The burden of migraine and predictions in the Asia–Pacific region, 1990–2021: a comparative analysis of China, South Korea, Japan, and Australia

Abstract

Background

Migraine is a leading cause of disability worldwide, significantly impacting quality of life and healthcare systems. Despite its high prevalence and burden, migraine remains underprioritized in global health policies. This study examines the epidemiological trends of migraine in Australia, China, Japan, and South Korea from 1990 to 2021, highlighting regional disparities and forecasting future burdens.

Methods

This study utilized data from the Global Burden of Disease (GBD) 2021 to analyze incidence, prevalence, and years lived with disability (YLDs) of migraine. Age-standardized rates (ASRs) were calculated to enable fair cross-country comparisons. Joinpoint regression analysis was applied to assess temporal trends, while Bayesian age-period-cohort (BAPC) modeling was used to project future trends until 2050. Additionally, decomposition analysis was conducted to differentiate the effects of population aging, growth, and epidemiological changes.

Results

In 2021, China had the highest migraine burden, with 13.05 million new cases and 184.75 million prevalent cases, followed by Australia, Japan, and South Korea. Incidence rates peaked in adolescence (10–14 years), while prevalence and disability were highest in middle-aged women (40–44 years). From 1990 to 2021, Australia exhibited stable trends, China experienced increasing burden, Japan saw a decline due to aging, and Korea exhibited mixed patterns influenced by opposing demographic and epidemiological forces. Future projections suggest a stable trend in Australia, declining incidence in China and Japan, and continued burden in Korea.

Conclusion

Migraine remains a significant public health challenge across all four countries, with age, gender, and demographic changes playing key roles in burden variations. The study highlights the need for region-specific healthcare strategies and age- and gender-sensitive interventions. Future research should explore socioeconomic, behavioral, and healthcare access factors to refine migraine management strategies.

Introduction

Migraine, a leading cause of disability worldwide, imposes a substantial public health burden due to its high prevalence, chronic nature, and profound impact on quality of life. Ranked among the top contributors to global years lived with disability (YLDs), migraine disproportionately affects women and individuals in their prime working years, exacerbating socioeconomic challenges and straining healthcare systems [1, 2]. The Global Burden of Disease (GBD) studies have consistently highlighted migraine’s prominence in disability-adjusted life year (DALY) rankings, particularly among populations aged 10–49 years [3]. Asia–Pacific countries face unique challenges, including rapid urbanization (China), aging populations (Japan), and evolving healthcare systems (South Korea), making them critical settings for studying migraine epidemiology. Despite its pervasive impact, migraine remains underprioritized in global health agendas, with significant gaps in region-specific epidemiological analyses and evidence-based policy responses [4].

Recent GBD data reveal marked heterogeneity in migraine burden across regions, influenced by sociodemographic, cultural, and healthcare factors. While high-income countries often report stable or declining trends due to advanced healthcare infrastructure and awareness, low- and middle-income regions face escalating burdens driven by population growth, urbanization, and diagnostic disparities [4, 5]. The Sociodemographic Index (SDI), a composite metric integrating income, education, and fertility rates, further underscores the interplay between socioeconomic development and health outcomes. The SDI framework is particularly relevant here, as Australia (high SDI), Japan and South Korea (high-middle SDI), and China (middle SDI) exemplify how socioeconomic gradients influence migraine reporting and management.

Existing studies emphasize age- and sex-specific patterns, with peak incidence in adolescence and highest prevalence and disability in middle-aged women, likely linked to hormonal, genetic, and environmental factors [6, 7]. Yet, the drivers of temporal trends—including aging populations, epidemiological transitions, and healthcare access—are poorly quantified. For instance, while Japan’s aging demographics may reduce migraine prevalence, China’s rapid urbanization and improved diagnostics could inflate reported cases, complicating cross-national comparisons [8, 9]. Similarly, gaps persist in forecasting future burdens, particularly in Asia, where demographic shifts and evolving disease profiles necessitate dynamic modeling approaches.

