Associations of Elderly Onset Headache With Occurrence of Poor Functional Outcome, Cardiovascular Disease, and Cognitive Dysfunction During Long-term Follow-up

Abstract

Background: Although the frequency and intensity of headaches decrease in older adults, headaches in this population are still an important neurological disorder. The purpose of this study was to investigate the associations of headache characteristics in older adults with the development of cardiovascular disease and cognitive dysfunction. Methods: We prospectively enrolled 125 older (≥ 65 years old) patients with headache who were making their first visit to outpatient clinics and who had no prior history of cognitive dysfunction from 11 hospitals in Korea between August 2014 and February 2015. We investigated the occurrence of newly developed/or recurrent headache, cardiovascular disease, cognitive dysfunction, and poor functional outcomes. Results: The mean age of all included patients was 72.6 years, 68.8% were women, and 43 (34.4%) had newly developed/or recurrent headache during follow-up. During a median follow-up of 31 months (interquartile range, 28-34 months), 21 participants (16.8%) experienced cardiovascular disease, and 26 (20.8%) developed cognitive dysfunction. Upon multivariate analysis and after adjusting for sex, age, and other factors, presence of newly developed/or recurrent headache was found to be associated with cardiovascular disease (hazard ratio [HR], 4.03; 95% confidence interval [CI], 1.28-12.61; p=0.017) and frequency of headache for the recent 3 months was related with cognitive dysfunction (HR, 1.05; 95% CI, 1.00-1.09; p=0.017) and poor functional outcomes (HR, 1.06; 95% CI, 1.01-1.11; p=0.011). Conclusion: Our study demonstrated that there is an increased risk of cardiovascular disease, cognitive dysfunction, and poor functional outcomes in older patients with frequent, newly developed, or recurrent headache.

Obstructive sleep apnea and stroke severity: Impact of clinical risk factors

“…[ 30 ] In addition, several studies have reported risk factors associated with poor neurologic outcome in elderly stroke populations. [ 31 32 33 ] Findings indicate that women were more likely to have a poor outcome than men. While hormonal factors and comorbid function are known to contribute to the poor functional recovery in older women, our study reveals that well-established factors including previous stroke,[ 34 35 ] AF,[ 36 ] heart failure,[ 37 ] antidepressant use,[ 38 ] higher blood glucose level,[ 39 ] higher heart rate,[ 40 ] and rtPA administration[ 41 ] are all linked to worsening outcome in the elderly patient population.…”