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ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Aging Psychiatry
Volume 15 - 2024 |
doi: 10.3389/fpsyt.2024.1373797
A Brain Care Score for Risk of Late-Life Depression and A Composite Outcome of Dementia, Stroke and Late-Life Depression: data from the UK Biobank cohort
Provisionally accepted- 1 McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
- 2 Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, England, United Kingdom
- 3 Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
- 4 Broad Institute, Cambridge, MA, United States
- 5 Yale Medicine, New Haven, United States
- 6 Department of Neurology, School of Medicine, Yale University, New Haven, Connecticut, United States
- 7 Center for Brain and Mind Health, School of Medicine, Yale University, New Haven, Connecticut, United States
- 8 Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
- 9 Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
- 10 Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States
- 11 Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
- 12 University of Toronto, Toronto, Ontario, Canada
- 13 Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
- 14 University of Alabama at Birmingham, Birmingham, Alabama, United States
- 15 Unit of Health-Care Epidemiology, Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, England, United Kingdom
The 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 motivating lifestyle changes. Because 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 as well as with a brain health composite outcome comprising stroke, dementia and late-life depression. The BCS was derived from the United Kingdom Biobank baseline evaluation in participants with complete data on BCS items. Associations of BCS and risk of subsequent incident late-life depression and composite brain health outcome were estimated using multivariable Cox proportional hazard models, adjusted for age at baseline and sex assigned at birth. A 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 incident composite outcome (95%CI: 24%-30%). These data further demonstrate the shared risk factors across depression, dementia and stroke. Additional validation of the BCS is warranted on the weighing of its components, motivational aspects, and acceptability and adaptability in routine clinical care worldwide. C.D.A.
Keywords: Depression - epidemiology, prevention, risk factor, Brain health, Stroke, Dementia
Received: 20 Jan 2024; Accepted: 01 Jul 2024.
Copyright: © 2024 Singh, Rivier, Papier, Chemali, Gutierrez-Martinez, Parodi, Mayerhofer, Senff, Clocchiatti-Tuozzo, Nunley, Newhouse, Ouyang, Westover, Tanzi, Lazar, Pikula, Ibrahim, Brouwers, Howard, Howard, Yechoor, Littlejohns, Sheth, Rosand, Fricchione, Anderson and Falcone. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Leidys Gutierrez-Martinez, McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, Massachusetts, United States
Livia Parodi, McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, Massachusetts, United States
Courtney Nunley, McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, Massachusetts, United States
An Ouyang, McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, Massachusetts, United States
Bart Brouwers, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, Massachusetts, United States
Nirupama Yechoor, McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, Massachusetts, United States
Thomas Littlejohns, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, OX3 7LF, England, United Kingdom
Kevin N. Sheth, Department of Neurology, School of Medicine, Yale University, New Haven, 06510, Connecticut, United States
Jonathan Rosand, McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, Massachusetts, United States
Gregory Fricchione, McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, Massachusetts, United States
Christopher D. Anderson, McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, Massachusetts, United States
Guido J. Falcone, Department of Neurology, School of Medicine, Yale University, New Haven, 06510, Connecticut, United States
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