While previous studies have explored migraine epidemiology in individual countries, comparative analyses across nations with divergent SDI trajectories—particularly in the Asia–Pacific region—remain scarce. This study addresses critical gaps by (1) quantifying regional disparities in migraine burden through age-standardized metrics, (2) employing Bayesian age-period-cohort modeling to forecast future trends, and (3) disentangling the effects of aging, population growth, and epidemiological changes via decomposition analysis. Focusing on Australia, China, Japan, and South Korea—countries representing distinct sociodemographic and healthcare contexts—we leverage GBD 2021 data to analyze migraine incidence, prevalence, and YLDs from 1990 to 2021. Age-standardized rates (ASRs) ensure equitable comparisons, while joinpoint regression identifies temporal trends and BAPC modeling projects future burdens to 2050. By elucidating regional disparities and their determinants, this work aims to inform tailored public health strategies and address critical gaps in migraine management across diverse sociodemographic contexts, particularly highlighting how SDI-driven factors shape migraine dynamics.

Methods

Overview

The Global Burden of Disease (GBD) 2021 study provides extensive epidemiological data for 371 conditions and injuries, broken down by age and sex, across 204 nations and territories. It delivers annual insights spanning the period from 1990 to 2021 at global, regional, and national levels. Comprehensive explanations of the applied methodologies have been previously documented, and findings related to fatal and non-fatal outcomes are accessible online (https://vizhub.healthdata.org/gbd-results/). The Sociodemographic Index (SDI), scaled between 0 and 1, serves as a composite metric reflecting the socioeconomic factors influencing health outcomes in specific locations. It integrates variables such as fertility rates for individuals under 25, educational levels for those aged 15 and older, and per capita income, all of which are strongly correlated with health-related results. Based on SDI values, the 204 countries and territories were classified into five distinct quintiles: low, low-middle, middle, high-middle, and high sociodemographic development.

Data sources

The GBD 2021 Study involved gathering information from a variety of sources, including surveys, censuses, civil registration systems, demographic monitoring, and other health-related datasets. Following the data collection process, potential biases in each dataset were evaluated and adjusted through standardized statistical modeling with DisMod-MR 2.1, a Bayesian meta-regression tool. This research focused on analyzing the incidence, prevalence, and YLDs (Years Lived with Disability) burden of migraine, utilizing data from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Country-specific adjustments were applied to account for variations in healthcare infrastructure and diagnostic practices. For instance, China’s data were adjusted for urban–rural disparities in healthcare access, while Japan’s aging population structure informed age-specific weighting. The analysis followed the GBD framework and adhered to the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).

Burden description

In this study, we employed annual incidence cases, prevalence cases, YLDs, and their respective age-standardized rates per 100,000 persons (ASR) to illustrate the burden of migraine. ASR were calculated using the WHO World Standard Population to ensure comparability with global studies. All estimates are reported as 95% uncertainty intervals (95% UI), the 2.5 and 97.5 percentiles of the 100 uncertainty distribution. By utilizing age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized mortality rate (ASYR), it is possible to facilitate comparisons across populations of varying age distributions and sizes and to enhance the accuracy of comparisons between populations. The ASR is calculated by the following formula:

$$ASR=\sum\limits_{i=1}^n(\frac{Ri\times P_i^{std}}{P_i})$$

(1)

Where R_i is the disease incidence or mortality (i. e. age rate), P_i is the population in the studied population, P_i^std is the population proportion of the age group in the standard population, and n is the number of age group.

Trends analysis

The joinpoint regression model, comprising multiple linear statistical models, was applied to analyze temporal trends in disease burdens. This method estimates changes in disease rates using the least squares approach, which avoids the subjectivity often found in traditional trend analyses based solely on linear patterns. By calculating the residual error’s squared sum between actual and predicted values, the model identifies the inflection point of trend changes. Additionally, the average annual percentage change (AAPC) was computed, and its comparison to 0 was used to determine whether the observed trend variations were statistically significant. A P-value of less than 0.05 was considered to indicate statistical significance.

