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Dementia diagnosis in developing countries: a cross-cultural validation study
Prince M, Acosta D, Chiu H, Scazufca M, Varghese M, 10/66 Dementia Research Group.. Lancet (London, England), 2003-03-01
Topic: Risk, prevention and care in population studies
Background Research into dementia is needed in developing countries. Assessment of variations in disease frequency between regions might enhance our understanding of the disease, but methodological difficulties need to be addressed. We aimed to develop and test a culturally and educationally unbiased diagnostic instrument for dementia. Methods In a multicentre study, the 10/66 Dementia Research Group interviewed 2885 people aged 60 years and older in 25 centres, most in Universities, in India, China and southeast Asia, Latin America and the Caribbean, and Africa. 729 had dementia and three groups were free of dementia: 702 had depression, 694 had high education (as defined by each centre), and 760 had low education (as defined by each centre). Local clinicians diagnosed dementia and depression. An interviewer, masked to dementia diagnosis, administered the geriatric mental state, the community screening instrument for dementia, and the modified Consortium to Establish a Registry of Alzheimer's Disease (CERAD) ten-word list-learning task. Findings Each measure independently predicted a diagnosis of dementia. In an analysis of half the sample, an algorithm derived from all three measures gave better results than any individual measure. Applied to the other half of the sample, this algorithm identified 94% of dementia cases with false-positive rates of 15%, 3%, and 6% in the depression, high education, and low education groups, respectively. Interpretation Our algorithm is a sound basis for culturally and educationally sensitive dementia diagnosis in clinical and population-based research, supported by translations of its constituent measures into most languages used in the developing world.
Key findings
- In an analysis of half the sample, an algorithm derived from all three measures gave better results than any individual measure.
Why it matters
In this multicentre cross-cultural study of 2885 people aged 60 and older in developing countries, an algorithm derived from three measures identified 94% of dementia cases with false-positive rates of 15%, 3% and 6% in the depression, high-education and low-education groups respectively. The study aimed to develop a culturally and educationally unbiased diagnostic instrument for dementia, so it concerns diagnosis rather than treatment, cure or prevention.
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Study details
- Participants2,885
- Evidence strengthLow
How this study scored 60/100
Published in a top-tier journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (Lancet (London, England)) |
| Journal's citation record | 4 / 4 | The Lancet: journal h-index 1,205 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 3 / 4 | 2,885 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 597 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 23.9 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 4 / 6 | Cited 10.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 47 other studies in this library |
| Still being cited | 3 / 4 | Cited 66 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Mathew Varghese: h-index 46 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | King's College London: institution h-index 1,348 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 5 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12648969) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 60 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Prince, M., Acosta, D., Chiu, H., Scazufca, M., Varghese, M., & 10/66 Dementia Research Group. (2003). Dementia diagnosis in developing countries: a cross-cultural validation study. Lancet (London, England). https://doi.org/10.1016/s0140-6736(03)12772-9
Vancouver
Prince M, Acosta D, Chiu H, Scazufca M, Varghese M, 10/66 Dementia Research Group. Dementia diagnosis in developing countries: a cross-cultural validation study. Lancet (London, England). 2003. doi:10.1016/s0140-6736(03)12772-9. PMID: 12648969.
BibTeX
@article{prince2003-12648969,
author = {Prince, M. and Acosta, D. and Chiu, H. and Scazufca, M. and Varghese, M. and {10/66 Dementia Research Group}},
title = {{Dementia diagnosis in developing countries: a cross-cultural validation study}},
journal = {Lancet (London, England)},
year = {2003},
doi = {10.1016/s0140-6736(03)12772-9},
pmid = {12648969},
url = {https://doi.org/10.1016/s0140-6736(03)12772-9}
}
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