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The potential of low-field MRI for global dementia care

Nature Reviews Neurology (2026)Cite this article

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Abstract

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.

Key points

  • The rapid rise in dementia prevalence in low-income and middle-income countries, where advanced neuroimaging access is scarce, highlights the urgent need for low-field MRI to close diagnostic and research gaps.

  • Studies demonstrate reliable detection of core Alzheimer disease markers, including hippocampal atrophy and white matter hyperintensities, on portable low-field systems, with promising correspondence to conventional high-field MRI findings.

  • Despite low resolution and signal-to-noise ratios, innovations such as segmentation algorithms and super-resolution methods extend the capability of low-field MRI, although validation across diverse populations is still required.

  • Low-field MRI offers transformative potential for global dementia research and care, but existing barriers must be addressed to enable scalable, sustainable worldwide implementation.

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Fig. 1: Global MRI scanner density and projected Alzheimer disease prevalence.
Fig. 2: Brain scans on two low-field MRI systems in healthy individuals.
Fig. 3: Paired brain scans from high-field and low-field MRI.
Fig. 4: Overview of MRI markers commonly observed in dementia.
Fig. 5: Amyloid-related imaging abnormalities.
Fig. 6: Unmet needs, opportunities and implementation challenges for low-field MRI in dementia research and care.

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Acknowledgements

T.E.E. is supported by the William H. Gates Sr. Fellowship from the Alzheimer’s Disease Data Initiative. A.S. is supported by the European Research Council (Horizon 2020 ERC Advanced PASMAR 101021218). H.H.H.A. is funded by a Hypatia Fellowship from the Radboud University Medical Center, project number R0007330. A.G.W. is supported by the European Research Council (Horizon 2020 ERC Advanced PASMAR 101021218) and the Dutch Science Foundation (NWO) Open Technology Grant 18981. D.M.C. is supported by an Alzheimer’s Society Dementia Research Leaders Fellowship (AS-DRL-23-005). D.K.J. is supported by Wellcome (Discovery Awards 227882/Z/23/Z and 317797/Z/24/Z) and the Gates Foundation (UNITY Programme). The authors thank C. Najac and B. Lena for providing example images from the 47 mT Halbach system. These images are from research funded by the NWO, Open Technology Grant 18981. The authors also thank J. Gholam for providing example images from the Hyperfine Swoop System. J. Gholam is supported by the Gates Foundation through the UNITY grant. The authors also thank M. Rosa-Grilo, M. Beament, C. Mummery, N. Fox and G. Parker for providing example images of individuals with ARIA-H and ARIA-E. These images are from research funded by the Alzheimer’s Society Heather Corrie Impact Fund (grant number 577 (AS-PG-21-045)), Biogen Idec UK, the National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre (NIHR UCLH BRC) and the Rosetrees Trust (CF-2022-2\128). The authors also thank N. Vilor Tejedor for aiding in the production of Figs. 4 and 6. Lastly, the authors thank F. Váša and colleagues for the use of open-source data for the figures.

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Authors and Affiliations

  1. Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands

    Tavia E. Evans, Aram Salehi & Hieab H. H. Adams

  2. Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands

    Tavia E. Evans

  3. Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland

    Tavia E. Evans

  4. Department of Technology and Applied Science, Universidad Comunera, Asuncion, Paraguay

    Joshua Harper

  5. C. J. Gorter MRI Centre, Department of Radiology, Leiden University Medical Center, Leiden, Netherlands

    Aram Salehi & Andrew G. Webb

  6. UCL Hawkes Institute, Faculty of Engineering, University College London, London, UK

    James H. Cole

  7. Department of Computer Science, University College London, London, UK

    James H. Cole

  8. Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK

    James H. Cole & David M. Cash

  9. Institute for Global Health, University College London, London, UK

    Ana Correa

  10. BrainLat, Universidad Adolfo Ibanez, Santiago, Chile

    Hieab H. H. Adams

  11. UK Dementia Research Institute at University College London, London, UK

    David M. Cash

  12. Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK

    Derek K. Jones

  13. School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK

    Derek K. Jones

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Contributions

T.E.E., J.H., A.S., D.M.C. and D.K.J. researched data for the article. T.E.E., J.H., A.G.W., J.H.C., H.H.H.A., D.M.C. and D.K.J. contributed substantially to discussion of the content. T.E.E., J.H., A.S., A.C., D.M.C. and D.K.J. wrote the article. All authors reviewed and/or edited the manuscript before submission.

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Correspondence to Tavia E. Evans.

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D.M.C. has received consulting fees and travel support from Perceptive Imaging. The other authors declare no competing interests.

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Nature Reviews Neurology thanks František Váša, Godwin Ogbole and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Evans, T.E., Harper, J., Salehi, A. et al. The potential of low-field MRI for global dementia care. Nat Rev Neurol (2026). https://doi.org/10.1038/s41582-026-01199-7

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