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What if you could assess your risk of developing dementia or having a stroke as you age without medical procedures? A new tool named the Brain Care Score, or BCS, may help you do just that while also advising how you can lower your risk, a new study has found.
The 21-point Brain Care Score refers to how a person fares on 12 health-related factors concerning physical, lifestyle and social-emotional components of health, according to the study published December 1 in the journal Frontiers in Neurology. The authors found participants with a higher score had a lower risk of developing dementia or having a stroke later in life.
“Patients and practitioners can start focusing more on improving their BCS today, and the good news is improving on these elements will also provide overall health benefits,” said the study’s senior author Dr. Jonathan Rosand, cofounder of the McCance Center for Brain Health at Massachusetts General Hospital, in a news release.
“The components of the BCS include recommendations found in the American Heart Association’s Life’s Essential (8) for cardiovascular health, as well (as) many modifiable risk factors for common cancers,” added Rosand, also the J.P. Kistler Endowed Chair in Neurology at Massachusetts General Hospital and a professor of neurology at Harvard Medical School. “What’s good for the brain is good for the heart and the rest of the body.”
The physical components included blood pressure, cholesterol, hemoglobin A1c and body mass index, while lifestyle factors included nutrition, alcohol consumption, aerobic activities, sleep and smoking. Social-emotional aspects referred to relationships, stress management and meaning in life.
The authors cited “the global brain health crisis” as one of the motivators for their work; in the United States alone, 1 in 7 people have dementia, and every four minutes someone dies from a stroke, according to the study. Prevention efforts can help substantially reduce deaths, but the American Heart Association’s Life’s Essential 8, the authors said, was developed without input from patients.
“In order to engage patients, we sought to develop a tool that responded to the question we received most frequently from our patients and their family members: ‘How can I take good care of my brain?’” the authors said.
Brain care and disease risk
The researchers sought to validate their tool by looking into the associations between nearly 400,000 participants’ Brain Care Score at the beginning of the UK Biobank study between 2006 and 2010, and whether they had dementia or stroke around 12 years later. The UK Biobank study has followed the health outcomes of more than half a million people between ages 40 and 69 in the United Kingdom for at least 10 years.
Among adults who were younger than 50 upon enrollment, every five-point positive difference in their score was associated with a 59% lower risk of developing dementia and a 48% lower risk of having a stroke later in life, the authors found. Those in their 50s had a 32% lower risk of dementia and a 52% lower chance of stroke. Participants older than 59 had the lowest estimates, with an 8% lower risk of dementia and a 33% lower risk of stroke.
“It’s rare for me to say this, but everyone age 40 and above who has a family member affected by Alzheimer’s or dementia should talk to their doctor about this score,” said Dr. Richard Isaacson, director of research at the Institute for Neurodegenerative Diseases in Florida, via email. Isaacson wasn’t involved in the study.
“Most people are unaware that at least 40% of dementia cases may be preventable if that person does everything right,” Isaacson added. “The Brain Care Score helps people at risk with a roadmap forward based on 12 modifiable factors before the onset of cognitive decline.”
Caring for your brain
The authors concluded the less significant benefits for older adults could be because in this age group, dementia tends to progress more slowly — meaning practitioners may not pick up on a patient having early dementia until it gets worse later.
But in terms of explaining the overall findings, many past studies have affirmed the benefits of these health components for brain health.
Swapping processed foods for more natural choices has been associated with a 34% lower risk of dementia, while frequent exercise and daily visits with loved ones reduced risk by 35% and 15%, respectively, according to two studies published in 2022.
And “while most of these factors can be evaluated by people at home, it’s also important for people at their next primary care doctor’s visit to ‘know their numbers’ in the areas of blood pressure, cholesterol and blood sugar control,” which are other factors in the Brain Care Score, Isaacson said. “Better control of these vascular risk factors has the power to slam the breaks on the road to cognitive decline (and) dementia, as well as stroke.”
He added, “When you combine this with better dietary choices, less alcohol, having a sense of purpose in life and staying socially engaged, the dividends add up greatly over time.”
Since participants’ scores were measured only once in their lives, more research is needed to find whether someone can reduce their stroke or dementia risk by improving their Brain Care Score over time — a hypothesis the authors are currently studying, they said.
“We have every reason to believe that improving your BCS over time will substantially reduce your risk of ever having a stroke or developing dementia in the future,” Rosand said. “But as scientists, we always want to see proof.”
Participating in studies like this one can be a good way to manage your brain health, Isaacson said — especially if you have limited access to health care.
Isaacson is a coinvestigator on a National Institutes of Health-funded study starting soon. “People can actually sign up now to be notified when it’s launched within the next month at YourBrainStudy.org — which walks people through a free risk assessment, memory tests, and personalized advice from the comfort of their own cell phone,” he added via email.
