Women with a higher McCance Brain Care Score (BCS) – a score that measures physical, lifestyle, and social-emotional factors – have a lower risk of experiencing a stroke or other cerebrovascular event reducing blood flow to the brain, according to a new study conducted by experts from Mass General Brigham . The results are published in Neurology , the medical journal of the American Academy of Neurology.
"Our findings underscore that the McCance Brain Care Score is a valuable tool for predicting cerebrovascular event risk in women, for whom stroke remains a leading cause of death," said senior author Nirupama Yechoor, MD, MSC, of the Department of Neurology at Massachusetts General Hospital (MGH), a founding member of the Mass General Brigham healthcare system. "Our study further highlights the need for broader, long-term research across diverse populations and to investigate how changes in scores over the lifespan impact the risk of stroke and related events."
One in five women between the ages of 55 and 75 in the United States is expected to experience a stroke. Previous research has shown that the McCance Brain Care Score can predict risk of stroke, dementia, and depression in a general population. Ranging from 0 to 21 points, the BCS incorporates 12 modifiable risk factors, including physical components (blood pressure, blood sugar, cholesterol levels, and body mass index [BMI]), lifestyle factors (alcohol intake, diet, smoking, physical activity, and sleep), and social-emotional factors (social relationships, stress, and sense of meaning in life).
Along with lead author Devanshi Choksi, MBBS, MPH , a research fellow in the Department of Neurology at MGH, Yechoor, and colleagues pooled data from 21,271 women with a median age of 57.9 from the Women's Health Study (WHS), a landmark clinical trial led by Brigham and Women's Hospital designed to test the effects of aspirin and vitamin E on heart disease and cancer prevention in women. Using data collected from the WHS, investigators calculated women's BCS and used follow-up data to compare scores and cerebrovascular event incidence.
They found that a higher score correlated with a reduced risk of cerebrovascular events across one's lifetime. At a median 22.4 years follow-up, 6.1 percent of participants had experienced a cerebrovascular event (stroke or transient ischemic attack). Those with a five-point higher baseline BCS (the mean baseline score was 15) were 37 percent less likely to experience a cerebrovascular event after adjusting for age, menopausal status, use of hormonal replacement therapy, and other cardiovascular disease risk factors.
Authorship: In addition to Yechoor and Choksi, Mass General Brigham authors include Leidys Gutiérrez-Martínez, Pamela M. Rist, Julie E Buring, Jasper R Senff, Sandro Marini, Christina Kourkoulis, Zeina Chemali, Amy Newhouse, M. Brandon Westover, Rudolph E Tanzi, Gregory Fricchione, Sanjula Singh, Jonathan Rosand, and Christopher D. Anderson.
Disclosures: Choksi is supported by the Lavine Brain Health Innovation Fund. Gutiérrez-Martínez has received research support from the American Heart Association. Westover is a co-founder, scientific advisor, consultant to, and has personal equity interest in Beacon Biosignals. Rosand has received payments for consulting and expert testimony from the National Football League and Eli Lilly and has a leadership or fiduciary role at Columbia University, Lancet Neurology, and European Stroke Journal. Anderson has received sponsored research support from Bayer AG, Massachusetts General Hospital, and the American Heart Association, is a member of the Editorial Board for Neurology, and has consulted for ApoPharma Inc.
Funding: This study was funded in part by the Lavine Brain Health Innovation Fund, the American Heart Association (AHA Award No.963719), the National Institutes of Health (NIH R01NS103924, U01NS069673), the American Heart Association (AHA 18SFRN34250007, AHA-Bugher 21SFRN812095), the MGH McCance Center for Brain Health, the National Institutes of Health, the American Heart Association-Bugher Foundation, the National Cancer Institute (CA047988 and UM1 CA182913), and the National Heart, Lung, and Blood Institute (HL043851, HL080467, and HL099355).
Paper cited: Choksi, D. et al. "Use of the Brain Care Score to Estimate the Risk of Incident Cerebrovascular Events in Middle-Aged Women" Neurology DOI: 10.1212/WNL.0000000000213674
