Why do older people report fewer headaches?
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.


CONCLUSIONS
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.
Thomas
Elaine
E
Primary Care Sciences Research Centre, Keele University, Keele, Staffs, UK. e.thomas@cphc.keele.ac.uk
Boardman
Helen F
HF
Croft
Peter R
PR
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000375:Aging; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D006261:Headache / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012179:Retirement; D013312:Stress, Physiological / Q000453:epidemiology
D000894:Anti-Inflammatory Agents, Non-Steroidal