New-onset headaches in the elderly: An indicator of underlying disease

Headache is an important symptom at any age. At older ages, primary headache is less common and new-onset headache should be considered to be secondary until proven otherwise. The clinical presentation of illness in the elderly (those over the age of 65 years) is frequently nonspecific or atypical, and thus the complaint of headache in an older person may be related to a wide range of conditions, from arteritis and stroke to neoplastic diseases and glaucoma. Thus, the presence of headache at this age should always be given serious consideration by the physician. This review covers the wide range of conditions causing new-onset headache in the older population, and provides the clinician with a practical diagnostic approach to this important symptom.