The potential of low-field MRI for global dementia care

With elderly populations increasing in many countries, rates of Alzheimer disease and related dementias (ADRD) are expected to rise worldwide in the coming years. Low-income and middle-income countries, where barriers to health care are most pronounced and research representation is limited, are predicted to experience the greatest increases in ADRD prevalence. Access to advanced diagnostic and research tools, such as neuroimaging, is severely restricted in these regions, but low-field MRI is emerging as a promising, accessible alternative to conventional imaging. By reducing infrastructure, cost and siting requirements, low-field MRI offers a potential pathway to expand access to dementia-relevant imaging beyond specialized centres. In this article, we summarize key structural imaging biomarkers in ADRD and review the current literature supporting the use of low-field MRI in the ADRD field. We highlight the utility of low-field MRI for the assessment of regional atrophy and cerebrovascular lesion burden and discuss emerging diffusion-based markers. We also consider challenges and future directions, offering insights to advance equitable access to diagnostic imaging, guide research priorities and support global implementation of low-field MRI in ADRD care and investigation.