A new study led by researchers at Mass General Brigham has found that the Brain Care Score (BCS) is a strong predictor of stroke risk across racial groups in the United States. The findings, published in Neurology, the medical journal of the American Academy of Neurology, suggest that this composite measure of brain health may be especially valuable for addressing long-standing disparities in stroke risk. In particular, the results indicate that improvements in the Brain Care Score could yield meaningful benefits for stroke prevention among Black adults.
Black adults in the United States face a two- to threefold higher risk of stroke compared with white adults, a disparity that has persisted despite decades of research and public health efforts. Senior author Sanjula Dhillon Singh, a principal investigator in the Brain Care Labs within the Mass General Brigham Department of Neurology, explained that the Brain Care Score offers a practical way to understand better and address this gap. By focusing on modifiable behaviours, the score provides a framework for identifying concrete actions that can lower stroke risk, rather than treating such disparities as inevitable or purely genetic.
The Brain Care Score was initially developed at the McCance Center for Brain Health as a holistic tool that brings together multiple dimensions of brain health into a single metric. It incorporates physical, lifestyle, and social-emotional factors, including blood pressure and blood sugar control, nutrition, alcohol intake, physical activity, stress levels, and social relationships. Scores range from 0 to 21, with higher values reflecting healthier behaviours and a lower risk of age-related brain diseases such as stroke, dementia, and depression.
To assess the predictive value of the BCS, the researchers analysed data from 10,861 participants in the federally funded Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. This large national cohort included Black and white adults aged 45 and older who had no history of stroke at baseline and complete data for all components of the Brain Care Score. Participants were followed for a median of 15.9 years, allowing the researchers to examine long-term stroke outcomes in relation to baseline brain health.
Over the follow-up period, higher Brain Care Scores were consistently associated with lower stroke risk in both racial groups. A five-point increase in the BCS was linked to a 53 per cent reduction in stroke risk among Black participants and a 25 per cent reduction among white participants, even after adjusting for demographic and socioeconomic factors. These findings suggest that while the Brain Care Score is predictive across groups, its potential benefits may be particularly pronounced for those at higher baseline risk.
The study was observational and cannot establish causality, but the results reinforce the importance of addressing behavioural and social determinants of health in efforts to reduce stroke disparities. As Jonathan Rosand, Director of the Brain Care Labs at Mass General Brigham and Founder of the Global Brain Care Coalition, noted, confirming the predictive power of the Brain Care Score in diverse populations is a critical step towards ensuring that everyone has the opportunity to protect and improve their brain health.
More information: Evy M. Reinders 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
Journal information: Neurology Provided by Mass General Brigham
