Population-based door-to-door survey of migraine in Japan: the Daisen study.
OBJECTIVE
To determine prevalence and characteristics of migraine in Japan, and to investigate use of medical care and whether food preference is associated with risk of migraine.


METHODS
Structured questionnaires were given to all adult residents (N = 5758; 2681 men and 3077 women) in Daisen, a rural community in western Japan. Second questionnaires, specific to headache, were given to 1628 residents with headache. A telephone survey was also carried out. Statistical Packages for the Social Sciences analyzed the data.


RESULTS
The 1-year prevalence of migraine was 2.3% (migraine with aura, 0.4% and without aura, 1.9%) in men and 9.1% (migraine with aura, 1.0% and migraine without aura, 8.1%) in women. Overall prevalence of migraine in Daisen was 6.0% (95% confidence interval [CI], 5.4% to 6.6%). Women observed a 5.9-fold higher risk of migraine than men (odds ratio, 5.9; 95% CI, 4.5 to 8.0; P <.0001, after age adjustment, by logistic analysis). Fatigue and loss of vigor were predominant premonitory symptoms of migraine. Fatigue, mental stress, and lack of sleep were the main headache triggers. Over a 3-month period, 20.3% of migraineurs experienced time or days off work due to headache. Only 7.3% of those with migraine with aura and 5.3% of those with migraine without aura had consulted a physician, and of those with migraine, 61.0% with aura and 71.8% without aura had never visited a medical doctor for their headache. Consumption of alcohol and cigarette smoking did not influence the risk for migraine or tension-type headache, after age and gender adjustment (logistic analysis). Migraineurs consume significantly more fatty/oily foods, coffee, and tea than nonheadache subjects of the same community. Migraineurs consume significantly fewer fish than nonheadache residents.


CONCLUSIONS
Only a few Japanese migraineurs receive benefits of medical services and recent advances of headache medicine. Public education concerning headaches is one of the most urgent issues in Japan.
Department of Neurology, Institute of Neurological Sciences, Tottori University Faculty of Medicine, Yonago, Japan.
Takao
T
Takeshima
Kumiko
K
Ishizaki
Yoko
Y
Fukuhara
Tamami
T
Ijiri
Masayoshi
M
Kusumi
Yosuke
Y
Wakutani
Masatada
M
Mori
Mika
M
Kawashima
Hisanori
H
Kowa
Yoshiki
Y
Adachi
Katsuya
K
Urakami
Kenji
K
Nakashima
D000328:Adult; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008881:Migraine Disorders / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D012424:Rural Population / Q000706:statistics & numerical data