More women in Delhi suffer from headaches, face ‘huge disease burden’: AIIMS-GB Pant hospital study

Finally, she consulted a neurologist at GB Pant Hospital in 2023 and was diagnosed with migraine.

Today, she is in far better shape. “I now take propranolol 80 mg for my headaches,” she adds.

Mahima is not alone.

A study conducted last year, focusing on 2,066 participants in Delhi-NCR, found that headaches — including migraines and tension-type headaches — are leading to disability, significantly affecting an individual’s ability to work and manage daily activities.

Findings from the first phase of the study showed that throughout 2024, around 67.9% people reported having headaches, and about 26.3% had migraines. On average, participants experienced moderate intensity headaches about 9.5% of the time throughout the year.

Women were also found to have a higher prevalence of headaches than men.

According to Dr Debashish Chowdhary, Director, Professor, and Head of the Neurology Department at GB Pant Hospital, headaches and migraines have become a huge burden.

The study was conducted by him in collaboration with doctors from AIIMS.

According to Dr Anand Krishnan, Professor, Centre for Community Medicine at AIIMS Delhi, and co-author, the participants were from Ballabgarh, Dakshinpuri, and an upscale South Delhi colony.

What the study found

First, women had a higher prevalence of headaches than men, said Dr Krishnan. “These headaches were primary disorders, not caused by any underlying health issue.”

Second, he said, the headaches cause significant disability and affect the quality of life and work.

Further, the study found that the total time spent per month experiencing headaches ranged from 5.5% to 6.6%.

Out of the total participants, 8.2% reported migraine, which was much more burdensome than a tension-type headache at 1.7%. Women with migraine (8.7%) or tension-type headache (2.0%) were more burdened than men (6.0% and 1.0% respectively).

Migraine also caused a significant amount of health problems for individuals (3.6%).

However, the overall burden was highest in people who had probable medication-overuse headaches (pMOH) or other types of headaches that occurred more than 15 days a month. Tension-type headaches caused the least burden.
However, for all types of headaches, participation in household activities was more impaired than in paid work, which was minimally affected. On average, men lost 0.3 days per month of paid work, while women lost 0.1 days.

Impaired participation in social or leisure activities was negligible. Headaches reported on the previous day affected only 1.8% of overall activity participation across all domains.

Analysing the ‘disease burden’

Dr Chowdhary said the study was conducted to know the prevalence of headache disorder in Delhi-NCR and, in general, its implications for the Indian scenario. “We wanted to know the disease burden, the cost, and how many patients are disabled by frequent headaches, divided by subtypes,” he said.

There is a concept called Disability-Adjusted Life Years (DALYs), which accounts for the total years lost due to ill health — whether from premature death, morbidity, or disability. “Since headache disorders are not typically fatal, we refer to the impact as Years Lost to Disability (YLDs). Studies have found that migraine ranks as the second most disabling condition after stroke. This highlights the significant burden of the disorder,” he explained.

“In the study, when assessing the burden, we found that, on average, individuals experienced three attacks a month — a substantial frequency that would warrant prophylactic treatment for most patients,” said Dr Chowdhary.

“Secondly, the severity was also high. On a scale of 1 to 3, most participants rated their pain between 2.1 and 2.2. indicating that the majority were suffering from severe headaches.”

“The third factor is the proportion of time spent in the ictal state — that is, the period during which a person is actively experiencing a headache in a month,” he explained. “This was found to be quite high, around 8.6% per month.”

Dr Chowdhary said the study also examined health loss specifically due to headaches and found it to be significantly high, 3.2%. This figure reflects the health burden from headaches alone, excluding any other ailments the individual may have.

There are various types of headaches as well.

The first is medication-overuse headache.

“When people take excessive medication to relieve headaches, it creates a cycle known as medication-overuse headache. In the study, a significant proportion of patients, 4.5%, had probable medication-overuse headache,” he said.

Then, there is chronic daily headache. Dr Chowdhary said it is characterised by recurring headaches for 15 days or more each month. The study found that this affected 3.2% of those part of the study.

“One quarter (26%) of the population aged 18-65 years would be expected to benefit from health care, meeting our criteria for need: 16.1% with migraine, 6.4% with chronic daily headache,” noted the study.

What should be done on a policy level?

Dr Debashish says the economic cost due to productivity loss is enormous. “We have another paper awaiting publication where we calculated the productivity costs lost to the nation… The government should take notice and establish headache care structures at the primary, secondary, and tertiary levels, which could save significant resources,” he added.

The paper is titled ‘Headache-attributed burden and a health-care needs assessment in Delhi and National Capital Region of India: estimates from a cross-sectional population-based study’.