565: Age-Stratified Determinants of Headache Among Older Adults: A National Population-Based Study

Topic: Education, Societal Impact, and Others
Subtopic: Epidemiology

Background and Aims: Headache is a major contributor to chronic pain and disability across the lifespan, yet remains poorly characterized among older adults, a rapidly growing global demographic. Evidence on headache determinants in advanced age is limited, particularly in low- and middle-income countries, where multimorbidity, psychosocial vulnerability, and functional decline are prevalent. This study aimed to identify independent sociodemographic, clinical, and psychosocial determinants of headache across older age groups using nationally representative data from the Indonesian Family Life Survey wave 5 (IFLS-5).

Methods: We conducted a cross-sectional analysis of IFLS-5 participants, including 2528 individuals aged 60-74 years and 389 individuals aged ≥75 years. The IFLS-5 was conducted between September 2014 and April 2015. The data represented approximately 83% of the Indonesian population. Headache was defined based on self-reported pain symptoms within the preceding four weeks. Covariates included gender, educational attainment, economic status, employment status, smoking habit, hypertension, diabetes mellitus, cardiac disease, hypercholesterolemia, stroke history, depression, sleep disturbances, and sleep quality. Multivariable logistic regression models were used to estimate the adjusted odds ratio (aOR) and 95% confidence interval (CI).

Results: Among participants aged 60-74 years, headache was associated with sleep disturbance (aOR 2.21; 95% CI 1.85-2.64), poor sleep quality (aOR 1.25; 95% CI 1.05-1.48, depression (aOR 1.93; 95% CI 1.51-2.46, hypertension (aOR 1.75; 95% CI 1.45-2.12), low education level (aOR 1.49; 95% CI 1.18-1.89), and female (aOR 1.32; 95% CI 1.08-1.63) (all p<0.05). Headache in the ≥75 years group was significantly associated with sleep disturbances (aOR 3.23; 95% CI 2.03-5.34), depression (aOR 2.13; 95% CI 1.13-4.01), and low education level (aOR 3.40; 95% CI 1.42-8.15) (all p<0.05).

Conclusions: Sleep disturbance, depression, and low education level emerged as dominant determinants of headache across older age groups in the Indonesian population. Poor sleep quality, hypertension, and female sex were additional risk factors among adults aged 60–74 years. These findings support multidimensional pain management strategies integrating sleep optimization, mental health care, pain education, and management of comorbidities to reduce headache burden in advanced age.

References: 1. Müller B, Gaul C, Reis O, et al.: Headache impact and socioeconomic status: findings from a study of the German Migraine and Headache Society (DMKG). J Headache Pain. 2023, 24:37. 10.1186/s10194-023-01564-7
2. Navaneetham K, Arunachalam D: Global Population Aging, 1950–2050. In: Handbook of Aging, Health and Public Policy. Springer Nature Singapore: Singapore; 2025. 99–116.10.1007/978-981-99-7842-7_154
3. Mortel D, Kawatu N, Steiner TJ, Saylor D: Barriers to headache care in low- and middle-income countries. eNeurologicalSci. 2022, 29:100427. 10.1016/j.ensci.2022.100427
4. Olanrewaju O, Trott M, Smith L, et al.: Chronic physical conditions, physical multimorbidity, and quality of life among adults aged ≥ 50 years from six low- and middle-income countries. Qual Life Res. 2023, 32:1031–41. 10.1007/s11136-022-03317-6
5. Strauss J, Witoelar F, Sikoki B: The Fifth Wave of the Indonesia Family Life Survey: Overview and Field Report: Volume 1. Fifth Wave Indones Fam Life Surv Overv F Rep Vol 1. 2016, 1:. 10.7249/wr1143.1

Presenting Author: Aurelia Vania, MD, Neurologist
Submitting Author: Aurelia Vania

Senior Author: Jimmy Fransisco Abadinta Barus, MD, Ph.D, Neurologist

IASP 2026 Global Year theme of Neuropathic Pain: No

• Aurelia Vania: MD, Neurologist - Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
• Yuda Turana: Prof. MD, Ph.D, Neurologist - Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
• Budi Riyanto Wreksoatmodjo: MD, Ph.D, Neurologist - Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
• RR Josephine Retno Widayanti: MD, Neurologist - Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
• Linda Suryakusuma: MD, Neurologist - Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
• Andre: MD, Neurologist - Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
• Octavianus Darmawan: MD, Neurologist - Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
• Raesa Yolanda: MD, Neurologist - Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
• Jimmy Fransisco Abadinta Barus: MD, Ph.D, Neurologist - Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia