Global Migraine Burden Rising Fastest Among Men and Adolescents, New Research Finds

The global prevalence of migraine increased by 51.8% during the 3 decades between 1990 and 2021, with substantial differences between the sexes, according to new data published in the journal Pain and Therapy. While women experienced higher absolute rates of migraine incidence and prevalence compared with men over the study period, the increase among men was 4- to 5-fold more rapid across the same parameters. The neurologic disorder affected more than 1 billion worldwide in 2021.

Authors of the global study predict the observed trends will continue and that the growing burden among men, historically overlooked in migraine research, "requires prioritized intervention strategies, including early diagnosis and targeted health education."

The Chinese research team recommended the same strategies for youth aged 20 years and younger, the population and the age group in which they expect to see the fastest growth in incidence, prevalence, and disability adjusted life years (DALYs). The standardized age rate will be more rapid than in older adult groups (20 to 64 and 65 years and older) This trend, too, will continue, authors said.

The authors observed that the preponderance of current research in migraine has focused on women and specific age groups with few studies taking a systematic approach to analyzing developments more broadly across age groups and sexes within large populations. Their study, using data culled from the Global Burden of Disease databased from 1990 to 2021, explored long-term trends in migraine burden across 204 countries and 21 regions, examining variations by age, sex, and sociodemographic index (SDI) to more comprehensively understand worldwide trends in the distribution of neurologic disorder.

Overall the global prevalence of migraine increased from 733 million to 1.16 billion from 1990 to 2021 and incidence rose by 42%, according to the study. DALYs associated with migraine increased by 58.27%. Investigators reported highest age-standardized rates in DALYs in high SDI regions and the lowest in low SDI regions. However, they emphasized that “the medium SDI and low to medium SDI populations are huge,” with the total number of individuals who experience migraine across the groups including “more than half of the global population,” a considerable burden for the vulnerable geographic areas.

By country, the most significant increases were observed in East Asia and Latin America while a decrease was most pronounced in Southeast Asia, according to the study.

When the investigators applied predictive analyses to project global migraine burden between 2020 and 2050, the patterns were similar to the changes between 1990 and 2021, ie, with prevalence increasing most significantly among women but the absolute rate of increase in both incidence and prevalence being more pronounced among men and adolescents.

Despite substantial advances in medical technology and pharmacologic treatments during the 32 years of the study’s observation, the global burden of migraine remains high, the authors wrote. They posit factors including population growth, aging, accelerated urbanization, and lifestyle change as contributing variables, pointing to the potential socioeconomic impact the condition may exact and the challenge that effective intervention will continue to pose for public health officials worldwide.

The significant disparity in migraine burden between men and women has complex underpinnings that include hormonal fluctuations, pain sensitivity and pain tolerance, authors wrote. They ascribe the escalating rates of incidence, prevalence, and DALYs among men to increasing challenges to health in "modern society, such as intense physical labor, increased work stress, and a poorer awareness of individual health management." They also point to traditional barriers among men to reporting and treating migraine [38, 39]. The disability burden of migraine begins to increase in the 10- to 14-year age group with absolute numbers for DALYs in the “very large” 30- to 34-years age group, a period the researchers point out coincides with peak career productivity and family responsibilities.

Future research and policy should continue to prioritize this global health challenge to ensure effective resource allocation and mitigation of the migraine burden through appropriate interventions, particularly among men and adolescents, the authors concluded.

Study limitations include potential bias and underreporting of migraine in SDI regions.

References

Dong L, Dong W, Jin Y, Jiang Y, Li Z, Yu D. The global burden of migraine: a 30-year trend review and future projections by age, sex, country, and region. Pain Ther. Published online December 11, 2024. doi:10.1007/s40122-024-00690-7