Dementia risk prediction modelling in low- and middle-income countries: current state of evidence.

Frontiers in epidemiology Pub Date : 2024-09-18 eCollection Date: 2024-01-01 DOI:10.3389/fepid.2024.1397754
Maha Alshahrani, Serena Sabatini, Devi Mohan, Jacob Brain, Eduwin Pakpahan, Eugene Y H Tang, Louise Robinson, Mario Siervo, Aliya Naheed, Blossom Christa Maree Stephan
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Abstract

Dementia is a leading cause of death and disability with over 60% of cases residing in low- and middle-income countries (LMICs). Therefore, new strategies to mitigate risk are urgently needed. However, despite the high burden of disease associated with dementia in LMICs, research into dementia risk profiling and risk prediction modelling is limited. Further, dementia risk prediction models developed in high income countries generally do not transport well to LMICs suggesting that context-specific models are instead needed. New prediction models have been developed, in China and Mexico only, with varying predictive accuracy. However, none has been externally validated or incorporated variables that may be important for predicting dementia risk in LMIC settings such as socio-economic status, literacy, healthcare access, nutrition, stress, pollutants, and occupational hazards. Since there is not yet any curative treatment for dementia, developing a context-specific dementia prediction model is urgently needed for planning early interventions for vulnerable groups, particularly for resource constrained LMIC settings.

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中低收入国家痴呆症风险预测模型:证据现状。
痴呆症是导致死亡和残疾的主要原因,60% 以上的病例发生在中低收入国家(LMICs)。因此,亟需新的战略来降低风险。然而,尽管中低收入国家与痴呆症相关的疾病负担很重,但对痴呆症风险分析和风险预测模型的研究却很有限。此外,在高收入国家开发的痴呆症风险预测模型通常不能很好地应用于低收入与中等收入国家,这表明需要建立针对具体情况的模型。目前仅在中国和墨西哥开发了新的预测模型,其预测准确性各不相同。但是,这些模型都没有经过外部验证,也没有纳入对预测低收入和中等收入国家痴呆症风险可能很重要的变量,如社会经济状况、文化程度、医疗保健服务、营养、压力、污染物和职业危害等。由于目前还没有治疗痴呆症的方法,因此迫切需要开发一种针对具体情况的痴呆症预测模型,以便为弱势群体规划早期干预措施,尤其是在资源有限的低收入与中等收入国家环境中。
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