Clinical Characteristics And The Diagnosis And Treatment Status Of Headaches In The Elderly

Objectives: To evaluate clinical characteristics and compare thecharacteristics in the different headache group, as well as the the diagnosisand treatment status of headaches among the elderly patients hospitalizedin a department of Gerontology.Methods: Consecutive patients hospitalized in the Department ofGerontology during October2012to February2014eligible for this studywere registered. All the patients were scanned for headache. Those whoreported at least headache in the previous year would underwent headacheevaluation. Headache was evaluated by two neurologists specialized inheadache research. Headache diagnosis was made according to the criteriaof the second edition of the International Classification of HeadacheDisorders. Data were collected by questionnaires. The pain intensity wasevaluated by Visual Analogue Scale.Results: A total of529patients finished the evaluation. Among them,there were134(25.3%)patients reported at least one time headache attackin the previous year. Among the headache patients,19.5%were diagnosedas migraine,49%were diagnosed as tension type headache and36.7%were diagnosed as other type headache.73.1%of the migraineurs and84.7%ofthe TTH patients reported bilateral pain. Throbbing/pulsating andtightness/pressing was the most frequently described pain quality by themigraineur(61.5%) and TTH patients(52.4%) respectively.Throbbing/pulsating also was the most frequently reported pain quality byothers headache.62.5%migraineurs reported phengophobia andphonophobia,23.1%reported nausea,11.5%reported vomit duringheadache attack.16%of the TTH patients reported phonophobia. Theassociated symptoms were rare among other type headaches. Themigraineurs reported lower headache attack frequencies and higher level ofpain intensity than TTH and other type headache group. About77.0%ofthe migraineurs,57.2%of the TTH and51.0%of the other type headachepatients had consulted a physician for their headaches in previous year.Only23.1%migraineurs,6.5%TTH patients and16.2%other typeheadache had ever been got a right diagnose.61.9%of all the headachepatients had ever used analgesic in the previous years for headache.Combination analgesics, Chinese patent medicine and the NSAID were thetop three kind of analgesics were used.Conclusions: The prevalence of headache in the elderly above65years old in Geriatrics departement was about25%. TTH was the mostcommon headache, followed by migraine. The characteristics of migrainein the elderly tended to show as bilateral, medium, pulsating pain. Phengophobia and phonophobia were common accompany symptoms,nausea and vomit was relatively rare. The characteristics of TTH mainlyshowed as bilateral, mild-medium, non-pulsating pain. The characteristicsdid not change with age as they do in migraine.More than two thirds of the headaches had ever consulted a doctor for theirheadaches, but only a small portion of them got a right diagnosis. About60%of the headache patients took analgesics, less than10%of theanalgesics users taking analgesics followed by the doctors advise.Combination analgesics, Chinese patent medicine and the NSAID were thetop three kinds of analgesics were used.