Clinical characteristics and the diagnosis and treatment status of headaches in the Department of Gerontology of a university hospital in China

Abstract

Headache is a common problem among the population, many factors may impact the headache characteristics and medical consultation behaviors in different age groups. The purpose of this study was to evaluate the clinical characteristics and the diagnosis and treatment status of headaches in elderly patients hospitalized in a gerontologic department. Consecutive patients hospitalized in the Department of Gerontology eligible for this study were registered. All the patients underwent a comprehensive evaluation of their whole health status, performed by three gerontologists initially. Then headache was evaluated by two physicians experienced in headache studies. Headache diagnosis was made according to the criteria of the second edition of the International Classification of Headache Disorders. In this study, 20% of the participants reported at least one headache attack in the previous year. Sixty percent of the migraineurs and 79·7% of the tension type headache (TTH) patients reported bilateral pain. Throbbing/pulsating and tightness/pressing were the most frequently described pain quality by the migraineurs and TTH patients, respectively. The migraineurs reported the most severe pain (P < 0·001). The frequency of headache attacks was not significantly different in the three subgroups (P = 0·053). About 76·2% of the migraineurs, 68·8% of the TTH, and 80% of the other type headache patients had consulted a physician for their headaches in the previous year. Taking acute analgesics for headache was more common in migraineurs (P < 0·001). The results showed that headache remained under-recognized and under-treated in the geriatrics department.