Study Links Higher Brain Care Score to Reduced Risk of Late-Life Depression

Late-life depression, defined as depression onset in individuals over 60, affects up to a third of this age group and can be profoundly debilitating. Recent research highlighted that lifestyle choices may significantly influence the risk of developing this condition. A study conducted by researchers from Mass General Brigham, in collaboration with Yale University, has shown that a higher Brain Care Score (BCS) is associated with a reduced risk of late-life depression.

The findings were published in the journal Frontiers in Psychiatry.

The Brain Care Score (BCS) was previously developed and validated by researchers at Mass General Brigham to help patients and clinicians identify lifestyle changes that could reduce the risk of dementia and stroke. The new study extended the utility of BCS by linking it to a lower risk of late-life depression. This research underscores the shared biological risk factors among stroke, dementia, and depression and highlights the potential of the BCS to guide lifestyle changes for better brain health.

Developed by researchers at the McCance Center and their collaborators, the BCS is designed to help prevent brain diseases by focusing on modifiable risk factors. The score comprises four physical risk factors (blood pressure, haemoglobin A1c, cholesterol, and body mass index), five lifestyle elements (nutrition, alcohol intake, smoking, physical activity, and sleep), and three social/emotional elements (stress, relationships, and life purpose). A higher score on the 21-point scale indicates a lower risk of brain disease.

Utilizing data from over 350,000 participants in the U.K. Biobank (UKB) study, the researchers demonstrated that a five-point increase in baseline BCS was associated with a 33% lower risk of late-life depression and a 27% lower composite risk of late-life depression, stroke, and dementia over a median follow-up period of 13 years.

Under-diagnosis and under-documentation of depression pose challenges to epidemiological research, but the inclusion of primary care records in this study helped mitigate the risk of missing diagnoses. Interestingly, the researchers found a substantial association between baseline BCS and risk of depression in individuals under 50 years of age. While they expected older individuals to show neurodegenerative and inflammatory processes contributing to late-life depression, stroke, and dementia, the neurobiological changes leading to depression in younger individuals are less understood.

Furthermore, the researchers are investigating whether increasing the BCS by five points or more over time can reduce the future risk of stroke and dementia compared to those without significant score increases. The ongoing research aims to elucidate the relationship between BCS scores and the risk of brain diseases.

Reference: Singh, S. D., et al. (2024) 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. Frontiers in Psychiatry. doi.org/10.3389/fpsyt.2024.1373797.