{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:30:25Z","timestamp":1760059825202,"version":"build-2065373602"},"reference-count":44,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T00:00:00Z","timestamp":1752278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korean government (MSIT)","award":["2022-0-00621","RS-2023-00262087"],"award-info":[{"award-number":["2022-0-00621","RS-2023-00262087"]}]},{"name":"Korea Health Industry Development Institute (KHIDI)","award":["2022-0-00621","RS-2023-00262087"],"award-info":[{"award-number":["2022-0-00621","RS-2023-00262087"]}]},{"name":"Ministry of Health and Welfare, Republic of Korea","award":["2022-0-00621","RS-2023-00262087"],"award-info":[{"award-number":["2022-0-00621","RS-2023-00262087"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and Objectives: Medication overuse headache (MOH) presents unique clinical challenges in older adults due to age-related changes and comorbidities. However, data on MOH characteristics and treatment responses in this population remain limited. This study investigated the clinical features, treatment patterns, and short-term outcomes of MOH in older patients. Methods: We analyzed data from the RELEASE registry, a nationwide, multicenter prospective cohort of MOH patients in South Korea. Participants were stratified into older (\u226565 years) and younger (&lt;65 years) groups. We compared clinical features, treatment patterns, and 3-month outcomes, and identified factors associated with treatment response in the older group. Results: Among 791 patients, 72 (9.1%) were older. Compared to younger patients, older patients reported more monthly headache days (30.0 vs. 27.0, p = 0.012), more days using acute medication (30.0 vs. 20.0, p &lt; 0.001), and fewer headache-free days (0.0 vs. 3.0, p = 0.012). They also experienced more severe headache days (12.5 vs. 10.0, p = 0.056). Despite this, older patients showed lower disability, with significantly lower Migraine Disability Assessment scores (30.0 vs. 46.0, p &lt; 0.001) and a trend toward lower Headache Impact Test-6 scores (64.5 vs. 66.0, p = 0.065). In multivariable analysis, poor adherence to preventive treatment (\u226424%) was significantly associated with non-response (OR 0.13, 95% CI: 0.02\u20130.96, p = 0.045) at 3 months. Conclusions: Older patients with MOH showed distinct clinical features, including higher headache frequency and severity but relatively lower disability. Improving adherence to preventive treatment may enhance treatment response. Age-specific management strategies are needed.<\/jats:p>","DOI":"10.3390\/jcm14144948","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T10:55:41Z","timestamp":1752490541000},"page":"4948","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Features and Treatment Outcomes of Medication Overuse Headache in Older Patients: Insights from a Nationwide Prospective Registry"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8693-2831","authenticated-orcid":false,"given":"Yooha","family":"Hong","sequence":"first","affiliation":[{"name":"Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong 18450, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi-Kyoung","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong 18450, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-Kyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min Kyung","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun-Young","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University School of Medicine, Jeonju 54896, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5629-6136","authenticated-orcid":false,"given":"Jin-Ju","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University School of Medicine, Jeonju 54896, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6847-497X","authenticated-orcid":false,"given":"Heui-Soo","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi Ji","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9937-762X","authenticated-orcid":false,"given":"Tae-Jin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, 260 Gonghang-daero, Gangseo-gu, Seoul 07804, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"on behalf of the RELEASE Investigators","family":"on behalf of the RELEASE Investigators","sequence":"additional","affiliation":[{"name":"The Korean Headache Society, Hangeulbiseok-ro, Nowon-gu, Seoul 01830, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1468-2982.2009.01906.x","article-title":"Prevalence of chronic migraine and medication overuse headache in Germany--the German DMKG headache study","volume":"30","author":"Straube","year":"2010","journal-title":"Cephalalgia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1177\/0333102411410082","article-title":"Epidemiology of medication overuse headache in the general Swedish population","volume":"31","author":"Jonsson","year":"2011","journal-title":"Cephalalgia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1046\/j.1468-1331.2003.00551.x","article-title":"Depression and anxiety disorders associated with headache frequency. 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