The prevalence of headache and associated psychosocial factors in an urban biracial sample of older adults.

Abstract

There are limited epidemiological data about headache in urban elderly persons in the United States, especially those from minority backgrounds. This article examines the prevalence of headache and associated psychosocial factors in a biracial sample of older adults in New York City. Data from a population-based sample consisting of 214 Caucasians and 859 Blacks aged 55 and over (mean age: 68 years) were analyzed using an adaptation of George's Social Antecedent Model of Psychopathology. The model consisted of 15 independent variables, one interactive variable, and a dependent variable that dichotomized headaches that bothered respondents into "none or little of the time" versus "some, a good part, or most of the time" in the past few weeks. Controlling for design effects, 17.8% of the sample met headache criteria. For the entire sample, logistic regression analysis indicated that headache was significantly associated with anxiety symptoms, depressive symptoms, religiosity, and a smaller proportion of confidantes. When examined separately, headache among blacks was significantly associated with anxiety symptoms, larger social networks, and greater financial strain. Among Caucasians, headache was associated with anxiety symptoms, smaller social networks, religiosity, physical illness, and higher daily functioning. The study confirms earlier findings that anxiety and depressive symptoms are associated with headache in older adults. The results also identify other psychosocial factors that may differ by race. These findings have important implications with respect to the etiology and management of headache in older adults.