Lifetime Probability of Developing Migraine: A Novel Epidemiological Perspective Based on Global Burden of Disease...

Migraine affects over one billion people worldwide and imposes substantial burdens, yet the lifetime risk of developing migraine has been understudied. Using Global Burden of Disease 2021 data, we estimated age-, sex-, and location-specific lifetime probabilities with the adjusted-for-multiple-primaries method, which accounts for competing mortality and life expectancy. Trends were quantified by average annual percentage change, socioeconomic inequality by concentration indices, and future trajectories with autoregressive integrated moving average models. In 2021, the global lifetime probability of migraine was 51.53% (95% CI: 51.51%-51.55%); females faced a higher risk than males (59.84% vs. 41.99%; ratio: 1.42). Regional estimates ranged from 60.58% in Western Europe to 35.63% in Eastern Sub-Saharan Africa, paralleling the sociodemographic index gradient (high SDI 55.74% vs. low SDI 45.13%). Risk accumulated mainly during early and middle adulthood. The concentration index declined from 0.35 in 1990 to 0.27 in 2021, indicating reduced socioeconomic disparities, while projections suggest global lifetime risk will rise to 57.18% by 2050. Roughly half the world's population is therefore expected to experience migraine during their lives, with pronounced heterogeneity by sex, region, and socioeconomic level, underscoring the need for targeted public-health strategies, particularly for younger individuals during high-riskperiods.