{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:56:02Z","timestamp":1791186962514,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005851","name":"Shahid Beheshti University of Medical Sciences","doi-asserted-by":"publisher","award":["43017558"],"award-info":[{"award-number":["43017558"]}],"id":[{"id":"10.13039\/501100005851","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Tension\u2010type headache (TTH) is an under\u2010recognized 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2023, there were an estimated 17.3 million prevalent cases (95% UI: 14.0\u201321.7), corresponding to a prevalence of 30,148.9 per 100,000 population (95% UI: 24,482.2\u201337,866.4). There were 5.8 million incident cases (95% UI: 4.7\u20137.3), corresponding to an incidence rate of 10,110.4\/100,000 population (95% UI: 8171.9\u201312,736.4). 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\u2010shaped association was observed between the Sociodemographic Index (SDI) and YLD rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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\u2010sensitive and age\u2010appropriate public health strategies for older adults in the region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73128","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:19:46Z","timestamp":1787811586000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Burden of Tension\u2010Type Headache Among Older Adults in the Middle East and North Africa Region, 1990\u20132023"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7986-9072","authenticated-orcid":false,"given":"Saeid","family":"Safiri","sequence":"first","affiliation":[{"name":"Research Center for Integrative Medicine in Aging, Aging Research Institute Tabriz University of Medical Sciences Tabriz Iran"},{"name":"Neurosciences Research Center, Aging Research Institute Tabriz University of Medical Sciences Tabriz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0178-3732","authenticated-orcid":false,"given":"Ali\u2010Asghar","family":"Kolahi","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3688-3515","authenticated-orcid":false,"given":"Maryam","family":"Beigrezaee","sequence":"additional","affiliation":[{"name":"Neurosciences Research Center, Aging Research Institute Tabriz University of Medical Sciences Tabriz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2590-8467","authenticated-orcid":false,"given":"Mostafa","family":"Araj\u2010Khodaei","sequence":"additional","affiliation":[{"name":"Neurosciences Research Center, Aging Research Institute Tabriz University of Medical Sciences Tabriz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5392-9599","authenticated-orcid":false,"given":"Reza","family":"Aletaha","sequence":"additional","affiliation":[{"name":"Neurosciences Research Center, Aging Research Institute Tabriz University of Medical Sciences Tabriz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7920-6818","authenticated-orcid":false,"given":"Mark J. M.","family":"Sullman","sequence":"additional","affiliation":[{"name":"Department of Life and Health Sciences University of Nicosia Nicosia Cyprus"},{"name":"Department of Social Sciences University of Nicosia Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koroush","family":"Gharagozli","sequence":"additional","affiliation":[{"name":"Brain Mapping Research Center Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30322-3"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(20)30190-0"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","unstructured":"M.Arnold \u201cHeadache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders 3rd Edition \u201dCephalalgia38 no. 1 (2018): 1\u2013211.","DOI":"10.1177\/0333102417738202"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/conmed-2025-000015"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00257-2"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","unstructured":"S.Li GBD 2019 Ageing Collaborators \u201cGlobal Regional and National Burden of Diseases and Injuries for Adults 70 Years and Older: Systematic Analysis for the Global Burden of Disease 2019 Study \u201dBMJ376 (2022): 068208.","DOI":"10.1136\/bmj-2021-068208"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.34172\/ija.2023.e16"},{"issue":"2","key":"e_1_2_13_9_1","first-page":"112","article-title":"Ageing in the Middle\u2010East and North Africa: Demographic and Health Trends","volume":"6","author":"Abyad A.","year":"2021","journal-title":"International Journal on Ageing in Developing 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