PainRelief.com Interview with:
Carolyn DiGuiseppi, MD, MPH, PhD
Professor of Epidemiology
Colorado School of Public Health
University of Colorado Denver
Aurora, CO 80045
PainRelief.com: What is the background for this study?
Response: Migraine headache is a leading cause of disability worldwide and affects many older adults in the US and globally.
Some of the symptoms of an acute migraine, like fatigue, impaired concentration, headache, or dizziness, could affect older adults’ ability to drive safely. In fact, past research has suggested that people with migraine are at higher risk of having injuries resulting from motor vehicle crashes (compared to people without this diagnosis). We wanted to learn whether the risk of crashes depends on whether people have had a migraine diagnosis for some time or have been recently diagnosed, and whether being treated with migraine medications affects the risk of crashes.
PainRelief.com: What are the main findings?
Response: What we found is that older adult drivers who reported having had migraine headache at any time in the past were not at increased risk of motor vehicle crashes, at least, not over a two year study period, although we did find some evidence of slightly less safe driving in people with an existing migraine diagnosis.
Of greater concern, we found that older adult drivers with new onset of migraine headache were more than three times as likely to have a motor vehicle crash in the year after onset compared to older adult drivers who had never had a migraine. We also looked at whether medications commonly prescribed for acute migraine treatment, like triptans, and for migraine prevention, like β-blockers and antiepileptics, made a difference. We found that the relationship of migraines with crashes did not appear to be affected by use of these medications. However, it should be noted that our study did not collect specific information on why people used the medications, so some may have been using these medications for other health conditions.
PainRelief.com: What should readers take away from your report?
Response: Older adults with longer-standing migraine, on average, do not appear to have an increased risk of having a motor vehicle crash. However, older adults newly diagnosed with migraine have a substantially increased risk of crashes. This could be because their migraines are not yet stabilized or adequately treated with medication or lifestyle changes, or these individuals may be self-medicating with potentially inappropriate medications like opioids, which could themselves increase crash risk.
Older adults with a new diagnosis of migraine may benefit from reducing or avoiding driving during initial stabilization and management of migraine, holistic clinical assessment of driving risk factors and counseling to reduce other risks for motor vehicle crashes, such as avoiding use of alcohol or cannabis before driving.
PainRelief.com: What recommendations do you have for future research as a result of this study?
Response: It would be useful to understand the relationship between specific, current migraine symptoms (e.g., type, severity, frequency), as well as the duration of the diagnosis, with driving safety and crash risk. Prospective studies that collect more detailed information about use of medications (such as type, dose, duration) specifically prescribed for migraine could answer some important questions that remain about how medication use might affect crash risk.
Disclosures: This study was funded by the AAA Foundation for Traffic Safety, USA, although the findings and conclusions are solely those of the authors.
Citation:
DiGuiseppi CG, Johnson RL, Betz ME, et al. Migraine headaches are associated with motor vehicle crashes and driving habits among older drivers: Prospective cohort study. J Am Geriatr Soc. 2023; 1-11. doi:10.1111/jgs.18719
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Last Updated on January 7, 2024 by PainRelief.com