McCance Brain Care Score Tool Assesses Both Dementia and Depression Risk
Boosting your brain health with positive lifestyle changes not only reduces your odds of dementia, it also decreases your risk of late-life depression.
The research provides further evidence of shared modifiable risk factors for depression, stroke, and dementia, says the first author, Sanjula Singh, MD, PhD, a researcher at the McCance Center for Brain Health and instructor in neurology at Harvard Medical School in Boston.
“The findings also emphasize the importance of behavioral changes that everyone can start doing today to take better care of their brain,” says Dr. Singh.
The Brain Care Score Covers a Range of Physical, Social, and Emotional Factors
“The Brain Care Score is a simple tool designed to help anyone answer the question, ‘What can I do to take better care of my brain?’” says the study coauthor Jonathan Rosand, MD, a critical care neurologist at Massachusetts General Hospital, a professor of neurology at Harvard, and the lead developer of the Brain Care Score.
The tool asks for answers about a person’s:
- Resting blood pressure, with or without treatment
- Hemoglobin A1C score (a measure of blood glucose levels)
- Cholesterol levels
- Body mass index
- Weekly diet (focused on intake of fruits and vegetables, lean protein, whole grains, sodium, and sugary beverages)
- Alcohol consumption
- Smoking habits
- Aerobic activity
- Sleep habits
- Stress levels
- Social relationships
- Feeling of meaning or purpose in life
Scores range from 0 to 21, with a higher score indicating better brain care.
“The ultimate goal of the Brain Care Score is to help people take care of their brains in a holistic way, by changing their health-related behaviors, and control modifiable risk factors that are associated with a reduced incidence of age-related brain diseases, including dementia, stroke, and late-life depression,” says Singh.
People With Better Brain Care Scores Had a Lower Risk of Later-Life Depression
For the recent research, scientists used data from more than 365,000 people in the UK Biobank (UKB) study. Participants were between 40 and 69 years old when enrolled (average age 56) and 55 percent were women. Brain Care Scores ranged between 2 and 19, and the median for the group was 12. Because the UK Biobank had collected nearly all, but not all, of the data components of the BCS in its study design, the highest possible score was 19 rather than 21.
Every 5-point positive difference in Brain Care Score (for example, a score of 15 compared with a score of 10) was associated with a 33 percent lower risk of late-life depression, as well as a 27 percent lower combined risk of late-life depression, dementia, and stroke over a follow-up period of 13 years on average.
These findings make sense given that older people may experience neurodegenerative and inflammatory processes that can contribute to all three of the conditions, the authors wrote.
There is still much to be learned about what pathways contribute to late-life depression, dementia, and stroke, says Singh.
“Our results emphasize the importance of a holistic view of the brain to further understand underlying connections between different brain diseases,” she adds.
Will Improving Your Brain Care Score Reduce Your Risk of Depression Later in Life?
The Brain Care Score could be a useful tool in for identifying and managing depression risk factors in primary care, which is where most of the individuals with depression will be seen and managed, says Bradley Gaynes, MD, MPH, a professor of psychiatry and epidemiology and the director of the division of global mental health at the UNC School of Medicine in Chapel Hill, North Carolina, and who was not involved in this research.
“People get so many messages about what to do and what not to do, and so this is exciting because it gives them some concrete areas that they can focus on,” says Dr. Gaynes.
The findings suggest that a higher Brain Care Score decreases your odds of late-life depression, and that’s a good thing to know, he says.
“But it’s important to note that this is a onetime score, and it doesn’t prove having a better score is causing the reduction in risk,” says Gaynes.
And although people with higher scores were less likely to develop late-life depression than people with lower scores, this study isn’t able to answer if a person will actually lower their risk by increasing their Brain Care Score, he says.
Researchers are pursuing additional studies to validate these results.
Reducing Depression Risk May Help Prevent Heart Disease and Other Illnesses
This research is hopeful in its implications for tackling prevalent illnesses like depression, which itself is a risk factor for many other diseases, says the coauthor Gregory Fricchione, MD, an associate chief of psychiatry at Massachusetts General Hospital.
How to Start Taking Better Care of Your Brain
For people who want to improve their Brain Care Score, the best place to begin is simple: It’s the area you are the most motivated to improve, says Rosand.
When you make strides in one area, it often “snowballs” and helps you improve in other areas as well, says Gaynes.
For example, if you focus on eating more nutritious meals, you may find you have more energy, which then allows you to be more active, which can lead to better sleep, which might help you achieve a healthy weight, he says.
“Then you’re able to go out and do more things that you’ll enjoy more, potentially socialize more, and that can likely reduce your overall stress level. All those things are going to help your overall quality of life, the heart, the brain, and your mood — they are all tied together,” says Gaynes.
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