Migraine in older adults

Publikation: Bidrag til tidsskriftReviewForskningfagfællebedømt

Migraine is an evolving, and sometimes lifelong disorder. The prevalence of episodic migraine peaks among individuals aged in their late 30s, implying a tendency for the disorder to remit with increasing age thereafter, whereas chronic migraine is more likely to persist into later life. Diagnosis and treatment of migraine in older adults, defined as individuals aged 60 years or older, is rendered more complex by increasing probabilities of atypical clinical features and comorbidities, with patients' comorbidities sometimes limiting their therapeutic options. However, the changing clinical presentation of migraine over an individual's lifespan is not well characterised. The neurobiological basis of remission in older adults remains unclear, although vascular, neuronal, and hormonal changes are likely to be involved. Long-term longitudinal studies of individuals with migraine would be particularly informative, with the potential not only to suggest new research directions, but also to lead to the identification of novel therapeutic agents. Although several novel migraine medications are becoming available, their effectiveness, tolerability, and safety often remain uncertain in older adults, who have commonly been excluded from the evaluation of these agents in randomised controlled trials, or who constitute only a small proportion of study populations. There is a need to recognise these limitations in the available evidence, and the specific, and often unmet, clinical needs of older adults with migraine, not least because older adults constitute an increasing proportion of populations worldwide.
OriginalsprogEngelsk
TidsskriftThe Lancet Neurology
Vol/bind22
Udgave nummer10
Sider (fra-til)934-945
Antal sider12
ISSN1474-4422
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
MA was supported by a Lundbeck Foundation Professorship grant (R310–2018–3711). KCB was supported by the National Institute of Neurological Disorders and Stroke (National Institutes of Health, grant numbers R01 NS 102978 and R01 NS 104742) and the Department of Defense Peer Reviewed Medical Research Program (grant number PR200891).

Publisher Copyright:
© 2023 Elsevier Ltd

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