Headaches in the Elderly Population

Elderly subjects are among those most affected by pain due to a plethora of chronic conditions, end of life issues, lack of personal resources and are often helpless to improve their situation without medical support [1]. Pain in elderly is often chronic, non-malignant and is disproportionately undertreated. Some elderly believe that pain is part of aging and they must live with it; health care professionals often believe that less pain medication is indicated to treat chronic pain in elderly according to the rate of therapies for concomitant medical pathologies. Italy is one of the most aged country and it is estimated that more than 30% of Italian people will be older than 65 years old in 2050. Even if primary headaches usually reduce their frequency in lifetime, the 13% of female and 7% of male older than 65 years old reported a headache disorder, especially migraine form. In fact, in people older than 65 years was founded a one-year prevalence between 5 and 50% of migraine; meantime 25-54% of aged more than 75 years old reported repetitive attacks in previous year [2,3]. Furthermore, headache is the 10th symptom most frequently reported by 65 years older female and it is the 14th symptom for male gender. Also in older patients’ primary headaches are the most form of headache founded by clinicians using ICH-II [4]. Prevalence of migraine is age-related; reducing its incidence lifetime, particularly after 55-60 years old. However, 13% of female and more than 7% of men older than 65 years old suffer from migraine. Chronic migraine and tension-type headache in particular, does not change its frequencies with age. Primary headache incidence seems to decrease with age while secondary and nevralgic head pain show growing number of cases in elderly population. Headache in older people is difficult to diagnose for different reason: