Skip to main content

Advertisement

SpringerLink
Log in

Chronic Daily Headache in the Elderly

  • Chronic Daily Headache (SJ Wang, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Disabling headache disorders are ubiquitous in all age groups, including the elderly, yet they are under-recognized, underdiagnosed and undertreated worldwide. Surveys and clinic-based research reports on headache disorders in elderly populations are extremely limited in number. Chronic daily headache (CDH) is an important and growing subtype of primary headache disorders, associated with increased burden and disruption to quality of life. CDH can be divided into two forms, based on headache duration. Common forms of primary headache disorders of long duration (>4 hours) were comprehensively defined in the third edition of the International Classification of Headache Disorders (ICHD-3 beta). These include chronic migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. Rarer short-duration (<4 hours) forms of CDH are chronic cluster headache, chronic paroxysmal hemicrania, SUNCT, and hypnic headache. Accurate diagnosis, management, and relief of the burden of CDH in the elderly population present numerous unique challenges as the “aging world” continues to grow. In order to implement appropriate coping strategies for the elderly, it is essential to establish the correct diagnosis at each step and to exercise caution in differentiating from secondary causes, while always taking into consideration the unique needs and limitations of the aged body.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. • Saxena S, et al. The Atlas of Headache Disorders, WHO. 2011. www.who.int/mental_health/who_altlas_headache_disorders.pdf. This report is the first comprehensive and rational report about the burden of headache on worldwide.

  2. Mathew NT, Stubits E, Nigam MP. Transformation of episodic migraine into daily headache: analysis of factors. Headache. 1982;22:66–8.

    Article  PubMed  CAS  Google Scholar 

  3. Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1988;8 Suppl 7:1–96.

    Google Scholar 

  4. Silberstein SD, Lipton RB, Sliwinski M. Classification of daily and near-daily headaches: field trial of revised IHS criteria. Neurology. 1996;47:871–5.

    Article  PubMed  CAS  Google Scholar 

  5. Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders. Second edition. Cephalalgia. 2004;24 Suppl 1:9–160.

    Google Scholar 

  6. •• Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629–808. doi:10.1177/0333102413485658. The last version of headache classification published first as beta version for discussing. This report each headache subtype has been defined by the last version.

    Article  Google Scholar 

  7. •• Lipton RB. Chronic migraine, classification, differential diagnosis, and epidemiology. Headache. 2011;51 Suppl 2:77–83. doi:10.1111/j.1526-4610.2011.01954.x. This study showed an updated comprehensive knowledge about CDH.

    Article  PubMed  Google Scholar 

  8. Özge A. Critical evaluation of headache classifications. Arch Neuropsychiatry (Noropsikiyatri Arsivi). 2013. doi:10.4274/npa.y7279.

    Google Scholar 

  9. • Srikiatkhachorn A. Epidemiology of headache in the Thai elderly: a study in the Bangkae Home for the Aged. Headache. 1991;31:677–81.

    Article  PubMed  CAS  Google Scholar 

  10. • Ward TN. Headache disorders in the elderly. Curr Treat Options Neurol. 2002;4:403–8.

    Article  PubMed  Google Scholar 

  11. • Prencipe M, Casini AR, Ferretti C, Santini M, Pezzella F, Scaldaferri N, et al. Prevalence of headache in an elderly population: attack frequency, disability, and use of medication. J Neurol Neurosurg Psychiatry. 2001;70:377–81. The first report about all aspect of headache in the elderly.

    Article  PubMed  CAS  Google Scholar 

  12. •• Camarda R, Monastero R. Prevalence of primary headache in Italian elderly: preliminary data from the Zabut Aging Project. Neurol Sci. 2003;24:122–4. First comprehensive report including data about CDH in the elderly.

    Google Scholar 

  13. • Tai ML, Jivanadham JS, Tan CT, Sharma VK. Primary headache in the elderly in South-East Asia. J Headache Pain. 2012;13(4):291–7. doi:10.1007/s10194-012-0434-9.

    Article  PubMed  Google Scholar 

  14. Wang SJ, Liu HC, Fuh JL, Liu CY, Lin KP, Chen HM, et al. Prevalence of headaches in a Chinese elderly population in Kinmen: age and gender effect and cross-cultural comparisons. Neurology. 1997;49:195–200.

