aminophenoxazone