Migraine Headaches – The Need For More Treatment And Research Later In Life

June is Migraine Awareness Month, which is designed to raise awareness about migraines and the need for research to understand the causes, find better treatments, and develop a cure.  

Encouraging developments include last month’s introduction of Aimovig, a monthly injection with a device similar to an insulin pen that blocks the protein fragment CGRP, which starts and perpetuates migraines.  

One in seven people worldwide experience migraines, among them 37 million Americans. By some estimates, migraines are the third most common disease in the world. It ranks among the top ten causes of disability because it is often accompanied by disabling symptoms like nausea and vomiting, difficulty speaking, and an aversion to light and noise that can last for hours or days. 

At least 90% of people with migraine experience it before the age of 40. While it’s thought that migraine attacks lessen with age, many people have migraines in their 60s, 70s, and 80s.  When new migraine-like symptoms develop in people over 60, underlying disease may be responsible. In a study of older patients with new migraine-like headaches, five out of 69 patients had an abnormality which showed on a scan.  

Also the likelihood of developing medical conditions increases as people age. So, treatment of migraine in the elderly may not be so straightforward since they may take a number of different medications or have other health conditions such as hardening of the arteries (atherosclerosis), high blood pressure, diabetes, heart disease or stroke.  

Health professionals also have less information to rely on when evaluating treatment options for migraine in older people. Drug trials are usually carried out on young adults so less is known about how a drug may work or react in an older person.  

Aging also can involve changes to the digestion, liver, kidneys and vascular system that may alter the response to medicines and their side effects. For example if a drug has a side effect of dizziness, this could be of more concern to a person who may also be at risk of falling, than another younger person for whom the same side effect may not be as serious. 

Medication overuse headache (MOH), a form of chronic migraine, also can be a serious problem among older adults and is often associated with overuse of analgesics to manage primary pain conditions. Studies have also reported an association of MOH with analgesic medication prescribed for the treatment of pain unrelated to headache, such as back or joint pain. Overuse of analgesics and the potential anxiety and depression in this age group may lead to dependency and medication overuse, ultimately contributing to MOH. 

When people experience migraine attacks in older age, special attention should be paid to the diagnosis of new migraine-like symptoms, especially visual migraine symptoms without headache. Any other co-existing health conditions have an important role not only in diagnosis but also in treatment choices. 

Sources:  www.migrainetrust.orghttp://migraineresearchfoundation.org