    Article  PubMed  CAS  Google Scholar 

  15. Yoon MS, Katsarava Z, Obermann M, Fritsche G, Oezyurt M, Kaesewinkel K, et al. Prevalence of primary headaches in Germany: results of the German Headache Consortium Study. J Headache Pain. 2012;13(3):215–23. doi:10.1007/s10194-012-0425-x.

    Article  PubMed  Google Scholar 

  16. Wang SJ, Fuh JL, Lu SR, Liu CY, Hsu LC, Wang PN, et al. Chronic daily headache in Chinese elderly: prevalence, risk factors, and biannual follow-up. Neurology. 2000;54:314–9.

    Article  PubMed  CAS  Google Scholar 

  17. Fuh JL, Wang SJ, Lu SR, Tsai PH, Lai TH, Lai KL. A 13-year long-term outcome study of elderly with chronic daily headache. Cephalalgia. 2008;28:1017–22.

    Article  PubMed  Google Scholar 

  18. Wang SJ, Liu HC, Fuh JL, Liu CY, Wang PN, Lu SR. Comorbidity of headaches and depression in the elderly. Pain. 1999;82:239–43.

    Article  PubMed  CAS  Google Scholar 

  19. •• Capobianco DJ. Headache in the elderly. Adv Stud Med. 2003;3(6C):S556–61. The first report including subtypes, diagnosis and management of CDH in the elderly.

    Google Scholar 

  20. Fowler MV, Capobianco SJ, Dodick DW. Headache in the elderly. Sem Pain Med. 2004;2:123–8.

    Article  Google Scholar 

  21. Pascual J, Berciano J. Experience in the diagnosis of headaches that start in the elderly. J Neurol Neurosurg Psychiatry. 1994;57:1255–7.

    Article  PubMed  CAS  Google Scholar 

  22. • Schwaiger J, Kiechl S, Seppi K, Sawires M, Stockner H, Erlacher T, et al. Prevalence of primary headaches and cranial neuralgias in men and women aged 55–94 years (Bruneck Study). Cephalalgia. 2009;29:179–87.

    Article  PubMed  CAS  Google Scholar 

  23. Lipton RB. Tracing transformation: chronic migraine classification, progression, and epidemiology. Neurology. 2009;72 suppl 5:S3–7.

    Article  PubMed  Google Scholar 

  24. Smitherman TA, Burch R, Sheikh H, Loder E. The prevalence, impact, and treatment of migraine and severe headaches in the United States: a review of statistics from national surveillance studies. Headache. 2013;53(3):427–36. doi:10.1111/head.12074. Epub 2013 Mar 7.

    Article  PubMed  Google Scholar 

  25. • Castillo J, Munoz P, Guitera V, Pascual J, Kaplan Award. Epidemiology of chronic daily headache in the general population. Headache. 1999;39(3):190–6. The first report about epidemiological data of CDH.

    Article  PubMed  CAS  Google Scholar 

  26. Scher AI, Stewart WF, Liberman J, Lipton RB. Prevalence of frequent headache in a population sample. Headache. 1998;38(7):497–506.

    Article  PubMed  CAS  Google Scholar 

  27. Bigal ME, Serrano D, Buse D, Scher A, Stewart WF, Lipton RB. Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal population-based study. Headache. 2008;48(8):1157–68.

    Article  PubMed  Google Scholar 

  28. • Natoli JL, Manack A, Dean B, Butler Q, Turkel CC, Stovner L, et al. Global prevalence of chronic migraine: a systematic review. Cephalalgia. 2010;30(5):599–609. doi:10.1111/j.1468-2982.2009.01941.x.

    PubMed  CAS  Google Scholar 

  29. Lipton RB. Chronic migraine, classification, differential diagnosis, and epidemiology. Headache. 2011;51 Suppl 2:77–83. doi:10.1111/j.1526-4610.2011.01954.x. PMID: 21770929.

    Article  PubMed  Google Scholar 

  30. Yong N, Hu H, Fan X, Li X, Ran L, Qu Y, et al. Prevalence and risk factors for depression and anxiety among outpatient migraineurs in mainland China. J Headache Pain. 2012;13(4):303–10. doi:10.1007/s10194-012-0442-9.

