Prevention of headache in adolescents: Population-attributable risk fraction for risk factors amenable to intervention

  • Albers L
  • Milde-Busch A
  • Bayer O
 et al. 
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INTRODUCTION: Several risk factors for headache have been identified, some of which are potentially amenable to interventions. The potential effect of such interventions can be predicted by the population-attributable risk fraction (PARF). We assessed PARFs of the the following risk factors: neck muscle pain, chronic stress, alcohol consumption, smoking, coffee consumption, and physical inactivity. We studied the maximal possible effect achievable by avoidance of these risk factors.

METHODS: Two approaches to estimate PARFs are compared, which assess their cumulative and individual impact of risk factors by age: the Levin formula and the average attributable fraction.

RESULTS: The overall impact for removal of all six risk factors amounts to 19.7% for the average attributable fraction. Neck tension and consumption of alcohol ranked as the strongest population-attributable risk factor for any headache. The potential impact for migraine was considerably higher (43.8%). With increasing age, the overall impact of risk factors on headache increases by 18.9%.

CONCLUSION: Based on the estimations of the most appropriate approach, up to 20% of headaches in general and up to 43% of migraine in adolescents might be preventable by removing risk factors amenable to intervention, with increasing proportions by age.

Author-supplied keywords

  • PARF
  • adolescents
  • headache
  • migraine
  • risk factors
  • tension-type headache

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  • Lucia Albers

  • Astrid Milde-Busch

  • Otmar Bayer

  • Steffi Lehmann

  • Christina Riedel

  • Michaela Bonfert

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