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A Northumbria University-led team developed and tested a five-factor score to estimate three-year dementia risk among older adults in low- and middle-income countries. It uses information collected through a conversation and is intended to support research and trial recruitment, not routine population screening; validation in other regions is still needed.
An international 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), where an estimated 60% of people living with dementia reside. The researchers say the tool can be applied using information gathered in a straightforward conversation, but its intended use is to help research studies identify participants at elevated risk—not to screen the general population.
The study, published in the American Journal of Epidemiology, used data from more than 11,000 older adults across seven countries: China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. The team developed and validated the model across those study sites. It reported an accuracy score of 0.75, above the 0.70 threshold the report describes as generally regarded as clinically useful.
The score draws on five factors: age, social engagement, physical activity, high blood pressure and difficulty managing money. Information can be gathered from the older person and, where relevant, a family member or carer. The assessment does not require blood tests, brain scans or specialist equipment, according to the report.
Each factor contributes points to a total from 0 to 9. The researchers estimate that a score of 0 corresponds to about a 1% chance of developing dementia within three years, while a score of 9 corresponds to a chance of nearly 19%. These figures describe risk estimates from the model, not a diagnosis or an individual’s certainty of developing dementia.
A Research Tool for Underserved Settings
The score addresses a gap in dementia research: prediction tools have largely been developed using data from high-income countries, and the report says they have transferred poorly to other settings. Yet LMICs are home to a large share of people living with dementia, while researchers there have had fewer locally relevant ways to identify people who may be at higher risk.
A low-cost assessment based on everyday information could help research teams and clinical trials recruit participants without relying on specialist tests or equipment. That could support studies of prevention and risk in communities that have been less represented in research. The study does not establish that using the score will prevent dementia or improve outcomes, and the authors frame it as a practical research resource rather than a clinical screening recommendation.
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Why Existing Risk Models Fell Short
Dementia affects more than 57 million people worldwide, with around 60% living in LMICs across Latin America, the Caribbean, Asia and Africa, according to the source report. The distribution of dementia means that tools designed around wealthier populations may not perform reliably when applied to different populations and health systems.
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 programme involved researchers across the 10/66 Dementia Research Group network. The countries included in this analysis span Latin America, the Caribbean and Asia, but the study did not cover all regions where the tool could potentially be used.
“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’s Applied Statistics and Data Science Research Group
Validation Outside Seven Study Sites
The reported testing covered seven sites in seven countries, not every population or health system in LMICs. The researchers have called for further validation, particularly in South Asia, the Middle East and North Africa, and Sub-Saharan Africa. It remains unclear how accurately the score would estimate risk in those regions or in communities with different social, health and demographic characteristics.
The report does not provide evidence that the tool has been adopted for routine care, nor does it recommend using it as a general-population screening test. A risk estimate is not a diagnosis, and the supplied material does not establish how the score would affect clinical decisions or health outcomes if used beyond research.
Testing the Score in More Regions
The next step identified by the researchers is to validate the model in populations not included in the study, especially in regions across Africa, the Middle East and South Asia. Further testing would help establish whether its estimates remain useful across different local settings.
For now, the team presents the score as a way for research studies and trials to identify people who may be at higher risk. The source report does not specify a timetable for additional validation or describe plans for a routine clinical rollout.
Key Questions
What does the new dementia risk score assess?
It combines five factors: age, social engagement, physical activity, high blood pressure and difficulty managing money. Information can be gathered through a conversation with an older adult and, when relevant, a family member or carer.
Is the score a dementia diagnosis?
No. It estimates the likelihood of developing dementia within a three-year period; it does not diagnose dementia or establish that a person will develop it. The study describes the score as a research tool, not a routine screening test.
How was the model tested?
The team used data from more than 11,000 older adults at seven study sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. The researchers reported an accuracy score of 0.75.
Where does the score still need validation?
The researchers called for testing in additional regions, particularly South Asia, the Middle East and North Africa, and Sub-Saharan Africa. Its performance in those populations has not been established by the study described in the report.
Source: news-medical.net
