The predictive validity of a Brain Care Score for late-life depression and a composite outcome of dementia, stroke, and late-life depression: data from the UK Biobank cohort.

Autor:	Singh SD; 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 Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States., Rivier CA; Department of Neurology, Yale School of Medicine, New Haven, CT, United States.; Yale Center for Brain and Mind Health, New Haven, CT, United States., Papier K; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom., 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 Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, 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 Massachusetts Institute of Technology (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 Hospitall, 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 Massachusetts Institute of Technology (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 Hospitall, Boston, MA, United States., Senff 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 Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States.; Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, Netherlands., Clocchiatti-Tuozzo S; Department of Neurology, Yale School of Medicine, New Haven, CT, United States.; Yale Center for Brain and Mind Health, New Haven, CT, 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., Westover MB; 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., Tanzi RE; 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., Lazar RM; Department of Neurology, University of Alabama at Birmingham (UAB) Heersink School of Medicine, University of Alabama at Birmingham (UAB) McKnight Brain Institute, Birmingham, AL, United States., Pikula A; Jay and Sari Sonshine Centre for Stroke Prevention & Cerebrovascular Brain Health, University Health Network, Krembil Brain Institute, Toronto, ON, Canada.; Department of Medicine, Division of Neurology, The Temerty Faculty of Medicine at the University of Toronto, Toronto, ON, Canada., Ibrahim S; Jay and Sari Sonshine Centre for Stroke Prevention & Cerebrovascular Brain Health, University Health Network, Krembil Brain Institute, Toronto, ON, Canada.; Program for Health System and Technology Evaluation; Toronto General Hospital Research Institute, Toronto, ON, Canada.; Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health; University of Toronto, Toronto, ON, Canada.; Centre for Advancing Collaborative Healthcare & Education (CACHE), University of Toronto, Toronto, ON, Canada., Brouwers HB; Department of Neurosurgery, Elisabeth TweeSteden Ziekenhuis, Tilburg, Netherlands., Howard VJ; 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., 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 Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States., Littlejohns T; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom., Sheth KN; Department of Neurology, Yale School of Medicine, New Haven, CT, United States.; Yale Center for Brain and Mind Health, New Haven, CT, United States., 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 Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States.; Center for Genomic Medicine, 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., 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 Massachusetts Institute of Technology (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 Hospitall, Boston, MA, United States., Falcone GJ; Department of Neurology, Yale School of Medicine, New Haven, CT, United States.; Yale Center for Brain and Mind Health, New Haven, CT, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in psychiatry [Front Psychiatry] 2024 Jul 23; Vol. 15, pp. 1373797. Date of Electronic Publication: 2024 Jul 23 (Print Publication: 2024).
DOI:	10.3389/fpsyt.2024.1373797
Abstrakt:	Introduction: The 21-point Brain Care Score (BCS) is a novel tool designed to motivate individuals and care providers to take action to reduce the risk of stroke and dementia by encouraging lifestyle changes. Given that late-life depression is increasingly recognized to share risk factors with stroke and dementia, and is an important clinical endpoint for brain health, we tested the hypothesis that a higher BCS is associated with a reduced incidence of future depression. Additionally, we examined its association with a brain health composite outcome comprising stroke, dementia, and late-life depression. Methods: The BCS was derived from the United Kingdom Biobank baseline evaluation in participants with complete data on BCS items. Associations of BCS with the risk of subsequent incident late-life depression and the composite brain health outcome were estimated using multivariable Cox proportional hazard models. These models were adjusted for age at baseline and sex assigned at birth. Results: A total of 363,323 participants were included in this analysis, with a median BCS at baseline of 12 (IQR: 11-14). There were 6,628 incident cases of late-life depression during a median follow-up period of 13 years. Each five-point increase in baseline BCS was associated with a 33% lower risk of incident late-life depression (95% CI: 29%-36%) and a 27% lower risk of the incident composite outcome (95% CI: 24%-30%). Discussion: These data further demonstrate the shared risk factors across depression, dementia, and stroke. The findings suggest that a higher BCS, indicative of healthier lifestyle choices, is significantly associated with a lower incidence of late-life depression and a composite brain health outcome. Additional validation of the BCS is warranted to assess the weighting of its components, its motivational aspects, and its acceptability and adaptability in routine clinical care 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. GF 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. LG-M receives sponsored research support from the American Heart grant number 963719. JR receives sponsored research support from the US National Institutes of Health and the American Heart Association, and receives payments for expert testimony and consulting fees from the National Football League. EM is an employee of Regeneron Genetics Center. 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.​ The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. (Copyright © 2024 Singh, Rivier, Papier, Chemali, Gutierrez-Martinez, Parodi, Mayerhofer, Senff, Clocchiatti-Tuozzo, Nunley, Newhouse, Ouyang, Westover, Tanzi, Lazar, Pikula, Ibrahim, Brouwers, Howard, Howard, Yechoor, Littlejohns, Sheth, Rosand, Fricchione, Anderson and Falcone.)
Databáze:	MEDLINE
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