Age at dementia diagnosis, subtype associations, and neuroimaging differentiation in Bangladesh: The CARED study
10 affiliations
- 1Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
- 2Department of Biological Sciences, Royal Holloway University of London, London, United Kingdom
- 3Department of Neurology, Combined Military Hospital, Chittagong, Bangladesh
- 4Department of Microbiology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
- 5Department of Neurology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
- 6Department of Medicine, Chottogram Army Medical College, Chittagong, Bangladesh
- 7Department of Neuroscience, Macquarie University, Sydney, Australia
- 8Department of Education, Southern Cross University, Sydney, Australia
- 9Department of Psychiatry, North East London NHS Foundation Trust, London, United Kingdom
- 10Department of Psychiatry, Aqidah Healthcare, Dhaka, Bangladesh
Abstract
Background: Evidence on age at diagnosis of dementia and differentiation of dementia subtypes in Bangladesh is limited. This study aimed to determine age at diagnosis, examine factors associated with dementia subtypes, and evaluate the discriminatory utility of neuroimaging scales in a Bangladeshi clinical population. Methods: The Community Awareness and Research on Early Dementia (CARED) study was a cross-sectional observational study conducted 2019−2024 at a tertiary care centre in Bangladesh. A total of 658 adults presenting with cognitive impairment, undergoing evaluation for suspected dementia were included. Diagnoses were established using DSM-5 criteria by a multidisciplinary team. Patients were categorized into dementia subtypes. Pseudodementia was retained as separate comparator group. Multivariable regression analyses were performed to identify factors associated with dementia subtypes. Receiver operating characteristic (ROC) curve analyses were used to assess the discriminatory performance of neuroimaging scales. Results: Among 658 patients, Alzheimer’s-related dementia (ARD) accounted for 51.7% of cases. The mean age at diagnosis was significantly higher in ARD compared with non-Alzheimer’s-related dementia (nARD) (67.7 ± 10.8 vs 64.3 ± 11.4 years, P < 0.001). In multivariable analysis, nARD was associated with an earlier age at diagnosis by 4.3 years compared with ARD. Vascular dementia was associated with hypertension, OR 4.2 (95% CI 1.1–16.6), P = 0.04, and smoking, OR 13.1 (95% CI 1.6–103.3), P = 0.01. Neuroimaging scales demonstrated variable discriminatory performance. Medial temporal atrophy showed good discrimination for ARD (AUROC 0.752), while Fazekas scores demonstrated good performance for vascular dementia (AUROC 0.838) and mixed dementia (AUROC 0.836). Global cortical atrophy showed moderate discriminatory ability for frontotemporal dementia (AUROC 0.659). Conclusions: Age at diagnosis varied across dementia subtypes in this Bangladeshi clinical cohort, with non-Alzheimer’s diagnosed earlier than Alzheimer’s. Structured MRI visual rating scales showed variable subtype-specific discriminatory performance, suggesting that they may provide adjunctive information for dementia subtype differentiation when interpreted alongside multidisciplinary clinical assessment.
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BibTeX
@article{ranjan2026dementia,
title = {{Age at dementia diagnosis, subtype associations, and neuroimaging differentiation in Bangladesh: The CARED study}},
author = {Redoy Ranjan and Ghulam Kawnayn and Md. Abdullah Yusuf and Mohammad Nur Uddin and Mim Tanzila Mamun and Alif Al Mamun and Shadad Hossain and Mohammad Sayeed Hassan and Nafiz Imtiaz and Maliha Hakim},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0359109},
url = {https://doi.org/10.1371/journal.pone.0359109},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Age at dementia diagnosis, subtype associations, and neuroimaging differentiation in Bangladesh: The CARED study
AU - Redoy Ranjan
AU - Ghulam Kawnayn
AU - Md. Abdullah Yusuf
AU - Mohammad Nur Uddin
AU - Mim Tanzila Mamun
AU - Alif Al Mamun
AU - Shadad Hossain
AU - Mohammad Sayeed Hassan
AU - Nafiz Imtiaz
AU - Maliha Hakim
PY - 2026
DA - 2026/09/25
JO - PLOS One
DO - 10.1371/journal.pone.0359109
UR - https://doi.org/10.1371/journal.pone.0359109
AB - Background: Evidence on age at diagnosis of dementia and differentiation of dementia subtypes in Bangladesh is limited. This study aimed to determine age at diagnosis, examine factors associated with dementia subtypes, and evaluate the discriminatory utility of neuroimaging scales in a Bangladeshi clinical population. Methods: The Community Awareness and Research on Early Dementia (CARED) study was a cross-sectional observational study conducted 2019−2024 at a tertiary care centre in Bangladesh. A total of 658 adults presenting with cognitive impairment, undergoing evaluation for suspected dementia were included. Diagnoses were established using DSM-5 criteria by a multidisciplinary team. Patients were categorized into dementia subtypes. Pseudodementia was retained as separate comparator group. Multivariable regression analyses were performed to identify factors associated with dementia subtypes. Receiver operating characteristic (ROC) curve analyses were used to assess the discriminatory performance of neuroimaging scales. Results: Among 658 patients, Alzheimer’s-related dementia (ARD) accounted for 51.7% of cases. The mean age at diagnosis was significantly higher in ARD compared with non-Alzheimer’s-related dementia (nARD) (67.7 ± 10.8 vs 64.3 ± 11.4 years, P < 0.001). In multivariable analysis, nARD was associated with an earlier age at diagnosis by 4.3 years compared with ARD. Vascular dementia was associated with hypertension, OR 4.2 (95% CI 1.1–16.6), P = 0.04, and smoking, OR 13.1 (95% CI 1.6–103.3), P = 0.01. Neuroimaging scales demonstrated variable discriminatory performance. Medial temporal atrophy showed good discrimination for ARD (AUROC 0.752), while Fazekas scores demonstrated good performance for vascular dementia (AUROC 0.838) and mixed dementia (AUROC 0.836). Global cortical atrophy showed moderate discriminatory ability for frontotemporal dementia (AUROC 0.659). Conclusions: Age at diagnosis varied across dementia subtypes in this Bangladeshi clinical cohort, with non-Alzheimer’s diagnosed earlier than Alzheimer’s. Structured MRI visual rating scales showed variable subtype-specific discriminatory performance, suggesting that they may provide adjunctive information for dementia subtype differentiation when interpreted alongside multidisciplinary clinical assessment.
SN - 1932-6203
ER -