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An international team led by Northumbria University developed and validated a simple five-factor score to estimate dementia risk in older adults in low- and middle-income countries. It is intended to help research studies and trials identify people at higher risk, not to serve as a general-population screening test; further validation is needed in regions not included in the study.
An international team led by Northumbria University has developed and tested a five-factor score to estimate dementia risk among older adults in low- and middle-income countries. The tool uses information gathered in a conversation, without blood tests, brain scans or specialist equipment, and is intended mainly to help research studies and trials identify people at higher risk—not to screen the general population.
The model was developed and validated using data from more than 11,000 older adults across seven study sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. The researchers reported an accuracy score of 0.75, above the 0.70 threshold generally regarded as clinically useful. That figure describes the model’s performance in the study; it does not mean that any individual risk estimate is certain.
The score draws on five factors: age, social engagement, physical activity, high blood pressure and difficulty managing money, all examples of modifiable dementia risk factors. Each contributes to a total from zero to nine. The researchers estimate that a score of zero corresponds to about a 1% chance of developing dementia within three years, while a score of nine corresponds to nearly 19%.
According to the report, age is the strongest individual predictor, with risk rising from 70 and more steeply from 80. Social engagement includes living arrangements and contact with friends, family or community groups. Physical activity includes everyday movement such as walking, farming or household tasks. The money-management factor is based on a family member’s or carer’s observation of a noticeable change in the person’s ability to handle finances.
A Research Tool for Underserved Settings
The score addresses a mismatch between where dementia is increasingly common and where many risk-prediction tools were developed. The report says around 60% of people living with dementia are in low- and middle-income countries, while many existing prediction models were built using data from high-income countries and have transferred poorly to other settings.
A tool that relies on a brief conversation rather than specialist tests could make it easier for researchers to identify and recruit participants where health resources are limited. That may support prevention research and clinical trials designed around local populations. But the study does not establish that using the score prevents dementia, improves clinical outcomes or is ready for routine use by health services.
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Why Existing Models May Not Transfer
Dementia affects more than 57 million people worldwide, according to the report, and the burden is shifting toward lower-income regions. Researchers and clinicians use risk models to estimate who may be more likely to develop dementia, but a model built on one population may not perform reliably in another.
The study, published in the American Journal of Epidemiology, was funded by the UK National Institute for Health and Care Research using UK Government international development funding, with additional support from Dementia Australia. The work involved researchers in the 10/66 Dementia Research Group network, according to the report.
Dr. Eduwin Pakpahan of Northumbria University said the model gives researchers a practical way to focus future studies and trials on people at elevated risk. Professor Blossom Stephan of Curtin University described it as a foundation for more inclusive prevention research, while stressing the need for validation in additional regions.
“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 seven study sites cover parts of Latin America and China, but the researchers have called for further testing in South Asia, the Middle East and North Africa, and Sub-Saharan Africa. The reported accuracy score does not establish how well the model will perform in those regions or in other populations with different social, health and service conditions.
The source material does not specify how the score performs for particular age groups or demographic subgroups, or whether its estimates remain calibrated across different settings. It also does not report that the tool has been adopted for routine clinical care. Its stated purpose is research recruitment and risk identification; a score should not be treated as a dementia diagnosis or a guarantee of future disease.
Testing Beyond the Seven Sites
The next stated step is to validate the score in regions that were not represented in the study, especially South Asia, the Middle East and North Africa, and Sub-Saharan Africa. Those studies would help show whether the model’s estimates and performance hold across a wider range of communities.
For now, researchers can assess the score as a practical way to identify potential participants for studies and trials in the settings represented by the data. The source report does not give a timetable for additional validation or describe plans for clinical rollout. Any broader use will depend on further evidence about how reliably the score works in local populations.
Key Questions
What is the new dementia risk score for?
It is designed mainly to help research studies and clinical trials identify older adults at elevated risk in low- and middle-income settings. The researchers do not present it as a routine screening test for the general population.
What factors does the score use?
It uses age, social engagement, physical activity, high blood pressure and difficulty managing money. Information can be gathered through a conversation with the older adult and, where relevant, a family member or carer.
How was the model tested?
The team used data from more than 11,000 older adults at seven sites in China and Latin America. The researchers reported an accuracy score of 0.75 in the study.
Can the score diagnose dementia?
No. The score estimates risk and is intended for research use; it is not a dementia diagnosis. The report does not establish it as a routine clinical screening tool.
Where does the model still need testing?
The researchers called for validation in South Asia, the Middle East and North Africa, and Sub-Saharan Africa, as well as further testing across diverse settings.
Source: news-medical.net
