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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. The researchers say it is intended to support research and trial recruitment, not routine population screening, and call for testing in regions not included in the study.
A Northumbria University-led international team has developed and validated a five-factor dementia risk score for older adults in low- and middle-income countries, using data from more than 11,000 people across seven sites. Published in the American Journal of Epidemiology, the model is designed to help researchers identify people at elevated risk without blood tests, brain scans or specialist equipment; its authors say it is not a routine screening test for the general public.
The score draws on information that can be gathered through a conversation with an older person and, where relevant, a family member or carer. Its five factors are age, social engagement, physical activity, high blood pressure and a noticeable change in the person’s ability to manage money. The researchers assign points across these factors to produce a total score from 0 to 9.
According to the study description, 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%. The model was developed and tested using data from China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. It recorded an accuracy score of 0.75; the researchers say 0.70 is generally regarded as a threshold for clinical usefulness.
The team describes the tool’s main role as supporting research studies and clinical trials, including identifying and recruiting participants at higher risk. The study was funded by the National Institute for Health and Care Research using UK government international development funding, with additional support from Dementia Australia.
A Research Tool for Underrepresented Regions
The score addresses a gap between where dementia is common and where many prediction tools were developed. The report says more than 57 million people worldwide live with dementia and around 60% are in low- and middle-income countries. Yet existing risk models have largely been built from data in high-income countries and, according to the researchers, have transferred poorly to other settings.
A tool that relies on questions rather than costly tests could give research teams in lower-resource settings a more practical way to identify people for prevention studies and trials. That may help research better reflect local populations. The findings do not establish that using the score will prevent dementia, improve health outcomes or make it suitable for individual diagnosis.
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Why Existing Risk Models May Fall Short
Dementia risk prediction depends on how well a model fits the population and circumstances where it is used. The research team says many existing tools were developed with high-income-country data, limiting their reliability when applied elsewhere. The new score instead draws on data from seven sites in Latin America, the Caribbean and Asia.
The five factors combine personal and social information with health and daily-function indicators. Physical activity includes routine movement such as walking, household tasks or farming, according to the report. The money-management question focuses on a noticeable change, rather than treating difficulty with finances alone as proof of dementia. The score is an estimate of risk over a stated three-year period, not a diagnosis.
“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
Where the Score Still Needs Testing
The study covered seven sites, but it does not establish how accurately the score will perform across all low- and middle-income countries. The researchers specifically called for validation in South Asia, the Middle East and North Africa, and Sub-Saharan Africa, regions not covered by the reported sites. Performance may vary across populations and health systems, and the source material does not give a separate accuracy estimate for each site.
It is also unclear from the available report how the score would perform if used outside research settings or how it compares head-to-head with other tools in particular countries. The stated three-year probabilities are estimates associated with score totals; they should not be read as an individual diagnosis or a guarantee of what will happen.
Validation Beyond the Seven Study Sites
The next step identified by the researchers is to test the model in more diverse regions, including those not represented in the current analysis. Further validation would help establish whether the score remains accurate across different communities and whether it can support locally relevant research recruitment.
For now, the authors frame the score as a tool for studies and clinical trials rather than routine screening. The available material does not announce a timetable for additional studies or a plan to deploy the score in public health services.
Key Questions
What does the new dementia risk score measure?
It estimates the chance of developing dementia within three years using age, social engagement, physical activity, high blood pressure and changes in managing money. The total score ranges from 0 to 9.
Is the score intended to diagnose dementia?
No. The researchers describe it primarily as a research and clinical-trial tool for identifying people at higher risk, not as a diagnostic test or routine screening test for the general population.
How accurate was the model in the study?
The model recorded an accuracy score of 0.75 across the seven study sites. The researchers say 0.70 is generally regarded as a threshold for clinical usefulness, but the reported result does not show performance in every country or region.
Which countries were represented?
The score was developed and tested using data from sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru.
What further research is needed?
The researchers call for validation in regions not included in the study, especially South Asia, the Middle East and North Africa, and Sub-Saharan Africa. The report does not give a schedule for that work.
Source: news-medical.net
