JUST how healthy is your brain?
Scientists have developed a tool to assess just that, and it can help predict if you’re at risk of having a stroke, dementia and depression in later life.
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Dubbed the ‘Brain Care Score‘ (BCS), the test assesses 12 modifiable physical, lifestyle and social-emotional factors.
It looks at things like your blood pressure, diet, and whether you smoke or get enough sleep.
The higher your score on the 21-point scale, the better shape your brain is in and the lower your chances of brain disease.
Depending on how you fare in different areas, doctors can then point patients to changes they can make to improve their brain health.
MORE AT-HOME HEALTH CHECKS
Dr Jonathan Rosand, lead developer of the test and co-founder of the McCance Center for Brain Health at Massachusetts General Hospital, said: “The BCS is a simple tool designed to help anyone in the world answer the question, ‘What can I do to take better care of my brain?’
“We now have compelling evidence that raising your BCS is not only likely to make your brain healthier and more resistant to diseases like dementia and stroke, but that it also offers the hope of protection from depression.
“What’s good for the brain is good for the heart and the rest of the body.”
The BCS measures blood pressure, cholesterol, hemoglobin A1c (blood sugar levels) and body mass index (BMI) to understand someone’s physical health, while it looks at nutrition, alcohol consumption, exercise, sleep and smoking for their lifestyle.
The three social-emotional aspects refer to relationships, stress management and meaning in life.
Researchers evaluated data from 363,323 people aged 40 to 69 in the UK Biobank study between 2006 and 2010.
Participants then had follow-up assessments three times over the next 13 years on average.
The average baseline score was 12.
For every five-point positive difference in their BCS from their baseline, there was a 59 per cent lower risk of developing dementia, and a 48 per cent lower risk of experiencing a stroke among adults aged 50 and under when they enrolled.
Similar estimates were found for participants aged 50 to 59 (32 per cent and 52 per cent respectively), but were lower for those aged 60 and over (eight per cent and 33 per cent).
When it came to depression, there was a 33 per cent lower risk of the mental health condition over the age of 60, and a 27 per cent lower composite risk of late-life depression, dementia and stroke.
The ‘Brain Care Score’ test
SCIENTISTS have created a tool created to assess someone’s risk of dementia, stroke and depression.
It involves answering 12 questions, which then provides a score out of 21.
On average, people score 12. Experts say the higher the score, the healthier your brain and the lower your risk of brain disease.
Once you have your score, speak to your GP about areas you could improve, then take the test again months, years and decades down the line.
PHYSICAL HEALTH
1. Blood pressure
- Resting blood pressure greater than 140/90, with or without treatment (rank 0)
- Resting blood pressure 120-139/80-89, with or without treatment (rank 2)
- Resting blood pressure less than 120/80 (rank 3)
2. Blood sugar
- Hemoglobin A1c greater than 6.4 (rank 0)
- Hemoglobin A1c between 5.7 and 6.4 (rank 1)
- Hemoglobin A1c less than 5.7 (rank 2)
3. Cholesterol
- 190 or higher (rank 0)
- No treatment required or less than 190mg/dL (rank 1)
- If cardiovascular disease is present, LDL is in accordance to the latest CDC recommendations (rank 1)
4. BMI
- Lower than 18.5kg/m2
- 18.5-25kg/m2
- 25-29.9kg/m2
- Greater than 30kg/m2
LIFESTYLE
5. Nutrition
Dietary habits – 4.5 servings of fruit and vegetables per day, 2 servings of lean protein per day, 3 or more servings of whole grains per day, less than 1,500mg of sodium per day, less than 1litre (36oz) of sugar sweet drinks (soda, juice etc.) per week.
