Mind the gender gap: how defining head trauma increases reporting in women aged 30-50.

BACKGROUND: The use of an objective measure to evaluate the history of head trauma has been shown to significantly impact the amount of reported sustained head trauma in athletic male populations. However, the generalization of this definition across a more diverse population remains challenging; the World Health Organization notes that 93% of current research on mild traumatic brain injuries lacks gender-specific data. Additionally, compared to reports on young adults, there is limited research on the effects of concussions in midlife. Researchers hypothesize that women aged 30-50 from a general population would report additional head injuries when provided with an objective definition similar to those previously used for male athletes.

MATERIALS AND METHODS: Highly educated women (M = 16.7 years of education, SD = 2.1) aged 30-50 (M = 40.3, SD = 5.1) completed an online survey. The survey collected demographic data on sports participation and head trauma history. Race, ethnicity, and socioeconomic status were not collected. Participants first reported lifetime mTBI history without an objective definition, and were then reassessed after being given an objective definition.

RESULTS: A Wilcoxen Signed Rank test indicated a significant change in number of reported head injuries, pre and post definition (z = 4.06, p < 0.0001). The number of head injuries reported increased for 42% of the population, for this portion of the sample the median increased fourfold. To better understand the differences between those who reported an increase, and those who did not, researchers performed an examination of commonalities between those groups. A Chi-Square Test of Independence indicated a significant relationship (chi = 7.03, p < 0.01) between participation in sports (recreational, organized) and change in reported head injuries: 21% of individuals without a sport history increased the number of reported head injuries, in contrast 58% of individuals with a sport history increased the number of head injuries reported.

DISCUSSION: Given the significant increase observed in reported mTBIs, this definition is a robust tool that may help researchers and clinicians, more accurately identify lifetime head trauma in women. Similar to findings in male athletic populations the increase in number of reported mTBIs was significantly greater in women with an athletic history. Through more accurate reporting this definition could help improve clinical care as well as research into better understanding the impact of head injuries. Further research into the effects of race, ethnicity, and socioeconomic status, in relation to gender and mTBI history, could serve to address opportunities related to the generalizability of this study.