Headache disorders (comprising migraine and tension-type headache) were the most prevalent neurological ailments in India in 2019, affecting 488 million people, noted the first comprehensive estimates of disease burden due to neurological disorders in India.
The paper titled “The burden of neurological disorders across the States of India: the Global Burden of Disease Study 1990–2019” has been published in The Lancet Global Health on Wednesday (July 14) by the India State-Level Disease Burden Initiative.
According to the paper, between the two types of headache disorders, the DALY (Disability-Adjusted Life Years) contribution of migraine to total neurological disorder DALYs was much higher than the tension-type headache. In 2019, the prevalence of migraine was higher in females aged 35-59 years than in males of the same age. Prevalence increased with age and peaked at around age 40-44 years, followed by a gradual decrease in both females and males, the paper noted.
“Variations in the crude DALY rate of headache disorders were minimal between the States in 2019. The crude prevalence and DALY rate of headache disorders had a strong significant positive correlation with the Socio-Demographic Index (SDI) of the States, but the age-standardised rates had no significant correlation,” the paper pointed out.
The crude prevalence and DALY rate of headache disorders increased in India from 1990 to 2019, but no significant change occurred in the age-standardised prevalence.
Pramod Kumar Pal, Professor of Neurology at Nimhans, who is one of the authors of this neurological disease burden analysis, said headache disorders are the most prevalent neurological disorders after stroke. While the contribution of stroke to total neurological disorder DALY in India is the highest at 37.9%, headache disorders follow at 17.5%, he said.
Of the 488 million people found to be suffering from headache disorders, 213 million people have migraines and 374 million have tension-type headache, according to the paper. Dr. Pal said the numbers could even be more as headaches are often not reported.
“Generally classical migraines tend to disappear with age and new onset of migraines do not usually happen after 50 years. New onset of headaches in the elderly indicate a much more serious medical condition and need to be investigated to rule out tumours and other neurological issues,” Dr. Pal said.
“Migraines and tension-type headaches apart, headaches due to eye strain, anxiety and depression-related and cervical spondylolysis are also of concern. All affect productivity and need to be investigated irrespective of the age. These are not taken into consideration in this article,” he said.
The contribution of non-communicable neurological disorders to total DALYs from all causes in India doubled from 4% in 1990 to 8.2% in 2019, whereas the contribution of communicable neurological disorders decreased from 4.1% in 1990 to 1.1% in 2019. Injury-related neurological disorders contributed to 0.6% of total DALYs in 2019, compared with 0.2% in 1990. The proportion of total DALYs due to all neurological disorders (combining communicable, non-communicable, and injury-related disorders) changed marginally in India, from 8.3% in 1990 to 9.9% in 2019, Dr. Pal explained.
N.K. Venkataramana, Chairman and Director Neurosciences at Brains Hospital, said although headache disorders have been one of the most common neurological problems for several years we never had any reliable data so far. “This study has brought out the interesting and alarming facts that millions of people are suffering from headaches and over the decade it has been steadily increasing,” he said.
The common reasons for the increase in headache and migraine among women are stress, pollution and lifestyle. In the last decade, there has been a phenomenal increase in women empowerment but at the same time increase in work-related stress, dual responsibility, poor dietary habits, social habits like smoking, all these have contributed to the increase in the number of migraine headaches among women, especially those in the most productive age group, he added.