Migraine, as we all know, is predominantly seen in younger patients. But for some patients, headache can accompany even in the old age.
According to the American Migraine Study, the prevalence of migraine headache was 25 % in 50-year-old women and 10 % in 70-year-old women1.
Although the prevalence of headache declines steadily after the age of 401, some form of secondary headache is more likely to be seen in the elderly. Secondary headache means experiencing visual or sensory disturbances without the actual headache.
Difference between headache in young and old patients
The characteristics of headache differ between elderly and younger patients. Headache in elderly patients usually have a typical aura without headache, facial pain syndrome, and secondary headache, which may be caused by hormonal or metabolic changes, simultaneous diseases, and various medications2.
The most common headache types in the elderly are tension, migraine, late-life migraine accompaniments, and cluster headache. Tension headache is the most common primary headache type in the elderly2.
Why does headache strike in old age?
Having a headache in your later life could be due to several reasons such as –
- Suffering from a serious but treatable disorder2 – sometimes persistent headache in old age can be due to a more serious neurological disorder such as –
- subarachnoid hemorrhage (bulging blood vessel in the brain),
- temporal arteritis (swelling of blood vessels),
- trigeminal neuralgia (chronic pain in nerve that carries sensation from face to brain)
- intracranial hemorrhage (bleeding inside skull)
If you or your loved one complains about frequent headache, consult your doctor immediately. The above mentioned conditions are treatable when diagnosed early.
- Cluster headache – The more severe form of headache to strike in old age is cluster headache. It is characterized by one sided pain, restlessness, drooping eyelids, pain behind the eye etc. Cluster headaches are different from migraines but follow the same pattern of treatment.
- Medication overuse – Old age comes with its own set of diseases and some of the medications used to treat these diseases can trigger a migraine headache. Medications used to treat certain types of chest pain (angina), some blood pressure reducing medicines, medication for depressive disorders etc are known to trigger headaches in patients who have had a history of migraine in their younger days2.
- Hypnic headache – this is a rare type of headache that occurs exclusively at night. The pain begins abruptly and can last from anywhere between 15 minutes to 6 hours.
Treatment of migraine in old age may not be as simple as it is in young, however, it is still treatable2. With the use of medications to treat other accompanying conditions, doctors need to be careful while prescribing migraine medicine for the elderly. Inform your doctor about the medicines you take on daily basis. This will help your doctor to make an informed decision.
Migraine in later life is uncommon but not impossible. Special attention should be given when migraine like symptoms persists but without the headache. Visual disturbances, aura without headache are some of the examples of migraine without headache.
Migraine is a treatable condition at all ages and proper care and treatment will help you in improving your quality of life.
Description: Although the prevalence of headache declines steadily after the age of 40, some patients experience migraine even in their old age.
1. Headache. 2001 Jul-Aug; 41(7):646-57 https://www.ncbi.nlm.nih.gov/pubmed/11554952/
2. Curr Treat Options Neurol. 2013 Feb; 15(1): 56–62. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553408/#CR1