Bayesian age-period-cohort (BAPC) analysis

The BAPC model was selected for its ability to disentangle age, period, and cohort effects—critical for forecasting in aging populations and rapidly urbanizing societies (e.g., China). This approach outperforms traditional linear models by capturing non-linear temporal trends and cohort-specific risk profiles. BAPC model using an integrated nested Laplace approximation (INLA) method. By leveraging INLA within the BAPC framework, the model can approximate the marginal posterior distributions, thereby circumventing the mixing and convergence challenges often encountered with Markov chain Monte Carlo sampling in conventional Bayesian approaches. The fundamental equation of the BAPC model is:

$$\log({Rate}_{ijt})=\alpha+\mu_{\mathrm i}+\beta_{\mathrm j}+\gamma_{\mathrm k}+\varepsilon_{\mathrm{ijt}}$$

(2)

Rate_ijt represents the incidence or mortality rate at time t, for age group j, and cohort k. α is the intercept term. μ_i represents the period effect that varies over time i. β_j represents the age effect that varies across age group j. γ_k represents the cohort effect that varies across birth cohort k. ε_ijt is the error term, capturing unobserved variation or random fluctuations.

Decomposition method

We used a robust decomposition analysis method detailed in previous studies. The decomposition analysis assumed (1) linear effects of population aging and growth, (2) independence between age-specific epidemiological changes and demographic shifts, and (3) stable healthcare reporting practices over the study period. This approach separates the net effect of population ageing from population growth and change in age-specific rates by considering the following three key components: the demographic composition, characterised by a shift toward a larger proportion of older individuals (otherwise known as population ageing); population growth; and age-specific epidemiological changes can be attributed to population ageing, population growth, and changes in age-specific mortality rates.

All the analyses and visualizations in this study were performed in the R language (version 4.2.2), and the differences were considered statistically significant at two-sided P < 0.05.

Results

Burden of migraine among Australia, China, Japan, and Korea in 2021

In Australia, a total of 249,307 (95% UI: 213,859–288,834) incidence and 3,571,618 prevalence (95% UI: 3,065,934–4,120,714), caused 133,811 YLDs (95% UI: 25,591–291,010) from migraine, with the ASIR, ASPR, and ASYR were 1,088.74 (95% UI: 929.52–1,261.42), 13,338.06 (95% UI: 11,292.05–15,572.72), and 494.98 (95% UI: 85.55–1,091.17) respectively. In China, a total of 13,047,221 (95% UI: 11,597,731–14,698,852) incidence and 184,752,280 prevalence (95% UI: 160,836,525–213,633,958), caused 6,988,199 YLDs (95% UI: 1,133,319–15,186,289) from migraine, with the ASIR, ASPR, and ASYR were 975.61 (95% UI: 862.32–1,102.06), 11,777.51 (95% UI: 10,137.56–13,538.56), and 443.65 (95% UI: 66.93–971.68) respectively. In Japan, a total of 840,431 (95% UI: 743,168–946,923) incidence and 13,831,413 prevalence (95% UI: 12,019,194–15,876,263), caused 545,229 YLDs (95% UI: 141,780–1,160,180) from migraine, with the ASIR, ASPR, and ASYR were 873.6 (95% UI: 767.24–994.18), 10,818.4 (95% UI: 9282.5–12,479.88), and 415.34 (95% UI: 88.83–920.24) respectively. In Korea (Republic of), a total of 401,658 (95% UI: 344,821–463,929) incidence and 6,685,316 prevalence (95% UI: 5,762,127–7,766,628), caused 256,226 YLDs (95% UI: 55,454–555,437) from migraine, with the ASIR, ASPR, and ASYR were 937.81 (95% UI: 790.34–1,097.69), 11,812.12 (95% UI: 9,986.5–13,862.85), and 444.1 (95% UI: 81.27–1,003.56) respectively (Table 1).

