Global, regional, and national burden of migraine in postmenopausal women: a 32-year analysis from the global burden of disease study 1990-2021.

Abstract

Background: Migraine is a major cause of disability globally, yet its epidemiological impact on postmenopausal women (aged ≥55 years) is not well understood. This study aims to fill this knowledge gap by analyzing long-term trends in migraine burden from 1990 to 2021.

Methods: Data from the Global Burden of Disease (GBD) 2021 study were utilized to estimate prevalence, incidence, and disability-adjusted life years (DALYs), stratified by age group, Socio-demographic Index (SDI), and geographical region. Temporal trends were assessed using the estimated annual percentage change (EAPC), while socioeconomic inequalities were evaluated through the Slope Index of Inequality (SII) and Concentration Index (CIX).

Results: The number of prevalent cases of migraine among postmenopausal women increased by 118.3% globally, rising from 55.29 million to 120.68 million between 1990 and 2021. Age-standardized rates (ASRs) in this population displayed contrasting trends: while age-standardized prevalence and incidence rates experienced slight increases (EAPC: 0.07-0.17), the age-standardized DALY rate (ASDR) remained stable. Middle-SDI regions faced the highest absolute burden of migraine in postmenopausal women and showed the most rapid growth in ASRs. Inequality analyses highlighted persistent socioeconomic disparities, revealing significant efficiency gaps in health resource utilization in high-SDI countries.

Conclusions: This study highlights the increasing absolute burden of migraine among postmenopausal women, despite stable age-standardized rates. This underscores the need for context-specific interventions across SDI strata to reduce health inequities and optimize resource allocation in migraine care.