A new study from Mass General Brigham found the Brain Care Score (BCS) is a strong predictor of stroke across different racial groups in the U.S. The findings, published in Neurology , the medical journal of the American Academy of Neurology, suggest that improvements in the BCS could have particularly meaningful benefits for stroke prevention among Black individuals.
"Black adults in the United States face a two- to threefold higher risk of stroke compared to white adults," said senior author Sanjula Dhillon Singh, MD, PhD, MS, a principal investigator in the Brain Care Labs within the Mass General Brigham Department of Neurology. "Our findings show that the Brain Care Score provides a practical framework to better understand and address this disparity — by identifying modifiable behaviors that lower stroke risk."
The Brain Care Score, originally developed at the McCance Center for Brain Health, is a tool that summarizes data across physical, lifestyle, and social-emotional factors. It creates a single score based on these factors, which include blood pressure, blood sugar, nutrition, alcohol consumption, social relationships, stress and more. A higher score indicates a lower risk of age-related brain diseases, including stroke, dementia, and depression.
The study analyzed data from 10,861 participants in the federally funded Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a large national cohort of Black and white U.S. adults aged 45 and older. None of the participants had a prior stroke at baseline, and all had complete data for the twelve lifestyle, physical, and social-emotional factors that make up the BCS, which ranges from 0 to 21 points, with higher scores indicating healthier behaviors.
Over a median of 15.9 years of follow-up, higher Brain Care Scores were associated with significantly lower stroke risk in both racial groups. A five-point higher BCS was linked to a 53% lower risk of stroke among Black individuals and a 25% lower risk among white individuals, even after adjusting for demographics and socioeconomic factors.
"The Brain Care Score integrates physical, lifestyle, and social-emotional factors into one measure of brain health," said Evy M. Reinders, MD, postdoctoral fellow and first author of this study. "Our analyses suggest that improving everyday behaviors could yield particularly large benefits for groups at higher risk of stroke, such as Black adults."
While the study was observational and cannot establish causality, the findings reinforce the importance of addressing social and behavioral determinants of health to reduce stroke disparities.
"This is a landmark publication for the Brain Care Score," said Jonathan Rosand, MD, MSc, Director of the Brain Care Labs at Mass General Brigham and Founder of the Global Brain Care Coalition. "Confirming its predictive power in diverse populations is essential if we are to make progress in ensuring that everyone everywhere has an opportunity to protect their brain health."
The research was supported by the National Institutes of Health and the American Heart Association. The funders had no role in study design, data collection, analysis, or reporting.
Authorship: In addition to Singh, Reinders, and Rosand, authors include Jasper R Senff, Reinier WP Tack, Benjamin YQ Tan, Tamara N. Kimball, Savvina Prapiadou, Marie-Gabrielle Duperron, Devanshi Choksi, Katelin Sherman BSc; Sophia Mendez BA; Riley Moran BSc; Ayneisha Tinoble BSc; Meara Maulik; Virginia Howard, Ronald M. Lazar, Christopher D Anderson, and George Howard.
Disclosures: The authors declare no conflicts of interest related to this manuscript.
Funding: National Institute of Health and American Heart Association. The funder had no role in this study's design, data collection, data analysis, and reporting.
Paper cited: first name, last name [first author] et al. "Association of Modifiable Risk Factors Measured with the Brain Care Score and Incident Stroke in the REGARDS Cohort" Neurology DOI: 10.1212/WNL.0000000000214488