Table 1 Burden of migraine among Australia, China, Japan, and Korea in 2021 and AAPC from 1990 to 2021

Among different age groups, the highest incidence rate was observed in the 10–14 age group, with the incidence rates were 2198.18 (95% UI: 1499.36–2996.31), 1757.41 (95% UI: 1262.21- 2319.01), 1725.20 (95% UI: 1256.94–2324.54), and 1971.69 (95% UI: 1366.17–2649.44) in Australia, China, Japan, and Korea respectively. However the highest ASPR and ASYR was observed in the 40–44 age group in all 4 countries. Additionally, among all age groups, the female had a heavier burden of migraine (Figs. 1, 2, 3 and 4).

Fig. 1

Burden of migraine regarding the sex and age in Australia in 2021. A Incidence, B Prevalence, C YLDs

Fig. 2

Burden of migraine regarding the sex and age in China in 2021. A Incidence, B Prevalence, C YLDs

Fig. 3

Burden of migraine regarding the sex and age in Korea in 2021. A Incidence, B Prevalence, C YLDs

Fig. 4

Burden of migraine regarding the sex and age in Japan in 2021. A Incidence, B Prevalence, C YLDs

Trends of migraine among Australia, China, Japan, and Korea from 1990 to 2021

From 1990 to 2021, the burden of migraine varies among these countries. In Australia, the burden remained stable during this period. The AAPC of ASIR of migraine in Australia was 0 (95% CI: 0–0), and the AAPC of ASPR and ASYR were 0.01 (95% CI: 0.01–0.01) (Figs. 5 and 6). But for the number, the trends increased, with the incidence number increased from 181,890 (95% CI: 155,325–211,381) in 1990 to 249,306 (95% CI: 213,859–288,834) in 2021, the prevalence number increased from 2,377,221 (95% CI: 2,023,732–2,762,819) in 1990 to 3,571,618 (95% CI: 3,065,934–4,120,713) in 2021, and the YLDs increased from 88,248 (95% CI: 15,628–194,719) in 1990 to 133,810 (95% CI: 25,590–291,010) in 2021 (Fig. 6). In China, the burden remained increased during this period. The AAPC of ASIR of migraine in China was 0.21 (95% CI: 0.19–0.23), and the AAPC of ASPR and ASYR were 0.25 (95% CI: 0.22–0.26) and 0.23 (95% CI: 0.21–0.25) (Figs. 5 and 7). In Japan, the burden was also remained increased during this period. The AAPC of ASIR of migraine in Japan was 0.09 (95% CI: 0.08–0.09), and the AAPC of ASPR and ASYR were 0.09 (95% CI: 0.08–0.09) and 0.07 (95% CI: 0.07–0.08) (Figs. 5 and 8). In contrast, In Korea, the burden was decreased during this period. The AAPC of ASIR of migraine in Korea was −0.1 (95% CI: −0.11 to −0.08), and the AAPC of ASPR and ASYR were 0.09 (95% CI: 0.08–0.09) and 0.07 (95% CI: 0.07–0.08) (Figs. 5 and 9).

Fig. 5

Average annual percent change among four countries from 1990 to 2021. A Incidence, B Prevalence, C YLDs

Fig. 6

Number and rates of migraine in Australia from 1990 to 2021. A Incidence, B Prevalence, C YLDs

Fig. 7

Burden of migraine regarding the sex and age in China in 2021. A Incidence, B Prevalence, C YLDs

Fig. 8

Burden of migraine regarding the sex and age in Japan in 2021. A Incidence, B Prevalence, C YLDs

Fig. 9

Burden of migraine regarding the sex and age in Korea in 2021. A Incidence, B Prevalence, C YLDs

Predictions of burden of migraine among China, Korea, Japan, and Australia from 2022 to 2050

