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From the Neurological Institute, Veterans General Hospital–Taipei, and Department of Neurology (Drs. S.-J. Wang, Fuh, Lu, Hsu, P.-N. Wang, and H.-C. Liu), National Yang-Ming University School of Medicine, Taipei; and the Department of Psychiatry (Dr. C.-Y. Liu), Chang-Gung Memorial Hospital, Taipei, Taiwan.
Address correspondence and reprint requests to Dr. Shuu-Jiun Wang, the Neurological Institute, Veterans General Hospital-Taipei 11217, Taiwan; e-mail: sjwang{at}vghtpe.gov.tw
OBJECTIVE: To investigate the prevalence, risk factors, and prognosis of chronic daily headache (CDH) in a population of elderly Chinese subjects.
METHODS: A community-based survey of registered residents 
65 years old (n = 2,003) in two townships of Kinmen Island in 1993. A neurologist used a structured questionnaire and clinical interview to make the diagnosis of headache. Subjects who had headaches 15 days/month for 6 months in the previous year were considered to have CDH. CDH was further classified into chronic tension-type headache (CTTH), CDH with migrainous features (CDH/MF), and other CDH. Person-to-person biannual follow-up of the subjects with CDH was done in June 1995 and August 1997.
RESULTS: A total of 1,533 people (77%) participated in our prevalence study. Sixty subjects (3.9%) fulfilled the criteria for CDH, with a higher prevalence in women (F/M: 5.6%/1.8%, p < 0.001). Of these subjects, 42 (70%) had CTTH, 15 (25%) had CDH/MF, and 3 (5%) had other CDH. Only 23% of those with CDH had consulted physicians for their headaches in the previous year. Multivariate logistic regression revealed the significant risk factors for CDH to be analgesic overuse (OR = 79), a history of migraine (OR = 6.6), and a Geriatric Depression Scale–Short Form score of 8 (OR = 2.6). The follow-up results in 1995 and 1997 showed that about two-thirds of the subjects still had CDH. Analgesic overuse (relative risk = 1.6) in 1993 was a significant predictor of persistent CDH at follow-up.
CONCLUSIONS: A total of 3.9% of this elderly population had CDH, with CTTH being the most common subtype. Almost two-thirds of those with CDH had persistent frequent headaches at follow-up. Analgesic overuse was a significant predictor of a poor outcome.
Key words: Chronic daily headache—Epidemiology—Prevalence—Old age
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