Chronic daily headache in Chinese elderly: prevalence, risk factors, and biannual follow-up.
OBJECTIVE
To investigate the prevalence, risk factors, and prognosis of chronic daily headache (CDH) in a population of elderly Chinese subjects.


METHODS
A community-based survey of registered residents > or =65 years old (n = 2,003) in two townships of Kinmen Island in 1993. A neurologist used a structured questionnaire and clinical interview to make the diagnosis of headache. Subjects who had headaches > or =15 days/month for > or =6 months in the previous year were considered to have CDH. CDH was further classified into chronic tension-type headache (CTTH), CDH with migrainous features (CDH/MF), and other CDH. Person-to-person biannual follow-up of the subjects with CDH was done in June 1995 and August 1997.


RESULTS
A total of 1,533 people (77%) participated in our prevalence study. Sixty subjects (3.9%) fulfilled the criteria for CDH, with a higher prevalence in women (F/M: 5.6%/1.8%, p < 0.001). Of these subjects, 42 (70%) had CTTH, 15 (25%) had CDH/MF, and 3 (5%) had other CDH. Only 23% of those with CDH had consulted physicians for their headaches in the previous year. Multivariate logistic regression revealed the significant risk factors for CDH to be analgesic overuse (OR = 79), a history of migraine (OR = 6.6), and a Geriatric Depression Scale-Short Form score of > or =8 (OR = 2.6). The follow-up results in 1995 and 1997 showed that about two-thirds of the subjects still had CDH. Analgesic overuse (relative risk = 1.6) in 1993 was a significant predictor of persistent CDH at follow-up.


CONCLUSIONS
A total of 3.9% of this elderly population had CDH, with CTTH being the most common subtype. Almost two-thirds of those with CDH had persistent frequent headaches at follow-up. Analgesic overuse was a significant predictor of a poor outcome.
Wang
S J
SJ
Neurological Institute, Veterans General Hospital-Taipei, and Department of Neurology, Taiwan. sjwang@vghtpe.gov.tw
Fuh
J L
JL
Lu
S R
SR
Liu
C Y
CY
Hsu
L C
LC
Wang
P N
PN
Liu
H C
HC
D000368:Aged / Q000706:statistics & numerical data*; D000700:Analgesics / Q000008:administration & dosage; D044466:Asian People; D002908:Chronic Disease; D003863:Depression / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D018781:Tension-Type Headache / Q000188:drug therapy / Q000453:epidemiology*
D000700:Analgesics