    Article  PubMed  Google Scholar 

  31. •• Stark RJ, Ravishankar K, Siow HC, Lee KS, Pepperle R, Wang SJ. Chronic migraine and chronic daily headache in the Asia-Pacific region: a systematic review. Cephalalgia. 2013;33(4):266–83. doi:10.1177/0333102412468677. The last report about systematically reviewed clinical and epidemiological data of CDH, including CM.

    Article  PubMed  Google Scholar 

  32. •• Buse DC, Manack AN, Fanning KM, Serrano D, Reed ML, Turkel CC, et al. Chronic migraine prevalence, disability, and sociodemographic factors: results from the American migraine prevalence and prevention study. Headache. 2012. doi:10.1111/j.1526-4610.2012.02223.x. Among the last comprehensive report including burden of CM.

    Google Scholar 

  33. •• Özge A, Uludüz DU, Selekler M, Öztürk M, Baykan B, Cınar N, et al. Gender differences of chronic migraine in the elderly. LBP 34. Late-breaking abstracts of the 2013 International Headache Congress: International Headache Society and American Headache Society 27-30 June 2013 John B. Hynes Veterans Memorial Convention Center Boston, MA. Cephalalgia. 2013;33(11):954–92. doi:10.1177/0333102413493854. The last report about clinical characteristics of CM according to changes of age on both genders.

    Article  Google Scholar 

  34. Martins KM, Bordini CA, Bigal ME, Speciali JG. Migraine in the elderly: a comparison with migraine in young adults. Headache. 2006;46(2):312–6.

    Article  PubMed  Google Scholar 

  35. Tepper SJ. Medication-overuse headache. Continuum (Minneap Minn). 2012;18(4):807–22. doi:10.1212/01.CON.0000418644.32032.7b.

    Article  Google Scholar 

  36. • Katsarava Z, Obermann M. Medication-overuse headache. Curr Opin Neurol. 2013;26(3):276–81. doi:10.1097/WCO.0b013e328360d596. Last detail report about MOH.

    Article  PubMed  Google Scholar 

  37. •• Dees B, Coleman-Jackson R, Hershey LA. Managing migraine and other headache syndromes in those over 50. Maturitas. 2013. doi:10.1016/j.maturitas.2013.04.009. Last detail report about CM management in the elderly.

    PubMed  Google Scholar 

  38. Fisher CM. Late-life migraine accompaniments–further experience. Stroke. 1986;17(5):1033–42.

    Article  PubMed  CAS  Google Scholar 

  39. Weeks RE. Application of behavioral therapies in adult and adolescent patients with chronic migraine. Neurol Sci. 2013;34 Suppl 1:S11–7. doi:10.1007/s10072-013-1360-6.

    Article  PubMed  Google Scholar 

  40. Solomon GD, Kunkel Jr RS, Frame J. Demographics of headache in elderly patients. Headache. 1990;30(5):273–6.

    Article  PubMed  CAS  Google Scholar 

  41. Lu SR, Fuh JL, Chen WT, Juang KD, Wang SJ. Chronic daily headache in Taipei, Taiwan: prevalence, follow-up and outcome predictors. Cephalalgia. 2001;21(10):980–6.

    Article  PubMed  CAS  Google Scholar 

  42. • Cittadini E, Goadsby PJ. Update on hemicrania continua. Curr Pain Headache Rep. 2011;15(1):51–6. doi:10.1007/s11916-010-0156-0. Last comprehensive report of HC in all age groups.

    Article  PubMed  Google Scholar 

  43. Cittadini E, Matharu MS, Goadsby PJ. Paroxysmal hemicrania: a prospective clinical study of 31 cases. Brain. 2008;131(Pt 4):1142–55. doi:10.1093/brain/awn010. Epub 2008 Feb 5.

    Article  PubMed  Google Scholar 

  44. • Prakash S, Belani P, Susvirkar A, Trivedi A, Ahuja S, Patel A. Paroxysmal hemicrania: a retrospective study of a consecutive series of 22 patients and a critical analysis of the diagnostic criteria. J Headache Pain. 2013;14(1):26. doi:10.1186/1129-2377-14-26. The last report of CPHs based on case series including diagnostic tools and management strategies.

