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On-line version ISSN 1678-4227
Arq. Neuro-Psiquiatr. vol.61 no.2A São Paulo June 2003
Headache in elderly outpatients - Brazil (Abstratc)*. Thesis. Niterói, 2002.
Jano Alves de Souza**
INTRODUCTION: Brazilian population is aging. In contrast to what happens to most symptoms, headache prevalence decreases during aging. Yet, 13.9% of women and 6.5% of men report recurrent headache. Despite this, there have been published few papers referring to headache in the elderly.
OBJECTIVES: 1) Identify the most prevalent types of headache and their characteristics at presentation in a group of elderly; 2) compare frequency of headache types among the elderly and the young; 3) assess and compare frequency of diagnosed headache due to structural cause in the elderly and the young; 4) find out whether age is an independent risk factor for headaches due to structural cause.
METHOD: There were 2,735 sequential patients, over 18 years old, from a private neurological practice. They were divided into two groups: patients with headache (n=1,131) and those without headache (n=1,604). Patients with headache were further divided, according to age, into young (18 to 59 years old) and elderly (from 60 years old on); according to age of patient at onset of headache, into before or after 60 years of age; and according to time elapsed since onset of symptoms, into less than a year or over a year. Frequency and presentation aspects of primary headaches, headaches due to structural causes, and headaches due to severe structural causes were analyzed and compared in the groups. The significance of time elapsed since onset of symptoms and age as risk factors for headache due to structural cause were assessed. Statistical analyses were undertaken using either the Chi-square method or the Fisher's test, at 5% significance level.
RESULTS: Migraine was the most frequent type of headache among the elderly in general. In the elderly whose age at onset of headache was over 60 years old, tension type headache was the most frequent one. Cervicogenic headache was the most frequent headache due to structural cause diagnosed. The elderly as a whole, the elderly with onset of headache after 60 years of age, and the elderly with time elapsed since onset of symptoms of less than a year correlated with headaches due to structural cause and to headache due to severe structural cause.
CONCLUSION: The elderly present headaches due to structural cause more frequently than the young; 2) time elapsed since onset of symptoms of less than a year and age of patient at onset of headache after 60 years old are independent risk factors for headaches due to structural cause and to severe structural cause.
Key words: headache, elderly.
* Cefaléia em pacientes ambulatoriais idosos - Brasil. Resumo. Tese de Doutorado, Universidade Federal Fluminense (Área: Neurologia). Orientador: Pedro Ferreira Moreira Filho
** Address: Rua Otávio Carneiro, 143 sala 609, Icaraí . 24230-190 Niterói RJ - Brasil. E-mail: firstname.lastname@example.org