Headache and Migraine in Later Life

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Key Questions
  • What are the most common headache disorders in people over the age of 50?
  • How does migraine typically change in middle and older age?
  • Is it true that migraine improves with age?
  • Are triptans still safe for the older population with migraine?
  • How common is it for an older person to get a new diagnosis of migraine?
  • In someone with a history of migraine, what are some factors that might lead to increased frequency of attacks in middle age?
  • What are some alternatives if triptans either stop working for someone, or become unsafe to use?
  • How safe are some of the typical migraine medications for people older than 50?
  • Why do some people with migraine become more or less responsive to their usual medications as they age?
  • What are the risks of a long-term migraine history and the long-term medication use that may accompany it?
  • Are the newer medications safe for older people with migraine?
  • What nonmedicinal options exist for migraine after 50 years of age?
Interview Notes

Matthew Robbins, MD

Associate Professor of Neurology and Residency Program Director
Weill Cornell Medicine, New York Presbyterian Hospital

Dr. Matthew Robbins completed his B.S. from Yale University, his M.D. from SUNY Downstate College of Medicine, and his neurology residency and headache fellowship at the Albert Einstein College of Medicine/Montefiore Medical Center, where he remained on faculty for nearly a decade. In 2018 he joined the department of neurology at Weill Cornell Medicine/New York Presbyterian Hospital as the neurology residency program director and associate professor of neurology. For the American Headache Society (AHS), he is the secretary on the executive board, directs all resident education programming, and is a resident and fellow section editor for Headache. He has won the Members’ Choice award for the best publication in Headache, the Above and Beyond award from the AHS, and an AB Baker Teacher Recognition Award from the American Academy of Neurology (AAN). He has led organizational initiatives related to headache, including guidelines and quality measures. He is a graduate of the Palatucci Advocacy Leadership Forum of the AAN, where he has also served as an adviser.

Dr. Robbins regularly presents at national and international meetings, and has published widely on topics including headache procedures, headache in pregnancy and the elderly, cluster headache, new daily persistent headache, unusual forms of migraine aura, and neurologic education.

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