High Brain Care Score linked to lower risk for late-life depression, dementia, stroke

Key takeaways:

• A five-point increase in baseline Brain Care Score conferred a 33% lower risk for late-life depression.
• More research is needed on how the score can be used routinely to encourage risk-reducing behavior changes.

Individuals with a higher Brain Care Score had a significantly lower risk for late-life depression, dementia and stroke, according to a study published in Frontiers in Psychiatry.

“The Brain Care Score is a simple tool designed to help anyone in the world answer the question, ‘What can I do to take better care of my brain?’” Jonathan Rosand MD, MSc, co-founder of the Henry and Allison McCance Center for Brain Health at Massachusetts General Hospital and professor of neurology at Harvard Medical School, said in a Mass General Brigham press release. “This paper provides compelling evidence that raising your BCS is not only likely to make your brain healthier and more resistant to diseases like dementia and stroke, but that it also offers the hope of protection from depression.”

Rosand, along with colleagues at the McCance Center and other collaborators, led the development of the Brain Care Score (BCS), which assesses an individual’s physical risk factors (blood pressure, HbA1c, cholesterol and BMI), lifestyle factors (nutrition, alcohol use, smoking, physical activity and sleep) and social/emotional factors (stress, relationships and life purpose) to produce a score on a 21-point scale.

To determine whether a higher BCS was associated with a reduced incidence of future depression and a composite of late-life depression, dementia and stroke, Rosand and colleagues used multivariable Cox proportional hazard models to analyze data from 365,975 people without a nondepressive mood or psychiatric disorder who submitted baseline data to the UK Biobank between 2006 and 2010.

Overall, the median total BCS at baseline was 12 (interquartile range, 11-14), including a median of 13 for participants aged younger than 50 years and 12 both for participants aged 50 to 59 years and older than 59 years.

During a median follow up of 12.5 years, there were 6,628 incident cases of late-life depression in the cohort, after excluding 50,395 participants who had a nondepressive mood or psychiatric disorder and 2,652 with prevalent depression, for a cumulative incidence of 1.8%.

After excluding those participants, plus 7,777 with prevalent dementia, stroke or depression, the researchers observed 13,562 cases of incident dementia, stroke or late-life depression, for a cumulative incidence of 3.8%.

The researchers found that each five-point increase in baseline BCS was associated with a 33% lower risk for incident late-life depression (HR = 0.67; 95% CI, 0.64-0.71). This association appeared to be more pronounced among participants aged younger than 50 years at baseline (HR = 0.41; 95% CI, 0.26-0.63).

Each five-point increase in baseline BCS also was associated with a 27% lower risk for incident stroke, dementia or late-life depression (HR = 0.73; 95% CI, 0.7-0.76), again with a more pronounced effect in the younger cohort (HR = 0.62; 95% CI, 0.52-0.74).

“There is still much to be learned about what pathways contribute to late-life depression, dementia and stroke,” Sanjula D. Singh, MD, PhD, MSc, of the McCance Center and instructor in neurology at Massachusetts General Hospital and Harvard Medical School, said in the release. “Our results emphasize the importance of a holistic view of the brain to further understand underlying connections between different brain diseases.”

The researchers will conduct ongoing research to determine whether individuals who gradually increase their BCS by five points or more have a reduced risk for stroke and dementia in the future compared with those without substantial score increases, according to the release.

Reference:

• Brain Care Score for dementia and stroke also predicts late-life depression. https://www.massgeneralbrigham.org/en/about/newsroom/press-releases/brain-care-score-for-dementia-stroke-predicts-depression. Published July 23, 2024. Accessed Aug. 2, 2024.