Burden of Tension-Type Headache Among Older Adults in the Middle East and North Africa Region, 1990-2023.

BACKGROUND AND AIMS: Tension-type headache (TTH) is an under-recognized but substantial contributor to disability and diminished quality of life among older adults. This study evaluated the burden of TTH among adults aged 60 years and older in the Middle East and North Africa (MENA) region and changes in burden between 1990 and 2023. METHODS: Data from the Global Burden of Disease (GBD) Study 2023 were used to report the prevalence, incidence, and years lived with disability (YLDs) due to TTH among adults aged 60 years and older in the MENA region. Estimates were presented with 95% uncertainty intervals (UIs). RESULTS: In 2023, there were an estimated 17.3 million prevalent cases (95% UI: 14.0-21.7), corresponding to a prevalence of 30,148.9 per 100,000 population (95% UI: 24,482.2-37,866.4). There were 5.8 million incident cases (95% UI: 4.7-7.3), corresponding to an incidence rate of 10,110.4/100,000 population (95% UI: 8171.9-12,736.4). Iran and Egypt had among the highest prevalence, incidence, and YLD rates, whereas the countries with the lowest rates varied by outcome. Females generally had higher prevalence and incidence rates than males across age groups, while YLD rates declined with age in both sexes. YLD rates in MENA exceeded global rates across all age groups and both sexes in 1990 and 2023. A reverse U-shaped association was observed between the Sociodemographic Index (SDI) and YLD rates. CONCLUSION: TTH remained a substantial burden among older adults in MENA. The 95% UIs for percentage changes in prevalence, incidence, and YLD rates between 1990 and 2023 included zero. The observed association with SDI and variation across countries may inform sex-sensitive and age-appropriate public health strategies for older adults in the region.