    Article  PubMed  Google Scholar 

  45. • Williams MH, Broadley SA. SUNCT and SUNA: clinical features and medical treatment. J Clin Neurosci. 2008;15(5):526–34. doi:10.1016/j.jocn.2006.09.006.

    Article  PubMed  Google Scholar 

  46. Dodick DW, Mosek AC, Campbell JK. The hypnic ("alarm clock") headache syndrome. Cephalalgia. 1998;18(3):152–6.

    Article  PubMed  CAS  Google Scholar 

  47. • Dodick DW, Jones JM, Capobianco DJ. Hypnic headache: another indomethacin-responsive headache syndrome? Headache. 2000;40(10):830–5.

    Article  PubMed  CAS  Google Scholar 

  48. • Asghar MS, Hansen AE, Amin FM, van der Geest RJ, Koning P, Larsson HB, et al. Evidence for a vascular factor in migraine. Ann Neurol. 2011;69(4):635–45. doi:10.1002/ana.22292.

    Article  PubMed  Google Scholar 

  49. Hadjikhani N, Sanchez Del Rio M, Wu O, Schwartz D, Bakker D, Fischl B, et al. Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci U S A. 2001;98:4687–92.

    Article  PubMed  CAS  Google Scholar 

  50. Rossi P, Ambrosini A, Buzzi MG. Prodromes and predictors of migraine attack. Funct Neurol. 2005;20:185–91.

    PubMed  Google Scholar 

  51. Hooker WD, Raskin NH. Neuropsychologic alterations in classic and common migraine. Arch Neurol. 1986;43:709–12.

    Article  PubMed  CAS  Google Scholar 

  52. Ardila A, Sanchez E. Neuropsychologic symptoms in the migraine syndrome. Cephalalgia. 1988;8:67–70.

    Article  PubMed  CAS  Google Scholar 

  53. Dowson AJ. Assessing the impact of migraine. Curr Med Res Opin. 2001;17:298–309.

    PubMed  CAS  Google Scholar 

  54. •• Martins IP, Gil-Gouveia R, Silva C, Maruta C, Oliveira AG. Migraine, headaches, and cognition. Headache. 2012. doi:10.1111/j.1526-4610.2012.02218.x. Last report about cognitive deterioration of migraine sufferers.

    PubMed  Google Scholar 

  55. Rist PM, Dufouil C, Glymour MM, Tzourio C, Kurth T. Migraine and cognitive decline in the population- based EVA study. Cephalalgia. 2011;31:1291–300.

    Article  PubMed  Google Scholar 

  56. Jelicic M, van Boxtel MP, Houx PJ, Jolles J. Does migraine headache affect cognitive function in the elderly? Report from the Maastricht Aging Study (MAAS). Headache. 2000;40:715–9.

    Article  PubMed  CAS  Google Scholar 

  57. Kristoffersen ES, Grande RB, Aaseth K, Lundqvist C, Russell MB. Management of primary chronic headache in the general population: the Akershus study of chronic headache. J Headache Pain. 2012;13(2):113–20. doi:10.1007/s10194-011-0391-8.

    Article  PubMed  Google Scholar 

  58. Lionetto L, Negro A, Palmisani S, Gentile G, Del Fiore MR, Mercieri M, et al. Emerging treatment for chronic migraine and refractory chronic migraine. Expert Opin Emerg Drugs. 2012;17(3):393–406. doi:10.1517/14728214.2012.709846.

    Article  PubMed  CAS  Google Scholar 

  59. Lyngberg AN, Rasmussen BK, Jørgensen T, Jensen R. Prognosis of migraine and tension-type headache. A population-based follow-up study. Neurology. 2005;65:580–5.

    Article  PubMed  Google Scholar 

  60. • Scher AI, Stewart WF, Ricci JA, Lipton RB. Factors associated with the onset and remission of chronic daily headache in a population-based study. Pain. 2003;106(1-2):81–9.

    Article  PubMed  CAS  Google Scholar 

  61. •• Manack A, Buse DC, Serrano D, Turkel CC, Lipton RB. Rates, predictors, and consequences of remission from chronic migraine to episodic migraine. Neurology. 2011;76(8):711–8. Last important report about CM natural history including elderly population.

    Article  PubMed  CAS  Google Scholar 

  62. Scher AI, Lipton RB, Stewart WF. Habitual snoring as a risk factor for chronic daily headache. Neurology. 2003;60(8):1366–8.

