New Brain Care Score Instrument Developed at Massachusetts General Hospital Validated for Predicting Risk of Dementia and Stroke

A Brain Care Score (BCS) instrument developed by the McCance Center for Brain Health at Massachusetts General Hospital was validated for predicting risk of developing dementia and stroke, according to a study published in Frontiers in Neurology. The BCS, which was developed using a modified Delphi process and included input from patients, caregivers, and clinicians, provides a score based on physical, lifestyle, and social-emotional factors of health. Higher scores on the BCS were associated with reduced risk for dementia and stroke. Although the current BCS is a prototype and further refinement of the instrument is needed along with additional research, it is hoped that the BCS may be used to facilitate conversations between clinicians and their patients about lifestyle modifications that can improve long-term health.

The study included almost 398,900 participants from the UK Biobank study, which was a population-based prospective cohort study conducted in 502,408 UK participants aged 40 to 69 years at baseline (2006 to 2010). Researchers derived BCS scores based on data recorded from the UK Biobank, modifying the instrument to calculate scores from 0 to 19 points. A higher BCS score corresponds to greater brain health, and an increase in 5 points corresponds to a substantial yet achievable improvement in brain health. Researchers also assessed incident dementia and stroke according to routinely collected hospital and mortality data. Cox proportional hazard regression models were used to estimate associations between incident dementia and stroke according to 5-point differences in BCS score.

A total of 5354 incident cases of dementia were recorded after baseline, and a BCS score increase of 5 points at a median follow-up of 12.5 years was associated with a 14% lower risk of dementia when adjusted for age and sex. Each 5-point increase in BCS score was associated with a 59%, 32%, and 8% lower risk of incident dementia for participants aged <50, 50 to 59, and >59 years at baseline, respectively. 

There were 7259 incident cases of stroke recorded after baseline, and a BCS score increase of 5 points was associated with a 40% lower risk of incident stroke at a median 12.5 years of follow up when adjusted for age and sex. Each 5-point increase in BCS score was associated with a 48%, 52%, and 33% lower risk of stroke for participants aged <50, 50 to 59, and >59 years at baseline, respectively.