This study utilized the BAPC model to predict the burden of migraine from 2022 to 2050. In Australia, the burden remained stable during in the future. The ASIR of migraine in Australia will be 1,088.63 in 2022 and, 1087.01 in 2050, and the incidence number will be 253,982 in 2022 and 292,495 in 2050 (Figs. 10 and 11). The ASIR of migraine in China will be 970.18 in 2022 and 972.04 in 2050, and the incidence number will be 13,274,743 in 2022 and 10,664,118 in 2050 (Figs. 12 and 13). The ASIR of migraine in Japan will be 869.57 in 2022 and 859.39 in 2050, and the incidence number will be 801,664 in 2022 and 638,255 in 2050 (Figs. 14 and 15). The ASIR of migraine in Korea will be 937.98 in 2022 and 975.34 in 2050, and the incidence number will be 399,662 in 2022 and 296,235 in 2050 (Figs. 16 and 17).

Fig. 10

Predicted age-standardized rates of migraine regarding the sex in Australia from 1990 to 2021. A Incidence, B Prevalence, C YLDs

Fig. 11

Predicted number of migraine regarding the sex in Australia from 1990 to 2021. A Incidence, B Prevalence, C YLDs

Fig. 12

Predicted age-standardized rates of migraine regarding the sex in China from 1990 to 2021. A Incidence, B Prevalence, C YLDs

Fig. 13

Predicted number of migraine regarding the sex in China from 1990 to 2021. A Incidence, B Prevalence, C YLDs

Fig. 14

Predicted age-standardized rates of migraine regarding the sex in Japan from 1990 to 2021. A Incidence, B Prevalence, C YLDs

Fig. 15

Predicted number of migraine regarding the sex in Japan from 1990 to 2021. A Incidence, B Prevalence, C YLDs

Fig. 16

Predicted age-standardized rates of migraine regarding the sex in Korea from 1990 to 2021. A Incidence, B Prevalence, C YLDs

Fig. 17

Predicted number of migraine regarding the sex in Korea from 1990 to 2021. A Incidence, B Prevalence, C YLDs

Decomposition analysis of the change in the number of migrane between 1990 and 2021

In Australia, the incidence of migraine shows a moderate increase (67,415.93), with epidemiological changes contributing the most (141.35%) and aging contributing negatively (−41.7%). Prevalence increases by 1,194,397.07, with contributions from epidemiological changes and population dynamics at 108.97% and 0.43%, respectively. YLDs increase by 45,562.60, with epidemiological changes being the dominant factor (106.53%). The relatively steady growth in Australia’s disease burden may be closely associated with its high-quality healthcare services and widespread health education. In China, the incidence of migraine shows a significant total increase (1,529,123.10), with aging contributing −137.92% to the overall change, indicating a notable negative impact of aging. Population growth (188.38%) and epidemiological changes (49.53%) contribute significantly to the positive change in incidence. Prevalence and YLDs (Years Lived with Disability) exhibit similar trends, with epidemiological changes being the dominant factor, contributing 71.76% and 70.93%, respectively. Improved medical diagnostic technologies and increased awareness have led to more migraine cases being identified. In Japan, there is a marked downward trend in the data. The incidence decreases by 182,259.87, with aging contributing 133.5% to this reduction. Epidemiological changes and population dynamics contribute −16.67% and −16.83%, respectively, highlighting the complex impact of aging on disease burden. Prevalence decreases by 581,243.20, with aging contributing 254.11%, indicating that the reduction in migraine cases is primarily driven by the decline in potential cases due to an aging population. The trends in Korea are more complex. Migraine prevalence increases by 722,858.66 overall, with epidemiological changes (175.63%) being the primary driver of this growth, while population changes (−39.92%) show a significant negative impact. YLDs increase by 35,565.56, mainly influenced by epidemiological changes (134.34%), while aging contributes negatively (−10.47%). Korea faces dual challenges of aging and disease transitions in addressing its disease burden (Table 2 and Fig. 18).

