Characteristics of Elderly-Onset (≥65 years) Headache Diagnosed Using the International Classification of Headache Disorders, Third Edition Beta Version.
OBJECTIVE
New-onset headache in elderly patients is generally suggestive of a high probability of secondary headache, and the subtypes of primary headache diagnoses are still unclear in the elderly. This study investigated the characteristics of headache with an older age at onset (≥65 years) and compared the characteristics between younger and older age groups.


METHODS
We prospectively collected demographic and clinical data of 1,627 patients who first visited 11 tertiary hospitals in Korea due to headache between August 2014 and February 2015. Headache subtype was categorized according to the International Classification of Headache Disorders, Third Edition Beta Version.


RESULTS
In total, 152 patients (9.3%, 106 women and 46 men) experienced headache that began from 65 years of age [elderly-onset group (EOG)], while the remaining 1,475 patients who first experienced headache before the age of 65 years were classified as the younger-age-at-onset group (YOG). Among the primary headache types, tension-type headache (55.6% vs. 28.8%) and other primary headache disorders (OPH, 31.0% vs. 17.3%) were more common in the EOG than in the YOG, while migraine was less frequent (13.5% vs. 52.2%) (p=0.001) in the EOG. Among OPH, primary stabbing headache (87.2%) was more frequent in the EOG than in the YOG (p=0.032). The pain was significantly less severe (p=0.026) and the frequency of medication overuse headache was higher in EOG than in YOG (23.5% vs. 7.6%, p=0.040).


CONCLUSIONS
Tension-type headache and OPH headaches, primarily stabbing headache, were more common in EOG patients than in YOG patients. The pain intensity, distribution of headache diagnoses, and frequency of medication overuse differed according to the age at headache onset.
Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea.|Department of Neurology, Yonsei University School of Medicine, Seoul, Korea.
Tae Jin
TJ
Song
Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea.
Yong Jae
YJ
Kim
Department of Neurology, Eulji University School of Medicine, Seoul, Korea.
Byung Kun
BK
Kim
Department of Neurology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
Byung Su
BS
Kim
Department of Neurology, Chungnam National University College of Medicine, Daejeon, Korea.
Jae Moon
JM
Kim
Department of Neurology, Gyeongsang National University Hospital, Jinju, Korea.
Soo Kyoung
SK
Kim
Department of Neurology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Heui Soo
HS
Moon
Department of Neurology, National Police Hospital, Seoul, Korea.
Myoung Jin
MJ
Cha
Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Kwang Yeol
KY
Park
Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
Jong Hee
JH
Sohn
Department of Neurology, Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Min Kyung
MK
Chu
Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea. soojinc@hallym.or.kr.
Soo Jin
SJ
Cho
International Classification of Headache Disorders; Third Edition Beta Version; medication-overuse headache; old age; other primary headache disorders; tension-type headache