Headache in Older Adults – What to look for

Some people have the expectation that their headaches will go away as they get older. It’s understandable, because this does often happen.

On the other hand, for many people migraine continues on. It is not uncommon for migraine to start after age 40, and although very uncommon, migraine can even start after age 65.

But migraine is not the only cause of headache for older adults – tension type headaches are also common, and a host of other headache types.

So what unique concerns should these patients be aware of?

1. Headache in older adults is not uncommon: It’s important to remember that you’re not alone. On the other hand, just because headache is “common” does not mean it is “normal”. It should be taken seriously, and treated. Don’t just “put up with it”.
2. Symptoms may change as you age: Be aware of changes in symptoms, and any connection with other symptoms. This can be a challenge to keep track of, but the more information you have, the easier it will be for your doctor.
3. “Other” causes of headache become more common: For example stroke or heart conditions – blood clots, such as cerebral venous thrombosis, or blood vessel inflammation (vasculitis). When symptoms change, or a “new” headache starts, you need to see a doctor right away.
4. Emergencies: It is important to consult a doctor when there are changes, and at times this can be an emergency. When there are significantly new symptoms, or a sudden, severe headache, you need to get to a doctor now. Giant cell arteritis is one such emergency, and stroke is another.
5. Hypnic Headache: Hypnic headache is rare, but it does tend to start after age 60.
6. Medications: Older adults taking a variety of medications could end up with headaches that are actually caused by the meds – even if they are medications intended to fight pain. You need to make sure your doctor knows what medications, “painkillers”, and supplements you’re taking.
7. Lifestyle: As with any age group, a healthy lifestyle is critical for keeping symptoms at a minimum. Older adults, of course, have different challenges than other age groups. Key things to think about are: getting ample sleep, eating regularly (healthy food, of course – avoiding processed foods), and being as active as possible.

For more background on treating headache in older adults, check out:

• 6 tips for managing headaches in older adults
• Headache in Older Adults: Unique Causes and Treatments
• Migraine in later life