The prevalence of probable medication overuse may be high in elderly patients with migraine, and higher frequency of migraine may be associated with early onset in this patient population, according to a retrospective study published in Headache.

Using patient data from 16 tertiary care headache clinics and 1 specialized headache emergency department, investigators collected records of patients with migraine, assessed with the International Classification of Headache Disorders, 3rd edition (beta version), aged >64 years at their first hospital visit (n=239).

The patients were divided into 3 groups according to age of migraine onset: early migraine onset (<18 years old), intermediate migraine onset (18-64 years old), and late migraine onset (≥65 years old).

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A total of 175 (73.2%) patients were diagnosed with migraine without aura, 33 patients (13.8%) had migraine with aura, and 32 patients (13.4%) had aura without headache. Throbbing headache was reported by 120 patients (50.2%), and 79.9% reported severe headache-related pain. Probable medication overuse was found in 30.1% of study participants.

Age of migraine onset was not found to affect headache characteristics and associated migraine symptoms or headache caused by medication overuse. However, patients who had an earlier vs later migraine onset (<18 years) had a higher migraine frequency (P =.0357).

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Because this study evaluated patients who were treated in specialized, tertiary headache centers, the findings may not be generalizable to the entire patient population. Also, the headache diaries used to identify headaches caused by medication overuse could have introduced bias in this study.

“The association between migraine frequency and age of onset…could require the introduction of a preventive treatment at an early stage for high frequency migraineurs,” concluded the investigators.

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de Rijk P, Resseguier N, Donnet A. Headache characteristics and clinical features of elderly migraine patients [published online December 13, 2017]. Headache. doi: 10.1111/head.13247