Migraine epidemiology and demographics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Migraine is widespread in the population. The majority of migraine (as it is referred to commonly) is actually mixed Headache. In the U.S., 18% of women and 6% of men report having had at least one migraine episode in the previous year^[1] According to reports, 10% of people have been diagnosed with migraine and 5% have migraine but have not been diagnosed, with seriousness varying from a rare annoyance to a life-threatening and/or daily experience.

Migraine is an extremely common condition which will affect 12-28% of people at some point in their lives.^[2] However this figure — the lifetime prevalence — does not provide a very clear picture of how many patients there are with active migraine at any one time. Typically, therefore, the burden of migraine in a population is assessed by looking at the one-year prevalence — a figure that defines the number of patients who have had one or more attacks in the previous year. The third figure, which helps to clarify the picture, is the incidence — this relates to the number of first attacks occurring at any given age and helps understanding of how the disease grows and shrinks over time. Based on the results of a number of studies, one year prevalence of migraine ranges from 6-15% in adult men and from 14-35% in adult women.^[3] These figures vary substantially with age: approximately 4-5% of children aged under 12 suffer from migraine, with little apparent difference between boys and girls.^[4] There is then a rapid growth in incidence amongst girls occurring after puberty,^[5][6][7] which continues throughout early adult life.^[8] By early middle age, around 25% of women experience a migraine at least once a year, compared with fewer than 10% of men.^[9][10] After menopause, attacks in women tend to decline dramatically, so that in the over 70s there are approximately equal numbers of male and female sufferers, with prevalence returning to around 5%.^[2] At all ages, migraine without aura is more common than migraine with aura, with a ratio of between 1.5:1 and 2:1.^[11][12] Incidence figures show that the excess of migraine seen in women of reproductive age is mainly due to migraine without aura.^[13] Thus in pre-pubertal and post-menopausal populations, migraine with aura is somewhat more common than amongst 15-50 year olds^[14][15]Geographical differences in migraine prevalence are not marked. Studies in Asia and South America suggest that the rates there are relatively low,^[16][17] but they do not fall outside the range of values seen in European and North American studies.^[18][19]The incidence of migraine is related to the incidence of epilepsy in families, with migraine twice as prevalent in family members of epilepsy sufferers, and more common in epilepsy sufferers themselves.^[20]

Shown below is the age-standardised disability-adjusted life year (DALY) rates from Migraine by country (per 100,000 inhabitants).

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