Why Do Older People Report Fewer Headaches?

Abstract

Background: We have previously confirmed a clear decline in headache prevalence with increasing age. This parallels the pattern in other painful conditions but the age-related decline in prevalence is greater for headache. Objective: To investigate whether the decline in headache prevalence with age was associated with the elimination of work-related factors, increases in other health problems or concomitant use of pain-relieving medicines. We discuss these and other possible explanations from the literature. Methods: Cross-sectional postal survey to a random sample of 5,000 adults with follow-up by (i) consultations with general practitioners and prescriptions issued during the 12 months subsequent to the survey and (ii) a follow-up postal survey at 12 months. Results: Headache prevalence was similar in working and retired respondents within age strata. Headache sufferers were more likely to consult their general practitioner for any reason (excluding headache) compared with non-sufferers and this was true for each age group. Headache sufferers were also more likely to be frequent consulters compared with non-sufferers in all except the oldest age group (age 66 years and over) where there was no difference. There was a clear increase in prescriptions for analgesics and non-steroidal anti-inflammatory drugs issued with increasing age. There was no difference in the percentage of daily medication users among headache sufferers compared with non-sufferers. Conclusion: Neither retirement from work nor the presence of other health problems account for the decline in headache prevalence with age. Whilst the data on concomitant use of pain-relieving medicines suggest this is also not a major factor in the age-related decline, the high use of such medicines in older age groups means we cannot rule out a link. Evidence from the literature suggests that there may be a number of age-related factors involved including changes in reporting of headache, biochemical changes, and the development of strategies to prevent and manage headaches.

The Prevalence of Headache and Associated Psychosocial Factors in an Urban Biracial Sample of Older Adults

“…These figures are lower than studies of younger populations. However, this is not surprising because other studies have found that the prevalence of headache diminishes with age [8].…”

“…Compared to younger populations, community-based epidemiological studies of older adults are rare. Most of these studies have been conducted outside of the United States [1][2][3][4][5][6][7][8][9][10][11]. Only two epidemiological studies of older adults have been conducted in the United States [12,13], one of which focused only on headache lasting at least 4 hours.…”

Influence of retirement and work stress on headache prevalence: A longitudinal modelling study from the GAZEL Cohort Study

“…Improvements in health and psychological well-being around retirement transition have previously been reported also in some other studies (39–44). However, earlier cross-sectional analyses have found no differences in headache prevalence between working and retired persons (45).…”

Prevalence of chronic pain in the elderly Polish population – results of the PolSenior study

“…It seems that the occurrence of headaches in the elderly is underestimated [ 31 ]. In the British study, it was observed that the prevalence of headaches was at a similar level in people between 18 and 54 years of age, and decreased to 5% in the oldest age group aged 75–101 years [ 24 ].…”