    Article  PubMed  CAS  Google Scholar 

  63. Scher AI, Stewart WF, Lipton RB. Caffeine as a risk factor for chronic daily headache: a population-based study. Neurology. 2004;63(11):2022–7.

    Article  PubMed  CAS  Google Scholar 

  64. Ashina S, Buse DC, Maizels M, et al. Self-reported anxiety as a risk factor for migraine chronification: results from the American Migraine Prevalence and Prevention (AMPP) Study. Cephalalgia. (in press).

  65. Schulman EA, Lake AE, Lipton RB. Refractory migraine: introductory editorial. Headache. 2008;48:768–9.

    Article  PubMed  Google Scholar 

  66. Hagen K, Stovner LJ. A randomized controlled trial on medication- overuse headache: outcome after 1 and 4 years. Acta Neurol Scand. 2011;124 Suppl 191:38–43.

    Article  Google Scholar 

  67. • Buse DC, Manack A, Serrano D, Turkel C, Lipton RB. Sociodemographic and comorbidity profiles of chronic migraine and episodic migraine sufferers. J Neurol Neurosurg Psychiatry. 2010;81:428–32. An important report about CM comorbidity including elderly population.

    Article  PubMed  CAS  Google Scholar 

  68. Linde M, Dahlof C. Attitudes and burden of disease among self-considered migraineurs—a nation-wide population-based survey in Sweden. Cephalalgia. 2004;24:455–65.

    Article  PubMed  CAS  Google Scholar 

  69. • World Health Organization. The World Health Report 2001. Mental health: new understanding, New Hope. Geneva: World Health Organization; 2001. Available at: http://www.who.int/whr/2001/en/ (accessed July 2013).

  70. •• Buse DC, Manack AN, Fanning KM, Serrano D, Reed ML, Turkel CC, et al. Chronic migraine prevalence, disability, and sociodemographic factors: results from the American migraine prevalence and prevention study. Headache. 2012. doi:10.1111/j.1526-4610.2012.02223.x. Based on comprehensive epidemiological study data, last published CM natural history study.

    Google Scholar 

  71. Leonardi M, Steiner TJ, Scher AT, Lipton RB. The global burden of migraine: measuring disability in headache disorders with WHO’s Classification of Functioning, Disability and Health (ICF). J Headache Pain. 2005;6:429–40.

    Article  PubMed  Google Scholar 

  72. Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF. Migraine prevalence, disease burden and the need for preventive therapy (AMPP). Neurology. 2007;68:343–9.

    Article  PubMed  CAS  Google Scholar 

  73. Lisotto C, Mainardi F, Maggioni F, Dainese F, Zanchin G. Headache in the elderly: a clinical study. J Headache Pain. 2004;5:36–41.

    Google Scholar 

  74. Karli N, Zarifoğlu M, Ertaş M, Saip S, Oztürk V, Biçakçi S, et al. Economic impact of primary headaches in Turkey: a university hospital based study: part II. J Headache Pain. 2006;7(2):75–82.

    Article  PubMed  Google Scholar 

  75. Hawkins K, Wang S, Rupnow MFT. Indirect cost burden of migraine in the United States. J Occup Environ Med. 2007;49:368–74.

    Article  PubMed  Google Scholar 

  76. Stewart WF, Ricci JA, Leotta C, Chee E, Morganstein D, Lipton R. Lost productive time and cost due to common pain conditions in the US workforce. JAMA. 2003;290:2443–54.

    Article  PubMed  CAS  Google Scholar 

  77. Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27:193–210.

    Article  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Aynur Özge reported no potential conflicts of interest relevant to this article.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Mersin University School of Medicine, Eğriçam mah. GMK Bulvarı Kasım Ekenler Sitesi C Bl, D:2, 33160, Yenişehir, Mersin, Turkey

    Aynur Özge

Authors
  1. Aynur Özge
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aynur Özge.

Additional information

This article is part of the Topical Collection on Chronic Daily Headache

Rights and permissions

Reprints and permissions

About this article

Cite this article

Özge, A. Chronic Daily Headache in the Elderly. Curr Pain Headache Rep 17, 382 (2013). https://doi.org/10.1007/s11916-013-0382-3

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11916-013-0382-3

Keywords

Search

Navigation