Diagnosis and Treatment of Primary Headache Disorders in Older Adults

Thomas Berk, MD; Sait Ashina, MD; Vincent Martin, MD; Lawrence Newman, MD; Brinder Vij, MD


J Am Geriatr Soc. 2018;66(12):2408-2416. 

In This Article

Conclusion and Future Directions

Management of headache disorders can be challenging in general, and when treating elderly adults, one must even more carefully consider each individual's comorbidities, medication interactions, and intolerances. Four calcitonin gene-related peptide monoclonal antibodies are in Phase 3 trials and have been reported to be effective and safe; one recently received FDA approval. These antibodies may be another potential preventive option for chronic migraine or possibly even cluster headache, although they have been investigated only in adults younger than 65.

Nonpharmacological measures such as biofeedback, relaxation, lifestyle modification, and sleep hygiene should always be considered to optimize headache care in older adults, in whom pharmacological options might be limited. An interdisciplinary team approach may be necessary when evaluating and managing headache disorders in elderly adults, with input from various specialists, including geriatric medicine, psychology, psychiatry pain medicine, and headache medicine, with the goal being to provide the most comprehensive headache care to older adults.