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

Abstract

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.

Associations of Elderly Onset Headache With Occurrence of Poor Functional Outcome, Cardiovascular Disease, and Cognitive Dysfunction During Long-term Follow-up

“…34) In contrast, chronic headache or frequent headache in older patients was related with a higher incidence of seeking care for cognitive decline. 35) Our findings, which included relatively more patients with tension-type headache, are in line with the results of previous studies and may reconfirm the increased risk of cognitive decline in older patients who have a high frequency of headache or who have newly developed headache and/ or recurrent headache (even though this was significant in the univariate analysis). Although a clear mechanism has not been identified, there are hypotheses that can explain the link between headaches and cognitive dysfunction.…”

Prevalence of Migraine in the Elderly: A Narrated Review

“…Worldwide, headache is the tenth most common symptom in elderly women and fourteenth most common symptom in elderly men [23]. Headache has the potential to adversely affect quality of life and limit domestic and community activities of daily living, and therefore carries a high burden of disability [24].…”

“…In a Brazilian retrospective study on patients presenting to an outpatient headache clinic, migraine patients older than 60 years were more likely to be bilateral and less likely to have migraine associated symptoms (photophobia and phonophobia and/ or nausea or vomiting), compared to younger (aged 20-40 years) migraine patients [14]. Elderly patients may also present with aura only (acephalgic) migraines [23] and shorter attacks of migraine [24]. Fisher et al [24] point out that concomitant mild cognitive impairment and changes in memory and thinking are not uncommon in the elderly.…”

“…Elderly patients may also present with aura only (acephalgic) migraines [23] and shorter attacks of migraine [24]. Fisher et al [24] point out that concomitant mild cognitive impairment and changes in memory and thinking are not uncommon in the elderly. Therefore, the history of presenting complaint may be limited and therefore, a diagnosis of migraine may be challenging in this cohort.…”

“…Therefore, the history of presenting complaint may be limited and therefore, a diagnosis of migraine may be challenging in this cohort. The association between cognition and migraine is controversial -with some evidence that the two are not associated [24,26].…”