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An international team led by Northumbria University developed and tested a five-factor score to estimate dementia risk among older adults in low- and middle-income countries. It uses information gathered in conversation and is intended to help research studies recruit participants, not to serve as a general screening test. Researchers say it needs testing in regions not covered by the study.
An international research team led by Northumbria University has developed and tested a five-factor score to estimate dementia risk among older people in low- and middle-income countries (LMICs). The score uses information that can be gathered through a conversation and is intended primarily to help research studies and trials identify people at higher risk, rather than to screen the general population.
The study, published in the American Journal of Epidemiology, drew on data from more than 11,000 older adults across seven sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. The team reported an accuracy score of 0.75, above the 0.70 threshold the report describes as generally regarded as clinically useful. That figure measures the model’s performance in the study; it does not mean the score can diagnose dementia in an individual.
The five factors are age, social engagement, physical activity, high blood pressure and difficulty managing money. The score assigns a total from 0 to 9. According to the study report, a score of 0 corresponds to about a 1% chance of developing dementia within three years, while a score of 9 corresponds to nearly 19%. These are estimates from the model, not guarantees about any individual’s future health.
The researchers say the information can be collected without blood tests, brain scans or specialist equipment. Social engagement includes whether someone lives with others, sees friends or family and participates in community or religious groups. Physical activity includes everyday movement such as walking, farming or household work. A relative or carer may be asked about a noticeable change in the person’s ability to manage finances.
A Research Tool for Underrepresented Settings
The score addresses a gap in dementia research: tools developed using data from high-income countries may not work as well in different populations and health systems. The report says around 60% of people living with dementia are in low- and middle-income countries, where researchers have had fewer locally relevant ways to identify people at elevated risk for studies.
A low-cost approach based on a conversation could make it easier for research teams to recruit participants in places with limited access to specialist equipment. That could support studies and prevention trials whose participants better reflect local populations. However, the study does not establish that using the score itself prevents dementia, improves treatment or should determine an individual’s care.
The distinction between research use and routine screening matters. The authors describe the score as a practical way to select people for future research, not as a diagnostic test or an established population-screening program. Its reported performance and risk estimates should be understood within the settings and data used to develop and test it.
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Why Existing Risk Models May Not Transfer
Dementia affects more than 57 million people worldwide, according to the source report, and the number of people affected in LMICs has grown to represent about three-fifths of the global total. Yet prediction models have largely been built from data in wealthier countries. Differences in population characteristics and local conditions can limit how well such models apply elsewhere.
The research was funded by the National Institute for Health and Care Research using UK government international development funding, with additional support from Dementia Australia. The work involved the 10/66 Dementia Research Group network, whose contributors helped make the multi-country study possible. The seven study sites span China and parts of Latin America and the Caribbean, but do not cover every region where dementia research capacity is needed.
“This model is a step towards changing that. It is simple, it is built for the settings where it is needed most, and it gives researchers a practical way to find the people who should be the focus of future studies and trials.”
— Dr. Eduwin Pakpahan, Northumbria University
Regions Still Awaiting Validation
The model was tested in seven sites across China and Latin America and the Caribbean, but the report calls for further validation in South Asia, the Middle East and North Africa, and Sub-Saharan Africa. Its accuracy in those regions is not yet established. The source material also does not specify how well the score performs across different local communities or health systems within the study countries.
The score estimates risk; it does not confirm whether someone has dementia or explain the cause of cognitive changes. The report does not establish that it is suitable for routine clinical screening. Further evidence would be needed before drawing conclusions about its use outside research recruitment or about how the estimates translate into decisions for individuals.
Further Testing Across More Regions
The researchers are calling for the score to be assessed in populations not included in the current study, particularly in South Asia, the Middle East and North Africa, and Sub-Saharan Africa. Such validation would show whether the model’s risk estimates and performance hold across a broader range of settings.
For now, the reported next step is further research rather than general-population screening. Future studies can test whether the conversation-based score is useful for recruiting participants and whether it performs consistently in new populations. The source report does not give a timeline for those studies or say when the tool might be adopted by particular research or health programs.
Key Questions
What does the new dementia risk score measure?
It combines age, social engagement, physical activity, high blood pressure and difficulty managing money to estimate the chance of developing dementia within three years.
Is the score a dementia diagnosis or general screening test?
No. The researchers describe it as a research tool for helping studies and trials identify people at higher risk. It does not diagnose dementia, and the report does not recommend it for routine population screening.
How was the score tested?
The team used data from more than 11,000 older adults at seven sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. The study reported an accuracy score of 0.75.
Where does the model still need testing?
The researchers have called for validation in South Asia, the Middle East and North Africa, and Sub-Saharan Africa, regions not represented in the reported study sites.
Source: news-medical.net
