Evidence map›Paper›PMID 41927287›Full record

SynthesisBMJ open2026

Utilisation of brain MRI for the diagnosis of dementia in low and middle-income countries: systematic review and meta-analysis.

Rita Nassanga, Noeline Nakasujja, Aloysius Gonzaga Mubuuke, Kamada Lwere, Michael Grace Kawooya, Moses Ocan, Mark Kaddumukasa

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rita NassangaDepartment of Radiology, Makerere University College of Health Sciences, Kampala, Uganda ritanassanga@gmail.com.ORCID http://orcid.org/0000-0001-7699-2155
Noeline NakasujjaDepartment of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda.
Aloysius Gonzaga MubuukeDepartment of Radiology, Makerere University College of Health Sciences, Kampala, Uganda.
Kamada LwereDepartment of Microbiology, Faculty of Health Sciences, Soroti University, Soroti, Uganda.
Michael Grace KawooyaErnest Cook University, Kampala, Uganda.
Moses OcanDepartment of Pharmacology and Therapeutics, Makerere University, Kampala, Uganda.ORCID http://orcid.org/0000-0002-8852-820X
Mark KaddumukasaDepartment of Internal Medicine, Makerere University, Kampala, Uganda.

Funding

Research training and mentorship to strengthen brain health across the lifespan in Uganda.D43NS118560 · NINDS · MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES · PI KADDUMUKASA, MARK, KATABIRA, ELLY T · 2020 to 2024
$1.1M
NINDS NIH HHS D43 NS118560
6 · The paper itself

Abstract

objectivesTo synthesise the prevalence and patterns of dementia-relevant structural brain MRI abnormalities in adults with suspected or confirmed dementia in low- and middle-income countries (LMICs), and to summarise MRI protocols and the incremental diagnostic contribution of MRI beyond cognitive screening.

designSystematic review and meta-analysis. DATA SOURCES: PubMed, EMBASE, Web of Science and PsycINFO (January 1990-27 January 2025), plus reference list screening and targeted manual searches. ELIGIBILITY CRITERIA: Observational or diagnostic-accuracy studies from World Bank-defined LMICs including adults (≥50 years) with suspected or confirmed dementia who underwent brain MRI as part of diagnostic evaluation. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened, extracted data and assessed risk of bias using ROBINS-I. Random-effects models pooled prevalence of dementia-relevant MRI abnormalities; diagnostic-accuracy outcomes were synthesised narratively due to heterogeneous reference standards and incomplete reporting.

results39 LMIC studies were included; 23 studies (2513 participants) contributed to the meta-analysis. Dementia-relevant MRI abnormalities (defined as ≥1 clinically relevant structural abnormality per study definition) were present in 1248/2513 participants. The pooled prevalence of dementia-relevant MRI abnormalities was 58% (95% CI 43% to 72%), with substantial heterogeneity (I²=95%) and a wide prediction interval (8-96%), indicating marked between-study variability; this estimate should be interpreted as a descriptive summary of study-level proportions rather than a precise population parameter.

conclusionsBrain MRI frequently demonstrates dementia-relevant pathology in LMIC clinical cohorts, usually with mixed neurodegenerative-vascular patterns. Structured visual ratings may add aetiologic specificity beyond cognitive screening, but pooled estimates should be interpreted as summaries of heterogeneous study-level findings rather than precise population parameters, given high heterogeneity and risk of bias. PROSPERO REGISTRATION NUMBER: CRD42024510241.

Indexed as

BrainDementiaDeveloping CountriesMagnetic Resonance ImagingHumansPrevalenceCognitive dysfunctionDementiaGERIATRIC MEDICINENEUROLOGYNeuroradiology

Identifiers

PMID41927287
PMCPMC13052709

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.