Global Prevalence of Headache Disorders Increased in Women From 1990 to 2019

There is a significant increase in the prevalence, incidence, and disability-adjusted life years (DALYs) in headache disorders within the past 3 decades, according to study findings published in The Journal of Headache and Pain.

Headache disorders have become increasingly prevalent and have a significant disease burden worldwide. There are some gaps in research on headache disorders in adolescents and young adults, particularly in low- and middle-income countries. Researchers conducted a study to re-evaluate the global disease burden of headache disorders among adolescents and young adults.

The researchers collected data from the Global Burden of Disease (GBD) 2019 database, which includes disease information from 204 countries.

Migraine and tension-type headache (TTH) were diagnosed according to the International Classification of Headache Disorders, 3rd edition (ICHD-3). The researchers used the Sociodemographic Index (SDI) as a marker of a country’s development; this score is based on per capita income, average years of education among those aged 15 and older, and fertility rate. 

In 2019, the prevalence of migraine was estimated to be 581,761,847.2 cases worldwide (95% UI, 488,309,998.1-696,291,713.7), marking a 16% increase from 1990 (417,624,741.1 cases; 95% UI, 349,971,811.1-499,587,739). While there was an increase in cases, the age-standardized prevalence rate (ASPR) of migraine was relatively constant between 2019 (19,602 per 100,000 population) and 1990 (19,039 per 100,000 population).

There was also a 36.7% increase in global incidence of migraine between 1990 and 2019. The prevalence of TTH increased by 37% and the global incidence increased by 37.4% from 1990 to 2019. 

The DALYs due to migraine in 2019 were 21,529,090.4 (95% UI, 2,541,050.5-49,944,979.9), which represents a 40% increase from 1990.

The DALYs related to TTH increased 38% from 1990 to 2019, with 1,446,380.2 (95% UI, 386,965.6-5,450,782.5) in 1990 to 1,992,931.2 (95% UI, 529,490.2-7,415,829.4) in 2019.

When analyzing DALYs based on age groups, individuals aged 30 to 34 had the highest DALYs, with those aged 25 to 29 ranking next highest. 

Countries in the middle SDI regions had the highest number of TTH cases in both 1990 (210,136,691.6 cases) and 2019 (287,577,250 cases). Regions with a higher SDI had the most significant migraine prevalence rates in 1990 (22,429 per 100,000 population) and 2019 (22,606 per 100,000).

Across all countries, East Asia had the steepest rise in migraine prevalence, with an estimated annual percentage change of 0.29 (95% CI, 0.26-0.33). South Asia had the highest incidence of migraine with 12,041,286 (95% UI, 9,803,921.6-14,652,737.7) and the highest migraine associated DALYs with 5,570,590.8 (95% UI, 535,111.6-13,023,883.2). Overall, countries with higher SDI had a higher disease burden of migraine and TTH.

The greatest increase in global prevalence of migraine occurred among those aged 15 to 19, and this age group also had the highest migraine incidence. Prevalence rates were higher among females compared with males, with the highest disparities observed for individuals aged 35 to 39.

“We believe that the burden associated with migraine and TTH needs to be updated regularly and policymakers need to be kept informed to help identify best practices for headache prevention and control worldwide,” the researchers wrote.

They concluded, “This knowledge enables better allocation of preventive and therapeutic measures, promoting a more balanced global health landscape,” the researchers stated.

Study limitations are not analyzing trends for other headache disorders, the inclusion of many nations with unverified estimates, and differences in diagnostic criteria between countries.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.