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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
Sanjula Singh Sanjula Singh 1,2,3,4Cyprien Rivier Cyprien Rivier 5,6,7Keren Papier Keren Papier 2Zeina Chemali Zeina Chemali 1,3,8Leidys Gutierrez-Martinez Leidys Gutierrez-Martinez 1*Livia Parodi Livia Parodi 1,10,3,4,9*Ernst Mayerhofer Ernst Mayerhofer 1Jasper Senff Jasper Senff 1Santiago Clocchiatti-Tuozzo Santiago Clocchiatti-Tuozzo 6Courtney Nunley Courtney Nunley 1*Amy Newhouse Amy Newhouse 1An Ouyang An Ouyang 1*Michael Westover Michael Westover 1Rudolph E. Tanzi Rudolph E. Tanzi 1Ronald M. Lazar Ronald M. Lazar 11Aleksandra Pikula Aleksandra Pikula 12Sarah Ibrahim Sarah Ibrahim 12Bart Brouwers Bart Brouwers 13*Virginia Howard Virginia Howard 14George Howard George Howard 14Nirupama Yechoor Nirupama Yechoor 1*Thomas Littlejohns Thomas Littlejohns 15*Kevin N. Sheth Kevin N. Sheth 6,7*Jonathan Rosand Jonathan Rosand 1*Gregory Fricchione Gregory Fricchione 1*Christopher D. Anderson Christopher D. Anderson 1*Guido J. Falcone Guido J. Falcone 6*
  • 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 final, formatted version of the article will be published soon.

    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

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.