- Typical weekly diet does not include at least 2 of the recommendations above (rank 0)
- Typical weekly diet includes 2 or more of the recommendations above (rank 1)
- Typical weekly diet includes 3 or more of the recommendations above (rank 2)
6. Alcohol
- 4 or more alcohol drinks per week (rank 0)
- 2-3 alcoholic drinks per week (rank 1)
- 0-1 alcoholic drinks per week (rank 2)
7. Smoking
- Current smoker (rank 0)
- Never smoked or quiet more than a year go (rank 3)
8. Aerobic activities
- Less than 150 minutes of moderate or 75 minutes of high intensity physical activity per week (rank 0)
- At least 150 minutes of moderate physical activity (e.g. walking) or 75 minutes of high intensity physical activity (e.g. swimming) per week (rank 1)
9. Sleep
- Untreated sleep disorder and/or sleeps less than 7 hours per night (rank 0)
- Treated sleep disturbances and sleeps 7-8 hours of routine sleep per night (rank 1)
SOCIAL AND EMOTIONAL HEALTH
10. Stress
- High level of stress that often makes it difficult to function (rank 0)
- Moderate level of stress that occasionally makes it difficult to function (rank 1)
- Manageable level of stress that rarely makes it difficult to function (rank 2)
11. Social relationships
- I have few or no close connections other than my spouse or children (rank 0)
- I have at least two people, other than my spouse or children, that I feel close with and could talk to about private matters or call upon for help (rank 1)
12. Meaning in life
- I often struggle to find value or purpose in my life (rank 0)
- I generally feel that my life has meaning and/or purpose (rank 1)
TOTAL BRAIN CARE SCORE (0-21)
Source: McCance Brain Care Score
When stratifying the results by age, the team found a significant association between baseline BSC and risk of depression in those under 50.
Researchers found a five-point boost could be accomplished by:
- Stopping smoking
- Reducing stress levels (until someone displayed no symptoms of tension, restlessness or anxiety in the past two weeks)
- Improving social connections (engaging with family or friends at least once a month)
- Reducing alcohol intake (from four units per week to less than one, or only drinking on special occasions)
- Managing blood pressure (from >140/90mmHg to <120/80mmHg)
- Managing weight (from a BMI ≥30 kg/m2 to a range of 18.5–25 kg/m2)
- Controlling blood sugar levels (from HbA1c >6.4 to HbA1c <5.7)
Corresponding author Dr Christopher Anderson, chief of stroke and cerebrovascular diseases in the Department of Neurology at Brigham and Women’s Hospital, said: “Dementia, stroke, and depression are leading causes of human suffering as we age.
“This study highlights an extraordinary opportunity to prevent these conditions from developing in the first place.”
First author Dr Sanjula Singh, from the McCance Center for Brain Health at Department of Neurology of Massachusetts General Hospital and Harvard Medical School, added: “There is still much to be learned about what pathways contribute to late-life depression, dementia and stroke.
“Our results emphasise the importance of a holistic view of the brain to further understand underlying connections between different brain diseases.”
WHAT’S NEXT?
Scientists are now looking at whether people who continue to increase their BSC over time by five points or more have a reduced risk of stroke and dementia in the future, compared to those without substantial score rises.
“Increasingly, data suggests that the risk for a variety of non-communicable diseases is to some extent mediated by modifiable lifestyle changes, should they be undertaken early enough,” Dr Gregory Fricchione, associate chief of psychiatry at Massachusetts General Hospital, said.
“This research is provocative and hopeful in its implications for tackling prevalent illnesses like depression, which itself is a risk factor for many other diseases.
“This research reminds us of the interlocking of the nervous system with psychosocial and immunological stress, along with the opportunity to reduce vulnerabilities to downstream damage to the brain through improvements in the factors outlined in the BCS.”
The latest findings were published in Frontiers in Psychiatry.
Top tips to lower your score
Just like heart health, brain health can be maintained with lifestyle changes that will help keep you at your best, and work to prevent brain disease. Scientists recommend:
- Lowering your blood pressure can reduce risk of stroke, improving your BSC.
- A Mediterranean diet that’s high in vegetables, fruit and grains can improve brain health and heart health.
- Even moderate consumption of alcohol can increase your risk of cognitive decline over time.
- Smoking is also detrimental to cognition.
- Exercising 150 minutes a week can improve heart and brain health. Finding exercise you like and getting started is a great first step.
- Research has demonstrated that getting quality sleep is key to memory and brain health.
- Reducing stress, through meditation or other means, can improve your mental health overall, and reduce risk of Alzheimer’s and other types of dementia.
- Research has demonstrated that having people you can talk with and learning new things are good for brain health.
- Having a sense of purpose can improve brain health at any age.