학술논문
The predictive validity of a Brain Care Score for dementia and stroke: data from the UK Biobank cohort.
Document Type
Academic Journal
Author
Singh SD; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Broad Institute of MIT and Harvard, Cambridge, MA, United States.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States.; Oreskovic T; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.; Carr S; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States.; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States.; Papier K; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.; Conroy M; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.; Senff JR; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Broad Institute of MIT and Harvard, Cambridge, MA, United States.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands.; Chemali Z; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Division of Neuropsychiatry, Massachusetts General Hospital, Boston, MA, United States.; Gutierrez-Martinez L; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Broad Institute of MIT and Harvard, Cambridge, MA, United States.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States.; Parodi L; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Broad Institute of MIT and Harvard, Cambridge, MA, United States.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States.; Mayerhofer E; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Broad Institute of MIT and Harvard, Cambridge, MA, United States.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States.; Marini S; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Broad Institute of MIT and Harvard, Cambridge, MA, United States.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States.; Nunley C; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Newhouse A; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Division of Neuropsychiatry, Massachusetts General Hospital, Boston, MA, United States.; Department of Medicine, Massachusetts General Hospital, Boston, MA, United States.; Ouyang A; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Brouwers HB; Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands.; Westover B; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Broad Institute of MIT and Harvard, Cambridge, MA, United States.; Rivier C; Department of Neurology, Yale School of Medicine, New Haven, CT, United States.; Falcone G; Department of Neurology, Yale School of Medicine, New Haven, CT, United States.; Howard V; Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States.; Howard G; Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States.; Pikula A; Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.; Krembil Brain Institute, Toronto, ON, Canada.; Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.; Ibrahim S; Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.; Krembil Brain Institute, Toronto, ON, Canada.; Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.; Sheth KN; Department of Neurology, Yale School of Medicine, New Haven, CT, United States.; Yechoor N; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Broad Institute of MIT and Harvard, Cambridge, MA, United States.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States.; Lazar RM; McKnight Brain Institute, Department of Neurology, School of Medicine, University of Alabama School of Medicine, Birmingham, AL, United States.; Anderson CD; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Broad Institute of MIT and Harvard, Cambridge, MA, United States.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States.; Tanzi RE; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Fricchione G; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, United States.; Littlejohns T; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.; Rosand J; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States.; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.; Broad Institute of MIT and Harvard, Cambridge, MA, United States.; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States.
Source
Publisher: Frontiers Research Foundation Country of Publication: Switzerland NLM ID: 101546899 Publication Model: eCollection Cited Medium: Print ISSN: 1664-2295 (Print) Linking ISSN: 16642295 NLM ISO Abbreviation: Front Neurol Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
1664-2295
Abstract
Introduction: The 21-point Brain Care Score (BCS) was developed through a modified Delphi process in partnership with practitioners and patients to promote behavior changes and lifestyle choices in order to sustainably reduce the risk of dementia and stroke. We aimed to assess the associations of the BCS with risk of incident dementia and stroke.
Methods: The BCS was derived from the United Kingdom Biobank (UKB) baseline evaluation for participants aged 40-69 years, recruited between 2006-2010. Associations of BCS and risk of subsequent incident dementia and stroke were estimated using Cox proportional hazard regressions, adjusted for sex assigned at birth and stratified by age groups at baseline.
Results: The BCS (median: 12; IQR:11-14) was derived for 398,990 UKB participants (mean age: 57; females: 54%). There were 5,354 incident cases of dementia and 7,259 incident cases of stroke recorded during a median follow-up of 12.5 years. A five-point higher BCS at baseline was associated with a 59% (95%CI: 40-72%) lower risk of dementia among participants aged <50. Among those aged 50-59, the figure was 32% (95%CI: 20-42%) and 8% (95%CI: 2-14%) for those aged >59 years. A five-point higher BCS was associated with a 48% (95%CI: 39-56%) lower risk of stroke among participants aged <50, 52% (95%CI, 47-56%) among those aged 50-59, and 33% (95%CI, 29-37%) among those aged >59.
Discussion: The BCS has clinically relevant and statistically significant associations with risk of dementia and stroke in approximately 0.4 million UK people. Future research includes investigating the feasibility, adaptability and implementation of the BCS for patients and providers worldwide.
