Frontiers in Neurology (Dec 2023)
The predictive validity of a Brain Care Score for dementia and stroke: data from the UK Biobank cohort
- Sanjula D. Singh,
- Sanjula D. Singh,
- Sanjula D. Singh,
- Sanjula D. Singh,
- Sanjula D. Singh,
- Tin Oreskovic,
- Sinclair Carr,
- Sinclair Carr,
- Keren Papier,
- Megan Conroy,
- Jasper R. Senff,
- Jasper R. Senff,
- Jasper R. Senff,
- Jasper R. Senff,
- Jasper R. Senff,
- Zeina Chemali,
- Zeina Chemali,
- Zeina Chemali,
- Leidys Gutierrez-Martinez,
- Leidys Gutierrez-Martinez,
- Leidys Gutierrez-Martinez,
- Leidys Gutierrez-Martinez,
- Livia Parodi,
- Livia Parodi,
- Livia Parodi,
- Livia Parodi,
- Ernst Mayerhofer,
- Ernst Mayerhofer,
- Ernst Mayerhofer,
- Ernst Mayerhofer,
- Sandro Marini,
- Sandro Marini,
- Sandro Marini,
- Sandro Marini,
- Courtney Nunley,
- Amy Newhouse,
- Amy Newhouse,
- Amy Newhouse,
- An Ouyang,
- An Ouyang,
- H. Bart Brouwers,
- Brandon Westover,
- Brandon Westover,
- Brandon Westover,
- Cyprien Rivier,
- Guido Falcone,
- Virginia Howard,
- George Howard,
- Aleksandra Pikula,
- Aleksandra Pikula,
- Aleksandra Pikula,
- Sarah Ibrahim,
- Sarah Ibrahim,
- Sarah Ibrahim,
- Kevin N. Sheth,
- Nirupama Yechoor,
- Nirupama Yechoor,
- Nirupama Yechoor,
- Nirupama Yechoor,
- Ronald M. Lazar,
- Christopher D. Anderson,
- Christopher D. Anderson,
- Christopher D. Anderson,
- Christopher D. Anderson,
- Christopher D. Anderson,
- Rudolph E. Tanzi,
- Gregory Fricchione,
- Gregory Fricchione,
- Thomas Littlejohns,
- Jonathan Rosand,
- Jonathan Rosand,
- Jonathan Rosand,
- Jonathan Rosand
Affiliations
- Sanjula D. Singh
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Sanjula D. Singh
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Sanjula D. Singh
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Sanjula D. Singh
- Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Sanjula D. Singh
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Tin Oreskovic
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Sinclair Carr
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
- Sinclair Carr
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Keren Papier
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Megan Conroy
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Jasper R. Senff
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Jasper R. Senff
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Jasper R. Senff
- Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Jasper R. Senff
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Jasper R. Senff
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
- Zeina Chemali
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Zeina Chemali
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Zeina Chemali
- Division of Neuropsychiatry, Massachusetts General Hospital, Boston, MA, United States
- Leidys Gutierrez-Martinez
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Leidys Gutierrez-Martinez
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Leidys Gutierrez-Martinez
- Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Leidys Gutierrez-Martinez
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Livia Parodi
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Livia Parodi
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Livia Parodi
- Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Livia Parodi
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Ernst Mayerhofer
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Ernst Mayerhofer
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Ernst Mayerhofer
- Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Ernst Mayerhofer
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Sandro Marini
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Sandro Marini
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Sandro Marini
- Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Sandro Marini
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Courtney Nunley
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Amy Newhouse
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Amy Newhouse
- Division of Neuropsychiatry, Massachusetts General Hospital, Boston, MA, United States
- Amy Newhouse
- 0Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- An Ouyang
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- An Ouyang
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- H. Bart Brouwers
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
- Brandon Westover
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Brandon Westover
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Brandon Westover
- Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Cyprien Rivier
- 1Department of Neurology, Yale School of Medicine, New Haven, CT, United States
- Guido Falcone
- 1Department of Neurology, Yale School of Medicine, New Haven, CT, United States
- Virginia Howard
- 2Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
- George Howard
- 2Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
- Aleksandra Pikula
- 3Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada
- Aleksandra Pikula
- 4Krembil Brain Institute, Toronto, ON, Canada
- Aleksandra Pikula
- 5Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Sarah Ibrahim
- 3Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada
- Sarah Ibrahim
- 4Krembil Brain Institute, Toronto, ON, Canada
- Sarah Ibrahim
- 5Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Kevin N. Sheth
- 1Department of Neurology, Yale School of Medicine, New Haven, CT, United States
- Nirupama Yechoor
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Nirupama Yechoor
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Nirupama Yechoor
- Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Nirupama Yechoor
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Ronald M. Lazar
- 6McKnight Brain Institute, Department of Neurology, School of Medicine, University of Alabama School of Medicine, Birmingham, AL, United States
- Christopher D. Anderson
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Christopher D. Anderson
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Christopher D. Anderson
- Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Christopher D. Anderson
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Christopher D. Anderson
- 7Department of Neurology, Brigham and Women’s Hospital, Boston, MA, United States
- Rudolph E. Tanzi
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Gregory Fricchione
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Gregory Fricchione
- 8Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, United States
- Thomas Littlejohns
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Jonathan Rosand
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Jonathan Rosand
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Jonathan Rosand
- Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Jonathan Rosand
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- DOI
- https://doi.org/10.3389/fneur.2023.1291020
- Journal volume & issue
-
Vol. 14
Abstract
IntroductionThe 21-point Brain Care Score (BCS) was developed through a modified Delphi process in partnership with practitioners and patients to promote behavior changes and lifestyle choices in order to sustainably reduce the risk of dementia and stroke. We aimed to assess the associations of the BCS with risk of incident dementia and stroke.MethodsThe BCS was derived from the United Kingdom Biobank (UKB) baseline evaluation for participants aged 40–69 years, recruited between 2006–2010. Associations of BCS and risk of subsequent incident dementia and stroke were estimated using Cox proportional hazard regressions, adjusted for sex assigned at birth and stratified by age groups at baseline.ResultsThe BCS (median: 12; IQR:11–14) was derived for 398,990 UKB participants (mean age: 57; females: 54%). There were 5,354 incident cases of dementia and 7,259 incident cases of stroke recorded during a median follow-up of 12.5 years. A five-point higher BCS at baseline was associated with a 59% (95%CI: 40-72%) lower risk of dementia among participants aged <50. Among those aged 50–59, the figure was 32% (95%CI: 20-42%) and 8% (95%CI: 2-14%) for those aged >59 years. A five-point higher BCS was associated with a 48% (95%CI: 39-56%) lower risk of stroke among participants aged <50, 52% (95%CI, 47-56%) among those aged 50–59, and 33% (95%CI, 29-37%) among those aged >59.DiscussionThe BCS has clinically relevant and statistically significant associations with risk of dementia and stroke in approximately 0.4 million UK people. Future research includes investigating the feasibility, adaptability and implementation of the BCS for patients and providers worldwide.
Keywords
