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An international team led by Northumbria University developed and tested a simple five-factor score to estimate three-year dementia risk among older adults in low- and middle-income countries. The researchers say it is intended to support research and trial recruitment, not serve as a general-population screening test; further validation is needed in regions not included in the study.
An international research team led by Northumbria University has developed and validated a five-factor dementia risk score for older people in low- and middle-income countries, where about 60% of people living with dementia are estimated to reside, adding to research on ways to assess future dementia risk. Built from data on more than 11,000 older adults across seven sites, the score can be calculated from a conversation and is intended mainly to help researchers identify participants for studies and trials, not to screen the general population.
The study, published in the American Journal of Epidemiology, draws on data from sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. The researchers say the model achieved an accuracy score of 0.75, above the 0.70 level they describe as generally regarded as clinically useful. That performance figure does not by itself establish how well the score will work in every country or for every individual.
The five factors are age, social engagement, physical activity, high blood pressure and difficulty managing money, areas also addressed by a nurse-led dementia risk program. The assessment can include information from the older person and, where appropriate, a family member or carer. It does not require blood tests, brain scans or specialist equipment, according to the report. Each factor contributes to a total score from 0 to 9.
The study gives estimated three-year dementia risks of about 1% for a score of 0 and nearly 19% for a score of 9. These are estimates associated with the model, not a diagnosis or a guarantee of what will happen to an individual. The team says its principal purpose is to give research projects a practical, lower-cost way to find and recruit people at elevated risk in settings where existing prediction tools may be less suitable, complementing evidence that education may protect against dementia risk.
A Research Tool for Underrepresented Settings
The work addresses a mismatch between where dementia is prevalent and where many prediction models were developed. The report says roughly 60% of the world’s 57 million-plus people with dementia live in low- and middle-income countries, while many existing risk tools were created using data from high-income populations and have transferred poorly to other settings.
A score based on a short conversation could make it easier for researchers to identify potential participants without relying on costly tests or specialist facilities. That may support studies and prevention trials in communities that have had fewer locally suited research tools. The score does not, on the evidence provided, establish that using it prevents dementia or improves an individual’s health outcomes.
Its practical value will depend on whether it performs reliably across different languages, cultures and health systems. The five factors also reflect circumstances that may be reported by family members or carers, so local approaches to asking and interpreting questions will matter. The study offers a research resource, not a replacement for clinical assessment.
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Why Existing Risk Models May Not Transfer
Dementia affects more than 57 million people worldwide, according to the source report. As the share of cases in lower-income countries grows, researchers need ways to study risk that reflect those populations and the resources available in their settings.
The report says most existing prediction tools were developed with data from high-income countries and have shown limited transferability elsewhere. The new model was developed with the 10/66 Dementia Research Group network and tested across seven sites in Latin America, the Caribbean and Asia. It was funded by the National Institute for Health and Care Research using UK government international development funding, with additional support from Dementia Australia.
Among the factors, age is described as the strongest single predictor, with risk rising from age 70 and more steeply from 80 onward. The score also includes social contact and everyday activity, including work, walking and household tasks. High blood pressure is included because it can damage brain-supplying blood vessels over time and may go undiagnosed; financial-management difficulty is assessed as a possible change noticed in daily life.
“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, Applied Statistics and Data Science Research Group, Northumbria University
Where the Score Still Needs Testing
The model has been tested in seven sites across three continents, but the researchers call for validation in regions not covered, particularly South Asia, the Middle East and North Africa, and Sub-Saharan Africa. Its reported accuracy score does not show whether performance will be similar in those regions or in every local community.
The source does not provide detailed breakdowns of accuracy across demographic groups, nor does it establish how the score compares with other tools in routine clinical practice. It also does not present evidence that using the score itself changes dementia rates or patient outcomes. The researchers describe it as a tool for research and trial recruitment rather than routine population screening.
Further Validation Before Wider Use
The researchers are calling for the score to be tested in additional regions and diverse populations before its suitability beyond the study sites can be judged. Such validation would help determine whether the questions and estimated risks remain useful across different languages, social conditions and health systems.
For now, the stated next step is further research into whether the score can help identify and recruit higher-risk participants for studies and clinical trials. The report does not specify a timeline for those studies or for any decision about routine clinical use. Any broader application would require evidence beyond the seven sites included in this study.
Key Questions
What does the new dementia risk score measure?
It combines five factors—age, social engagement, physical activity, high blood pressure and difficulty managing money—to estimate a person’s dementia risk over three years.
Does the score diagnose dementia?
No. It is a risk estimate, not a diagnosis, and the researchers say it is intended mainly to support research and trial recruitment rather than routine screening of the general population.
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 model’s reported accuracy score was 0.75.
Where does the tool still need validation?
The researchers specifically call for testing in South Asia, the Middle East and North Africa, and Sub-Saharan Africa, along with further validation across diverse regions.
Source: news-medical.net