Table 2 Decomposition analysis of migraine between 1990 and 2021

Fig. 18

Decomposition method of migraine number from 1990 to 2021 for four countries. A Incidence, B Prevalence, C YLDs

Discussion

This study provides a comprehensive analysis of the burden of migraine across Australia, China, Japan, and Korea, revealing distinct regional differences in trends, age and gender-specific patterns, and the driving forces behind these variations. While Australia exhibited relatively stable trends in both incidence and prevalence, China showed a substantial increase in migraine burden, Japan experienced a decline, and Korea displayed mixed patterns influenced by opposing factors. Across all countries, the burden was disproportionately higher among females and peaked in prevalence and disability during middle adulthood, with the highest incidence observed in adolescence.

The GBD 2019 report highlights that headache disorders, particularly migraines, hold a prominent position in the global DALY rankings for the 10–49 age group, yet they receive little attention in global health policy debates [10]. Comparing these results to previous studies, the age and gender-specific trends observed align with established evidence that migraine disproportionately affects females and peaks in prevalence during middle adulthood. Migraine is more prevalent among females, particularly women of childbearing age 15–49 years, with the highest incidence observed in this group. Statistics indicate that 21% to 28% of WCBA experience migraines annually [11, 12]. The persistently high ASIR in adolescents (e.g., 2198.18 per 100,000 in Australia) underscores the need for school-based screening programs, while declining AAPC in Japan (− 0.1% annually) reflects successful aging-adapted healthcare policies. Furthermore, compared to males, females exhibit more severe clinical manifestations of migraine. Women with migraines endure longer durations of headaches, migraine symptoms, and migraine-related disabilities, along with a higher burden of comorbidities, which tend to worsen with age [13]. Studies suggest hormonal factors, particularly fluctuations in estrogen levels, play a pivotal role in explaining the higher burden among females [14]. Moreover, the high incidence rates among adolescents may be associated with developmental changes and increased exposure to environmental stressors during these years. These findings underscore the importance of gender-sensitive and age-targeted interventions [15,16,17].

Migraine is the leading cause of disability in Australia [18]. According to 2019 estimates, more than 3.41 million (95% UI: 2.931–3.995 million) Australians suffer from migraines, with a global prevalence of 1%–2%. It is estimated that one in four of these Australians experience migraines [19, 20]. In Australia, real-world evidence suggests a high rate of opioid use for treating acute migraines in emergency situations. Additionally, the prevalence of self-medication and the easy availability of over-the-counter analgesics may also contribute to the national healthcare burden [20,21,22].

In contrast, the significant increase in China’s migraine burden is consistent with previous findings, which highlighted the impact of rapid population growth, urbanization, and enhanced diagnostic capacity. The gradual increase in migraine-related BI observed over the years in our study aligns with previous research findings, confirming the growing prevalence of migraines in China [9]. The 2019 GBD data further corroborates these trends, showing a continuous rise in migraine prevalence in recent years, particularly in East Asia, where the average annual percentage change (AAPC) is approximately 23%, significantly higher than the global AAPC of 5% [23]. The improvement in healthcare access and awareness in China has likely contributed to better recognition of migraine cases, leading to higher reported incidence and prevalence. Previous studies have suggested that disease awareness and the use of prescription medications for migraines appear to be relatively low in East Asia [8]. Many patients identified as having migraines have not sought consultation or are not currently seeing a migraine specialist, and a significant number of patients have not been previously diagnosed with migraines. This indicates underdiagnosis and, consequently, undertreatment of migraines in the region [9]. However, the negative impact of aging on migraine burden in China, as revealed by this study, diverges from patterns observed in other countries and merits further investigation into how aging interacts with cultural, genetic, and healthcare factors. Japan’s declining migraine burden stands out and reflects the broader demographic shifts associated with its aging population. This trend illustrates how an aging society may experience reduced migraine prevalence as the population proportion in higher-risk age groups declines. A workplace-based survey conducted at a Japanese information technology company revealed a high prevalence and burden of migraines among employees, along with significant associated economic costs [24]. A study in Japan found that 36.5% of respondents reported hesitating to seek care for migraines or severe headaches. This hesitation increased with the frequency of headaches, which is concerning because those experiencing frequent headaches are the ones most in need of intervention. One of the most common reasons for hesitation was, “I don’t think they are severe/painful enough,” cited by 20–30% of respondents, suggesting that many Japanese individuals may not fully recognize the impact of migraines on their daily lives. Earlier population studies in Japan also identified similar reasons for not consulting a doctor, including “the headache is not severe enough” (30–36%) or “the headache is not bad enough” (7–15%) [25, 26]. Nevertheless, the potential underdiagnosis of migraine in elderly populations, as highlighted in earlier studies, may lead to an underestimation of its true burden in older age groups. This issue is less evident in Korea, where the burden of migraine remains influenced by both aging and epidemiological changes. The dual effect of these factors in Korea emphasized the challenges of managing chronic conditions amid a rapidly aging population and evolving disease profiles [27]. In China, targeted interventions should prioritize urban populations with improved diagnostic access, while Japan’s aging demographics necessitate geriatric migraine management protocols. South Korea’s dual burden of aging and epidemiological transitions calls for integrated primary care models.

