Questionnaire-Based Survey during COVID-19 Vaccination on the Prevalence of Elderly’s Migraine, Chronic Daily Headache, and Medication-Overuse Headache in One Japanese City—Itoigawa Hisui Study

Abstract

Background: The prevalence of headache disorders, migraine, chronic daily headache (CDH), and medication-overuse headache (MOH) among the elderly in Japan has not been sufficiently investigated. We performed a questionnaire-based survey and revealed 3-month headache prevalence and headaches’ characteristics. Methods: The population aged over 64 was investigated in Itoigawa during their third coronavirus disease 2019 vaccination. Migraine, MOH was defined as The International Classification of Headache Disorders Third edition. CDH was defined as a headache occurring at least 15 days per month. K-means++ were used to perform clustering. Results: Among 2858 valid responses, headache disorders, migraine, CDH, and MOH prevalence was 11.97%, 0.91%, 1.57%, and 0.70%, respectively. Combined-analgesic and non-opioid analgesic were widely used. Only one migraineur used prophylactic medication. We performed k-means++ to group the 332 MOH patients into four clusters. Cluster 1 seemed to have tension-type headache-like headache characteristics, cluster 2 seemed to have MOH-like headache characteristics, cluster 3 seemed to have severe headaches with comorbidities such as dyslipidemia, stroke, and depression, and cluster 4 seemed to have migraine-like headache characteristics with photophobia and phonophobia. Conclusions: This is the largest prevalence survey in the Japanese elderly. Headache disorders are still the elderly’s burden. Clustering suggested that severe headaches associated with some comorbidities may be unique to the elderly.

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“…The median HIT-6 scores before, one, and three months after treatment were 63 (58-64), 54 (53-62), and 52 (49-54), respectively. MHD before, one, and three months after treatment were 15 (9-28), 12 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), and 2 (2-8), respectively. AMD before, one, and three months after treatment were 10 (3-13), 3 (1-8), and 2 (0-3), respectively.…”

“…Additionally, when patients with headaches consult a doctor, only neuroimaging is performed to rule out organic or emergent disorders, and the diagnostic for a detailed primary headache and its treatment is insufficient, which causes patient discontent [ 7 ]. These inadequate headache medical resources and OTC medicine use may lead to medication-overuse headaches (MOHs) [ 3 , 8 , 9 ] and chronic migraine development [ 10 ]. To improve this situation, a headache awareness campaign has been performed and has raised patient awareness of consulting doctors regarding their headaches [ 10 , 11 ].…”

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“…In Japan, migraine prevalence is 4.3-8.4% [2][3][4][5], and 29.8-74.2% of patients with migraine headaches report that it significantly impairs their daily activity [1]. Also, the migraine prevalence among elderly aged over 64 years old is 0.9%, and those of medicationoveruse headache (MOH) is 0.7% in Japan [6]. Effective prophylactic treatment for the elderly with migraine is needed.…”

Fremanezumab Improved Migraine and Headache Attributed to Glioblastoma

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