HMN 2025: How Global dementia research must reflect global diversity

A major international research effort led by UNSW’s Center for Healthy Brain Aging (CHeBA) is reshaping our understanding of dementia by addressing a longstanding gap in global health equity.

A new paper published in a special issue of Neuroscience titled “Addressing global diversity in dementia research with the COSMIC collaboration” highlights how the Cohort Studies of Memory in an International Consortium (COSMIC) is helping to make dementia research more inclusive, equitable, and globally relevant.

Led by CHeBA Research Fellow Dr. Darren Lipnicki, this paper summarizes the research that has been published by the COSMIC consortium. It shows that dementia risk factors do not affect all populations equally. COSMIC’s global approach has uncovered key differences in how cardiovascular, lifestyle, and social factors relate to dementia across populations—differences that could help shape more effective, tailored prevention strategies.

“If we want to reduce the future burden of dementia globally, we need to understand how risk factors play out in diverse settings,” said Professor Perminder Sachdev, leader of the COSMIC consortium and Co-Director of CHeBA.

“What works for high-income countries may not apply in low- and middle-income regions. We need solutions that fit local realities.”

The need for this work is pressing. More than 55 million people worldwide are living with dementia, with 10 million new cases every year. As the global population ages, this number is projected to triple to 153 million by 2050, with the most rapid growth occurring in low- and middle-income countries. Despite this, these populations remain severely underrepresented in existing research.

Since its inception in 2012, COSMIC has brought together data from more than 60 cohort studies across 38 countries—spanning Asia, Africa, Europe, the Americas, and Australia—with more than 200,000 participants. This allows researchers to explore how age, genetics, education, environment, and gender intersect with dementia risk across ethnic and geographic lines.

Dr. Lipnicki says the latest findings demonstrate some key issues:

• Stronger effects of cardiovascular risk factors (like diabetes and high cholesterol) on cognitive decline among Asian populations compared to white populations
• Social factors, such as family interaction and community support, more strongly protecting against dementia in Asian countries
• Differences in the impact of education, parity, and genetics on dementia risk between regional and ethnic groups

COSMIC is also addressing critical gaps by developing risk models and diagnostic tools suited for use in low-resource settings, building international capacity, especially training researchers in low- and middle-income countries (LMICs), supporting global data access through Dementias Platform Australia (DPAU), a secure platform also led by CHeBA that enables researchers worldwide to collaborate on COSMIC data.

As the global burden of dementia rises, this inclusive research approach has never been more urgent.

COSMIC invites new cohort studies—particularly from underrepresented or LMIC populations—to join the collaboration and ensure that the future of dementia research and prevention is truly global.