Older Adults Had More Chronic Migraine and Medication Overuse in Italian Registry

A multicenter, post hoc analysis from the Italian Registry for Headache Disorders (RICe) examined headache diagnoses and migraine characteristics across four age groups. The study included 3,477 patients enrolled at 30 headache centers during 2019–2025, including 644 (18.5%) aged ≥60 years. Migraine was diagnosed in 3,013 patients (86.7%).

Migraine diagnoses differed across age groups (p<0.001). Patients aged ≥60 years more frequently had chronic migraine and medication-overuse headache, while migraine with aura was more common among those aged 18–30 and 31–45 years. Older patients reported more monthly migraine days but lower pain intensity and fewer severe attacks (all p<0.02). The abstract did not provide absolute subgroup rates or differences in migraine-day counts.

Among patients with available treatment data, prior beta-blocker and onabotulinumtoxinA use was more frequent in older adults; anti-CGRP monoclonal antibody prescribing did not differ across age groups. These findings support attention to headache frequency and medication overuse even when older patients describe less intense pain. However, the post hoc observational design cannot establish causality, and recruitment from specialist headache centers limits generalizability. Only the abstract was available for assessment.