Frontiers in Psychiatry (Jul 2024)
The predictive validity of a Brain Care Score for late-life depression and a composite outcome of dementia, stroke, and late-life depression: data from the UK Biobank cohort
- Sanjula D. Singh,
- Sanjula D. Singh,
- Sanjula D. Singh,
- Cyprien A. Rivier,
- Cyprien A. Rivier,
- Keren Papier,
- Zeina Chemali,
- Zeina Chemali,
- Zeina Chemali,
- Leidys Gutierrez-Martinez,
- Leidys Gutierrez-Martinez,
- Leidys Gutierrez-Martinez,
- Livia Parodi,
- Livia Parodi,
- Livia Parodi,
- Livia Parodi,
- Livia Parodi,
- Ernst Mayerhofer,
- Ernst Mayerhofer,
- Ernst Mayerhofer,
- Ernst Mayerhofer,
- Ernst Mayerhofer,
- Jasper Senff,
- Jasper Senff,
- Jasper Senff,
- Jasper Senff,
- Santiago Clocchiatti-Tuozzo,
- Santiago Clocchiatti-Tuozzo,
- Courtney Nunley,
- Amy Newhouse,
- Amy Newhouse,
- Amy Newhouse,
- An Ouyang,
- M. Brandon Westover,
- M. Brandon Westover,
- Rudolph E. Tanzi,
- Rudolph E. Tanzi,
- Ronald M. Lazar,
- Aleksandra Pikula,
- Aleksandra Pikula,
- Sarah Ibrahim,
- Sarah Ibrahim,
- Sarah Ibrahim,
- Sarah Ibrahim,
- H. Bart Brouwers,
- Virginia J. Howard,
- George Howard,
- Nirupama Yechoor,
- Nirupama Yechoor,
- Nirupama Yechoor,
- Thomas Littlejohns,
- Kevin N. Sheth,
- Kevin N. Sheth,
- Jonathan Rosand,
- Jonathan Rosand,
- Jonathan Rosand,
- Jonathan Rosand,
- Gregory Fricchione,
- Gregory Fricchione,
- Christopher D. Anderson,
- Christopher D. Anderson,
- Christopher D. Anderson,
- Christopher D. Anderson,
- Christopher D. Anderson,
- Guido J. Falcone,
- Guido J. Falcone
Affiliations
- Sanjula D. Singh
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Sanjula D. Singh
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Sanjula D. Singh
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States
- Cyprien A. Rivier
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States
- Cyprien A. Rivier
- Yale Center for Brain and Mind Health, New Haven, CT, United States
- Keren Papier
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- 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 Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, 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 Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States
- Livia Parodi
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Livia Parodi
- Department of Neurology, Brigham and Women’s Hospitall, 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 Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States
- Ernst Mayerhofer
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Ernst Mayerhofer
- Department of Neurology, Brigham and Women’s Hospitall, Boston, MA, United States
- Jasper Senff
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Jasper Senff
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Jasper Senff
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States
- Jasper Senff
- 0Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, Netherlands
- Santiago Clocchiatti-Tuozzo
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States
- Santiago Clocchiatti-Tuozzo
- Yale Center for Brain and Mind Health, New Haven, CT, 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
- 1Department 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
- M. Brandon Westover
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- M. Brandon Westover
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Rudolph E. Tanzi
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Rudolph E. Tanzi
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Ronald M. Lazar
- 2Department of Neurology, University of Alabama at Birmingham (UAB) Heersink School of Medicine, University of Alabama at Birmingham (UAB) McKnight Brain Institute, Birmingham, AL, United States
- Aleksandra Pikula
- 3Jay and Sari Sonshine Centre for Stroke Prevention & Cerebrovascular Brain Health, University Health Network, Krembil Brain Institute, Toronto, ON, Canada
- Aleksandra Pikula
- 4Department of Medicine, Division of Neurology, The Temerty Faculty of Medicine at the University of Toronto, Toronto, ON, Canada
- Sarah Ibrahim
- 3Jay and Sari Sonshine Centre for Stroke Prevention & Cerebrovascular Brain Health, University Health Network, Krembil Brain Institute, Toronto, ON, Canada
- Sarah Ibrahim
- 5Program for Health System and Technology Evaluation; Toronto General Hospital Research Institute, Toronto, ON, Canada
- Sarah Ibrahim
- 6Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health; University of Toronto, Toronto, ON, Canada
- Sarah Ibrahim
- 7Centre for Advancing Collaborative Healthcare & Education (CACHE), University of Toronto, Toronto, ON, Canada
- H. Bart Brouwers
- 8Department of Neurosurgery, Elisabeth TweeSteden Ziekenhuis, Tilburg, Netherlands
- Virginia J. Howard
- 9Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
- George Howard
- 9Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 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 Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States
- Thomas Littlejohns
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Kevin N. Sheth
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States
- Kevin N. Sheth
- Yale Center for Brain and Mind Health, New Haven, CT, United States
- 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 Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States
- Jonathan Rosand
- Center for Genomic Medicine, 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
- 0Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, 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 Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States
- Christopher D. Anderson
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Christopher D. Anderson
- Department of Neurology, Brigham and Women’s Hospitall, Boston, MA, United States
- Guido J. Falcone
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States
- Guido J. Falcone
- Yale Center for Brain and Mind Health, New Haven, CT, United States
- DOI
- https://doi.org/10.3389/fpsyt.2024.1373797
- Journal volume & issue
-
Vol. 15
Abstract
IntroductionThe 21-point Brain Care Score (BCS) is a novel tool designed to motivate individuals and care providers to take action to reduce the risk of stroke and dementia by encouraging lifestyle changes. Given that late-life depression is increasingly recognized to share risk factors with stroke and dementia, and is an important clinical endpoint for brain health, we tested the hypothesis that a higher BCS is associated with a reduced incidence of future depression. Additionally, we examined its association with a brain health composite outcome comprising stroke, dementia, and late-life depression.MethodsThe BCS was derived from the United Kingdom Biobank baseline evaluation in participants with complete data on BCS items. Associations of BCS with the risk of subsequent incident late-life depression and the composite brain health outcome were estimated using multivariable Cox proportional hazard models. These models were adjusted for age at baseline and sex assigned at birth.ResultsA total of 363,323 participants were included in this analysis, with a median BCS at baseline of 12 (IQR: 11-14). There were 6,628 incident cases of late-life depression during a median follow-up period of 13 years. Each five-point increase in baseline BCS was associated with a 33% lower risk of incident late-life depression (95% CI: 29%-36%) and a 27% lower risk of the incident composite outcome (95% CI: 24%-30%).DiscussionThese data further demonstrate the shared risk factors across depression, dementia, and stroke. The findings suggest that a higher BCS, indicative of healthier lifestyle choices, is significantly associated with a lower incidence of late-life depression and a composite brain health outcome. Additional validation of the BCS is warranted to assess the weighting of its components, its motivational aspects, and its acceptability and adaptability in routine clinical care worldwide.
Keywords