Competing Interests: CA receives sponsored research support from the US National Institutes of Health, the American Heart Association, and Bayer AG, and has consulted for ApoPharma. GrF receives sponsored research support from the National Institute of Mental Health Clinical Global Mental Health Research T32 Fellowship, receives royalties or licenses from Johns Hopkins University Press, University of Chicago Press, Belvoir Press, and the American Psychiatric Press, is on a Data Safety Monitoring Board or Advisory Board of Healthy Hearts Healthy Minds DSMB, is a Board of Directors member at the Rosalynn Carter Institute, and has stock or stock options from Revival Therapeutics Consultant. JR receives sponsored research support from the US National Institutes of Health and the American Heart Association, receives payments for consulting and expert testimony from the National Football League, and has a leadership or fiduciary role at Columbia University and Lancet Neurology. KP was supported by Cancer Research UK [grant number C570/A16491 and C16077/A29186]. LG-M receives sponsored research support from the American Heart [grant number 963719]. MC is supported by the Wellcome Trust [grant number 205339/Z/16/Z]. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Singh, Oreskovic, Carr, Papier, Conroy, Senff, Chemali, Gutierrez-Martinez, Parodi, Mayerhofer, Marini, Nunley, Newhouse, Ouyang, Brouwers, Westover, Rivier, Falcone, Howard, Howard, Pikula, Ibrahim, Sheth, Yechoor, Lazar, Anderson, Tanzi, Fricchione, Littlejohns and Rosand.)
Methods: The BCS was derived from the United Kingdom Biobank (UKB) baseline evaluation for participants aged 40-69 years, recruited between 2006-2010. Associations of BCS and risk of subsequent incident dementia and stroke were estimated using Cox proportional hazard regressions, adjusted for sex assigned at birth and stratified by age groups at baseline.
Results: The BCS (median: 12; IQR:11-14) was derived for 398,990 UKB participants (mean age: 57; females: 54%). There were 5,354 incident cases of dementia and 7,259 incident cases of stroke recorded during a median follow-up of 12.5 years. A five-point higher BCS at baseline was associated with a 59% (95%CI: 40-72%) lower risk of dementia among participants aged <50. Among those aged 50-59, the figure was 32% (95%CI: 20-42%) and 8% (95%CI: 2-14%) for those aged >59 years. A five-point higher BCS was associated with a 48% (95%CI: 39-56%) lower risk of stroke among participants aged <50, 52% (95%CI, 47-56%) among those aged 50-59, and 33% (95%CI, 29-37%) among those aged >59.
Discussion: The BCS has clinically relevant and statistically significant associations with risk of dementia and stroke in approximately 0.4 million UK people. Future research includes investigating the feasibility, adaptability and implementation of the BCS for patients and providers worldwide.
Competing Interests: CA receives sponsored research support from the US National Institutes of Health, the American Heart Association, and Bayer AG, and has consulted for ApoPharma. GrF receives sponsored research support from the National Institute of Mental Health Clinical Global Mental Health Research T32 Fellowship, receives royalties or licenses from Johns Hopkins University Press, University of Chicago Press, Belvoir Press, and the American Psychiatric Press, is on a Data Safety Monitoring Board or Advisory Board of Healthy Hearts Healthy Minds DSMB, is a Board of Directors member at the Rosalynn Carter Institute, and has stock or stock options from Revival Therapeutics Consultant. JR receives sponsored research support from the US National Institutes of Health and the American Heart Association, receives payments for consulting and expert testimony from the National Football League, and has a leadership or fiduciary role at Columbia University and Lancet Neurology. KP was supported by Cancer Research UK [grant number C570/A16491 and C16077/A29186]. LG-M receives sponsored research support from the American Heart [grant number 963719]. MC is supported by the Wellcome Trust [grant number 205339/Z/16/Z]. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Singh, Oreskovic, Carr, Papier, Conroy, Senff, Chemali, Gutierrez-Martinez, Parodi, Mayerhofer, Marini, Nunley, Newhouse, Ouyang, Brouwers, Westover, Rivier, Falcone, Howard, Howard, Pikula, Ibrahim, Sheth, Yechoor, Lazar, Anderson, Tanzi, Fricchione, Littlejohns and Rosand.)