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Researchers led by Northumbria University developed and validated a five-factor score to estimate three-year dementia risk among older adults in low- and middle-income countries. It uses information gathered in conversation and is intended to support research recruitment, not routine screening; further validation is needed in regions not studied.
An international team led by Northumbria University has developed and tested a conversational score that estimates dementia risk in older adults in low- and middle-income countries, using data from more than 11,000 people across seven countries. Published in the American Journal of Epidemiology, the tool is designed to help research teams identify people for studies and trials; it is not presented as a routine screening test.
The score combines five factors: age, social engagement, physical activity, high blood pressure and difficulty managing money. Researchers say the information can be gathered through a straightforward conversation with an older person and, where relevant, a family member or carer. The method does not require blood tests, brain scans or specialist equipment.
Each factor contributes to a total score from 0 to 9. In the study’s estimates, a score of zero corresponded to about a 1% chance of developing dementia within three years, while a score of nine corresponded to nearly 19%. The researchers reported an accuracy score of 0.75, above the 0.70 threshold they describe as generally regarded as clinically useful.
The model was developed and tested at sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. The study received funding from the UK National Institute for Health and Care Research through UK government international development funding, with additional support from Dementia Australia.
A Research Tool for Underserved Settings
The score addresses a gap in dementia research: according to the report, around 60% of people living with dementia are in low- and middle-income countries, while many existing prediction tools were built using data from high-income countries and have transferred poorly to other settings. A low-cost approach based on familiar questions could make it more practical to identify and recruit participants where access to specialist testing is limited.
That matters for research on prevention and risk because studies need ways to find people likely to develop dementia. The findings do not establish that the score prevents dementia, diagnoses it, or improves health outcomes. Its stated role is narrower: helping researchers select people for future studies and trials, with local validation still needed before wider use.
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Why Existing Risk Tools Fall Short
Dementia affects more than 57 million people worldwide, according to the source report. The burden is concentrated increasingly in lower-income regions, but prediction models have largely been developed using populations in wealthier countries. Differences in health systems, living conditions and the availability of medical tests can make direct transfer uncertain.
The five factors were selected to be assessable through everyday conversation. Age was identified as the strongest single predictor, with risk rising from age 70 and more steeply from 80 onward. Social engagement includes living arrangements and contact with family, friends or community groups; physical activity includes daily movement such as walking, farming and household tasks. The score also includes high blood pressure and changes in a person’s ability to manage money.
Professor Dame Louise Robinson of Newcastle University, who led the NIHR-funded programme, credited colleagues in the 10/66 Dementia Research Group network for enabling the work. The researchers say the tool was designed around settings where access to more resource-intensive assessments may be constrained.
“This model is a step towards changing that. It is simple, it is built for the settings where it is needed most.”
— Dr. Eduwin Pakpahan, Northumbria University’s Applied Statistics and Data Science Research Group
Where the Score Still Needs Testing
The study covered seven sites in Latin America, the Caribbean and Asia, but the researchers called for validation in regions not included, particularly South Asia, the Middle East and North Africa, and sub-Saharan Africa. Its performance in those populations is not yet established. The source report does not provide details here about how well the model performed at each individual site or whether accuracy differed among groups.
The score estimates risk; it does not determine whether someone has dementia or guarantee that dementia will develop. The report also does not say that the tool is ready for general-population screening. Its stated purpose is research recruitment, and how it might be adapted for any clinical use remains unclear.
Validation Beyond the Seven Sites
The researchers are calling for the score to be tested in additional regions, including South Asia, the Middle East and North Africa, and sub-Saharan Africa. Further studies could show whether the factors and risk estimates work reliably across different populations and community settings.
For now, the next step described by the team is broader validation and use as a potential aid to research recruitment. The source material does not set out a timetable for those studies or specify plans for clinical rollout. People concerned about memory or changes in daily functioning should seek guidance from a qualified health professional rather than use this research score as a diagnosis.
Key Questions
What does the dementia risk score measure?
It estimates the likelihood of developing dementia within three years, based on a total score from zero to nine. It is a risk estimate, not a diagnosis.
Which factors are included?
The five factors are age, social engagement, physical activity, high blood pressure and difficulty managing money. The researchers say they can be assessed through conversation, with input from a family member or carer where relevant.
Is this tool intended for routine screening?
No. The researchers describe it primarily as a tool for research studies and clinical trials, not as a routine screening test for the general population.
Where has the score been tested?
The study used data from sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. The researchers say further validation is needed in other regions.
Source: news-medical.net
