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Final Program


Final Congress Guide

Clinical Sciences/Health Conditions

300 Section - Exploring the relationship between headache burden, mood and symptom severity in older adults following concussion

Wednesday, May 20, 2026
6:00 PM - 7:30 PM PT
Objectives : Headache is a common and disabling symptom after concussion. In older adults, multimorbidity and age-related cognitive vulnerability may intensify the impact of headache on symptom domains, yet these associations remain poorly characterized. This study aimed to examine whether headache impact is associated with mental health symptoms, post-concussion symptoms, and fatigue in adults ≥60 years.

Design: A cross-sectional analysis was conducted using data from the Calgary Brain Injury Program. Headache burden was measured using the Headache Impact Test (HIT-6). Outcomes included depression (PHQ-9), anxiety (GAD-7), Rivermead Post-Concussion Questionnaire (RPQ), and fatigue (FSS). Participants were categorized into high headache burden (HIT-6 >60) and low (HIT-6 ≤60). Linear regression models adjusted for age and sex assessed associations, with additional stratified analyses for adults aged 60–64 (n=28) and ≥65 (n=21).

Results:

Older adults with high HIT-6 scores had higher PHQ-9 scores than those with lower HIT-6 scores (β = −6.38, 95% CI [−9.36, −3.39]; p ≤ .001). Associations with anxiety, RPQ, and fatigue showed similar directional trends but were not statistically significant.

Age-stratified analyses showed significant association between headache burden and depressive symptoms, but substantially stronger in adults aged ≥65 (β = 0.40, 95% CI [0.20, 0.60]; p < .001, R² = 0.47) than aged 60–64 (β = 0.18, 95% CI [0.02, 0.35]; p = .028, R² = 0.18). Higher headache burden was significantly associated with greater fatigue in adults ≥65 (β = 0.86, 95% CI [0.26, 1.46]; p = .007, R² = .32), but not in those 60–64 (β = 0.30, 95% CI [−0.20, 0.80]; p = 0.23).

Conclusion: In older adult’s post-concussion headache burden can significantly influence depressive symptoms and increase fatigue with greater association in those age ≥65. This underscores the need for integrated headache, mood, and fatigue assessment in older adults with concussion.