Headaches in adults over the age of 50 represent a different diagnosis than in younger people. Not just that, headaches in older adults also lead to more serious consequences. Headaches caused due to underlying or comorbid conditions become more prevalent with age. Also, because the elderly tend to use multiple chronic medications, they are at an increased risk of pharmacy-induced headache.
Headaches in older adults are a cause for concern and rightfully so. Primary headache types like tension headaches and migraines are more common amongst people over the age of 50. Hypnic headache is a rare primary headache condition that is observed almost exclusively amongst older adults. A hypnic headache wakes people from sleep.
Secondary headaches become more common with age and often have life-threatening consequences. It is therefore necessary to rule out secondary causes that are more likely to represent symptoms of an urgent medical condition.
Here are common headache types amongst older people.
Migraine headaches are the second most common type of headaches among older adults. A ‘late in life’ migraine is not only milder, but more likely to develop in people over the age of 50. ‘Migraine aura’ is also often seen in this age group. Migraine aura can affect vision, speech, movement and behavior. If a patient doesn’t have a history of migraine but the symptoms of migraine aura continue to increase, the patient should seek prompt evaluation for other serious causes like seizure disorder and intracranial hemorrhage.
A rare condition, hypnic headache usually occurs in adults above the age of 50 and most often starts around age 60. Hypnic headaches have a mild to moderate intensity that are capable of waking a person from their sleep. These headaches are of short duration, usually dull and are not associated with other symptoms of migraine or any other type of headache. If a patient suffers from this kind of headache, secondary causes like nocturnal hypertension and pituitary tumors need to be ruled out.
Several patients describe thunderclap headaches as “the worst headache of my life”. It is characterized by a sudden onset of sharp pain in the head of severe intensity that peaks within 60 seconds. When such a headache occurs, the patient should get immediate medical attention as he/she is at a risk for potential life-threatening conditions such as hematoma or intracranial bleeding from hemorrhage.
Giant Cell Arteritis (GCA) is characterized by an inflammation of the arteries in and around the scalp. GCA is common amongst people who are above 50 years of age and its incidence increases with age. Widespread headache is usually the first sign. Other symptoms of GCA include peripheral neuropathy and visual impairment.