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A Northumbria University-led team developed and tested a five-factor score to estimate three-year dementia risk among older people in low- and middle-income countries. Based on data from more than 11,000 adults in seven countries, it is intended to help research studies and trials identify participants—not to serve as a routine public screening test. Researchers say the model needs testing in additional regions.
A Northumbria University-led international team has developed and validated a five-factor score to estimate dementia risk among older people in low- and middle-income countries (LMICs), where around 60% of people living with dementia reside. The score uses information gathered through a conversation and is intended to support research and clinical trials, not routine screening of 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 researchers report an accuracy score of 0.75, above the 0.70 level they describe as generally regarded as clinically useful.
The score combines five factors: age, social engagement, physical activity, high blood pressure and difficulty managing money. Researchers say each can be assessed in a straightforward conversation with an older person and, where appropriate, a family member or carer. The method does not require blood tests, brain scans or specialist equipment.
Points across the five factors produce a total from 0 to 9. In the model, 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 are estimates from the study’s model, not a diagnosis or a guarantee of an individual’s future health.
A Tool for Research Where Resources Are Limited
The score addresses a gap in dementia research: many existing prediction tools were developed using data from high-income countries, and the researchers say those tools have transferred poorly to other settings. That can make it harder for studies in LMICs to identify people at higher risk and to plan prevention research around local populations.
A tool based on questions and everyday information could lower practical barriers to research in places where access to specialist testing is limited. The team’s stated purpose is to help researchers identify and recruit participants for studies and clinical trials. It is not presented as a population-wide screening program, and a higher score does not establish that someone has dementia.
The potential relevance is broad: the source report says dementia affects more than 57 million people worldwide, with roughly six in 10 living in LMICs. But the score’s usefulness beyond the countries in the study cannot be assumed; results would need to hold in other populations and health systems.
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Why Existing Risk Scores Fell Short
Dementia risk models are used to estimate who may be more likely to develop the condition, but a model built in one population may not perform as well elsewhere. Differences in health, living conditions and available data can affect how well its factors predict outcomes. The study’s authors say models created in wealthier countries have not reliably transferred to LMIC settings.
The new score includes factors that can be discussed without specialist equipment. Age was described as the strongest individual predictor, with risk rising from age 70 and more steeply from 80. Social engagement includes living arrangements and contact with friends, family or community groups. Physical activity covers work and leisure, including daily movement such as farming, walking and household tasks. The other factors are uncontrolled high blood pressure and a reported change in a person’s ability to manage money.
The work was funded by the National Institute for Health and Care Research using UK Government international development funding, with additional support from Dementia Australia. The research involved colleagues across the 10/66 Dementia Research Group network, according to the report.
“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 in Latin America and Asia, but the team says further validation is needed in regions not represented, particularly South Asia, the Middle East and North Africa, and Sub-Saharan Africa. It is not yet clear how accurately the score would perform across those populations or in settings with different patterns of health, social life and access to care.
The reported accuracy score of 0.75 reflects the model’s performance in the study data; it does not show that the tool will work equally well in every country or for every individual. The source report does not provide details on how the score would be implemented in local research programs, or whether further changes might be needed after testing in new regions. Its role remains research-focused rather than routine clinical screening.
Regional Validation Is the Next Step
The research team is calling for the score to be tested in additional regions, especially South Asia, the Middle East and North Africa, and Sub-Saharan Africa. That work would help establish whether the model’s performance carries over to communities not included in its development and validation.
Until further evidence is available, the score’s clearest proposed use is as a low-cost research tool for identifying and recruiting people at elevated risk for studies and trials. The source report does not set out a timeline for new validation studies or say when the score might be adopted by research groups in other regions.
Key Questions
What does the new dementia risk score measure?
It estimates the chance of developing dementia within three years using five factors: age, social engagement, physical activity, high blood pressure and difficulty managing money. The score ranges from 0 to 9.
Is the score meant for routine public screening?
No. The researchers describe it primarily as a tool to help research studies and clinical trials identify and recruit people at higher risk, not as routine screening for the general population.
How was the model tested?
The study used 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.
Does a high score mean someone has dementia?
No. The score estimates risk; it does not diagnose dementia or determine what will happen to an individual. The figures reported are model estimates for a three-year period.
What further work is needed?
The researchers say the model should be validated in regions not included in the study, including South Asia, the Middle East and North Africa, and Sub-Saharan Africa. Its performance in those settings is not yet established.
Source: news-medical.net
