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Psychological, Cognitive, and Quality of Life Features in Elders With Headache

Sureeporn Uthaikhup, Division of Physiotherapy, University of Queensland; Michele Sterling, Gwen Jull, Division of Physiotherapy, The University of Queensland, Australia

Background: Recurrent headache is common in the elderly but there has been little specific research on the impact of frequent headache on physical and psychological well-being in this age group. Likewise pain beliefs, an important component of pain assessment and management, have yet to be evaluated in elders with headache.

Purpose: To investigate features of physical and psychological well-being and pain beliefs in elders with frequent headaches and to determine any relationships between well-being, pain beliefs and headache features.

Methods: One hundred eighteen subjects with recurrent headache (at least once per month for the past year) and 44 nonheadache controls, aged 60-75 years, were recruited from the community. Subjects completed a headache questionnaire, the SF-36, the Geriatric Depression Scale-short form (GDS-S), the Survey of Pain Attitudes (SOPA-35) and the Neck Disability Index (NDI). Headache subjects were subgrouped as episodic (<15 days per month) or chronic (15 days per month).

Analysis: Analysis of covariance (ANCOVA) was used to investigate any differences in the GDS and SF-36 scores between the headache (episodic and chronic) and control groups. Multiple analysis of covariance (MANOVA) was used to evaluate any differences in pain beliefs between subjects with episodic and chronic headaches. Any relationships among headache relevant variables and outcomes were analyzed using bivariate correlation analysis.

Results: Of the 118 headache subjects, 69 had episodic and 49 chronic headaches. Significantly lower physical and mental well-being (SF36) was found in subjects with headache compared with controls (p < .001) and for subjects with chronic headache compared with those with episodic headache (p < .05). Depression (threshold GDS score 8) was not a feature in either subjects with chronic (3.5 ± 3.2) or episodic headache (2.1 ± 2.6) or controls (0.8 ± 1.4). Frequency and intensity of headache, the NDI and GDS scores and beliefs and attitudes about pain were significantly inversely correlated with physical and mental well-being (r range from .21 to .67, p < .05).

Conclusion: Headache has a substantial influence on headache related quality of life in elders with headache. Their physical and mental well-being is dependent on frequency and intensity of headache, severity of neck pain, depression scores, as well as beliefs about pain. Recognition of this interrelationship assists management of elders with frequent headache.


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