![](data:image/png;base64,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)
Headache Medicine, v.4, n.4, p.91-95, Oct./Nov./Dec. 2013 95
Diante dessas evidências, o baixo status socio-
econômico adquire maior importância, porque a impos-
sibilidade de atendimento especializado em cefaleia
somada à dificuldade diagnóstica potencializam todos
os prejuízos de vida funcional dos idosos, impossi-
bilitando ainda mais o envelhecimento ativo.
O contexto de status socioeconômico e consulta a
especialista pode ter, na adesão a planos privados de
saúde, uma solução ou um fator facilitador. No Brasil,
dada a vigência do Sistema Único de Saúde, essa opção
é quase que a única para tais consultas. Esse aspecto foi
objeto de estudo de base populacional realizado nos
Estados Unidos. Dentre 6.814 consultas de pacientes com
cefaleia a serviços ambulatoriais, emergenciais e hos-
pitalares, os atendimentos realizados por especialista em
cefaleia resultaram em diagnósticos mais precisos, trata-
mento adequado às crises e instituição de terapêutica
preventiva, do que derivaram menores custos sociais e
econômicos para o sistema de saúde.
(11)
Os custos sociais estão representados pela neces-
sidade de constante busca por atendimento, em virtude
da ineficácia do tratamento instituído, bem como pelos
custos indiretos infringidos pela dor, pelos prejuízos sociais
que a doença acarreta e pelo desgaste emocional do
insucesso na busca de cuidados médicos. Quanto aos
custos econômicos, há que se considerar o número de
consultas realizadas de forma inadequada e os gastos
com medicação, internamento e atendimento médico.
Em sistemas de saúde com escassez de recursos finan-
ceiros, de disponibilidade de leitos hospitalares e de
vagas para consultas ambulatoriais, a associação entre
cefaleia e status socioeconômico, tendo a adesão a
planos privados de saúde, é preocupante e pode não
ser a solução para a maioria dos idosos.
CONCLUSÃO
Nesse contexto, depreende-se das evidências apre-
sentadas a necessidade de prover treinamento às equipes
médicas sobre diagnóstico e tratamento de cefaleia
desenvolvido por especialistas; aumento desses profis-
sionais nos serviços de saúde e inclusão da cefaleia em
idosos nos cursos de formação médica, como tema de
especial importância devido ao envelhecimento da
população. Essas providências são indubitavelmente as
únicas viáveis para o Sistema Único de Saúde, quando
comparadas à possibilidade de adesão a planos
privados de saúde pelos idosos.
A implantação de tais condutas deverá, entretanto,
Correspondência
VV
VV
V
aléria Moura Moreira Laléria Moura Moreira L
aléria Moura Moreira Laléria Moura Moreira L
aléria Moura Moreira L
eiteeite
eiteeite
eite
Avenida Moraes do Rego s/n - Cidade Universitária
50670-901 - Recife, PE, Brasil
Telefone: (81) 2126-8931
Endereço eletrônico: vmmleite@hotmail.com
estar associada a pesquisas sobre o impacto da cefaleia
na vida funcional de idosos, para melhor adequação
das condutas terapêuticas, contribuindo para uma
assistência que efetive o envelhecimento ativo.
REFERÊNCIAS
1. Chaimowicz F. Saúde do idoso. 2a ed. Belo Horizonte: NESCON
UFMG; 2013.
2. World Health Organization. Envelhecimento ativo: uma política
de saúde. Brasilia: 2005.
3. Alves LC, Rodrigues RN. Determinantes da autopercepção de
saúde entre idosos do Município de São Paulo , Brasil 1. Rev.
Panam. Saúde Pública. 2005;1991(1):333-41.
4. Souza JA, Moreira Filho PF, Jevoux CC, Albertino S, Sarmento EM,
Brito CM. Idade como um fator de risco independente para cefaléias
secundárias. Arq. Neuropsiquiatr. 2004; 62(4):1038-45.
5. Jonsson P, Hedenrud T, Linde M. Epidemiology of medication
overuse headache in the general Swedish population.
Cephalalgia. 2011 Jul;31(9):1015-22.
6. Camarda R, Monastero R. Prevalence of primary headaches in
Italian elderly: preliminary data from the Zabút Aging Project.
Neurol. Sci. 2003 May;24 Suppl 2:S122-4.
7. Prencipe M, Casini AR, Ferretti C, Santini M, Pezzella F, Scaldaferri
N, et al. Prevalence of headache in an elderly population?: attack
frequency , disability , and use of medication. J. Neurol. Neurosurg.
Psychiatry. 2001;70:377-81.
8. Le H, Tfelt-Hansen P, Skytthe A, Kyvik KO, Olesen J. Association
between migraine, lifestyle and socioeconomic factors: a
population-based cross-sectional study. J. Headache Pain.
2011;12(2):157-72.
9. Hagen K, Vatten L, Stovner LJ, Zwart J, Krokstad S, Bovim G. Low
socio-economic status is associated with increased risk of
frequent headache?: a prospective study of 22 718 adults in
Norway. 2002;310(26):672-9.
10. Voley-Gómez M. Impacto social , económico y en el sistema de
salud de la migraña y otras cefaleas primarias. Rev. Neurol.
2006;43(4):228-35.
11. Wilper A, Woolhandler S, Himmelstein D, Nardin R. Impact of
insurance status on migraine care in the United States: a
population-based study. Neurology. 2010;74(15): 1178-83.
12. Tzourio C, Gagnière B, Amrani M El, Bousser M-G, Alpérovitch
A. Lay versus expert interviewers for the diagnosis of migraine in
a large sample of elderly people. J. Neurol. Neurosurg. Psychiatry.
2003;74(2):238-41.
13. Vaish S, Shekhawat B. Impact of socio-demographic factors on
quality of life of primary chronic daily headache patients. Indian
J. Pain. 2013;27(2):92.
ASPECTOS SOCIOECONÔMICOS DA CEFALEIA EM IDOSOS