Despite these insights, this study is not without limitations. First, the reliance on GBD data introduces potential biases stemming from incomplete or inconsistent reporting across countries. Although standardized statistical models were applied to address these biases, they cannot fully account for disparities in healthcare access, diagnostic accuracy, or cultural differences affecting disease reporting. Additionally, while this study examined age and gender-specific patterns, it did not explore other potential modifiers, such as socioeconomic status, lifestyle factors, or comorbidities, which could provide a more nuanced understanding of migraine burden. The projections of future trends, while valuable, are based on statistical assumptions that may not fully capture the impact of future healthcare innovations or policy changes. Unmeasured confounders, such as cultural stigma toward mental health in East Asia or temporal shifts in diagnostic criteria (e.g., ICD-10 to ICD-11), may bias reported trends. Future studies should incorporate behavioral surveys to capture self-medication practices and healthcare-seeking behaviors.

Future research should aim to address these gaps by integrating more granular data on socioeconomic and behavioral determinants of migraine. Longitudinal cohort studies could help elucidate causal relationships and provide insights into the mechanisms underlying observed trends. Additionally, cross-country comparisons incorporating healthcare system differences and cultural attitudes toward health could shed light on the variability in migraine management and outcomes. As the global burden of migraine evolves, there is a pressing need for international collaboration to develop comprehensive, evidence-based strategies that address the diverse challenges posed by this condition.

In conclusion, this study contributes to the understanding of migraine burden across four countries by identifying key trends and their underlying drivers. By situating these findings within the context of existing literature, it highlights the critical need for tailored interventions and robust future research to mitigate the global impact of migraine.

Conclusion

This study reveals significant disparities in migraine burden across four Asia–Pacific countries, shaped by distinct demographic, socioeconomic, and healthcare contexts. China faces escalating challenges linked to urbanization and population growth, while Japan’s aging demographics contribute to a declining burden. Australia’s stable trends highlight the effectiveness of its healthcare strategies, whereas South Korea navigates complex interactions between aging populations and evolving disease patterns.

Gender disparities remain a critical concern, with women experiencing disproportionately higher burdens due to biological and sociocultural factors. Addressing these gaps requires tailored interventions: prioritizing adolescent health initiatives, enhancing geriatric care in aging societies, and integrating gender-sensitive approaches into public health policies.

The findings emphasize the need for region-specific strategies that align with demographic shifts and socioeconomic realities. Strengthening healthcare infrastructure, advancing equitable access to diagnostics, and fostering cross-national collaboration are essential steps toward mitigating the migraine burden and improving quality of life across the Asia-Pacific region.