Score for predicting dementia risk also may predict depression, study finds

By CNN Newsource

Published July 22, 2024 9:00 PM

By Kristen Rogers, CNN

(CNN) — Scientists announced in December the successful creation of the Brain Care Score, a tool for assessing dementia or stroke risk without medical procedures.

That score, which also helps patients and doctors identify beneficial lifestyle changes, may now also be able to predict the odds of developing depression later in life, according to a new study.

The 21-point Brain Care Score, or BCS, refers to how a person fares on 12 health-related factors regarding physical, lifestyle and social-emotional components of health. Having a higher BCS was associated with a lower risk of developing depression in “late life,” defined as age 60 or older, found the study published Tuesday in the journal Frontiers in Psychiatry.

“The Brain Care Score 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?’” said study author Dr. Jonathan Rosand, cofounder of the McCance Center for Brain Health at Massachusetts General Hospital and lead developer of the BCS, in a news release.

“This paper provides 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,” added Rosand, a professor of neurology at Harvard Medical School in Boston.

The four physical components of the BCS are blood pressure, cholesterol, hemoglobin A1c and body mass index, while the five lifestyle factors are nutrition, alcohol consumption, aerobic activities, sleep and smoking. The three social-emotional aspects referred to relationships, stress management and meaning in life. The higher a participant’s score, the lower their risk of brain disease.

Up to one-third or more of people older than 60 experience late-life depression, the risk of which can be influenced by lifestyle habits, the authors said.

The team used health data from more than 350,000 people who had been recruited for the UK Biobank study between 2006 and 2010 and participated in follow-up assessments three times over the next decade or so. The UK Biobank study has followed the health outcomes of more than 500,000 people generally between ages 40 and 69 in the United Kingdom for at least 10 years.

For participants of the new study, every five-point positive difference in their BCS was associated with a 33% lower risk of late-life depression, as well as a 27% lower composite risk of late-life depression, dementia and stroke over a follow-up period of 13 years on average.

“People think of the skull as like a separating factor for the brain, (as if) the brain is like an individual thing,” said Dr. Richard Isaacson, a preventive neurologist at the Institute for Neurodegenerative Diseases in Florida who wasn’t involved in the study. “But it’s clear, based on this study and others, that if we can stay physically active, eat a healthy diet, minimize smoking and alcohol, keep a healthy weight and stay socially engaged, there’s going to be downstream benefits — not just on vascular health and dementia, but also for mental health and emotional health.”

The importance of lifelong brain care

The authors also found a substantial link between baseline BCS and depression risk among those younger than 50 — which they considered surprising since they expected only older adults may have neurodegenerative and inflammatory changes that can lead to depression, dementia and stroke.

But the association among younger adults falls in line with the life trajectory of other diseases associated with age, Isaacson said.

“In our Alzheimer’s prevention clinic, we’ve been seeing people age 25 and up,” Isaacson said. “That finding is not surprising to me, because there are early life, midlife and late-life risk factors for dementia. (For) Alzheimer’s disease, for example, pathology starts in the brain decades before symptoms of memory loss. If a person is 65 years old and diagnosed with dementia, that means the disease first started in their brains between the ages of 35 to 45.”

The process is similar for a heart attack or stroke an older adult experiences after having high cholesterol in their 30s, he added — so the findings underscore the importance of caring for your brain throughout your life.

“There is still much to be learned about what pathways contribute to late-life depression, dementia and stroke,” said Dr. Sanjula Singh, first author of the study and instructor at the McCance Center for Brain Health, in a news release. “Our results emphasize the importance of a holistic view of the brain to further understand underlying connections between different brain diseases.”

If you’re an older adult experiencing depression, know that being open and seeking care is critical, Isaacson said.

“Older generations may have been primed to just fight through it, (thinking) it’s mind over matter,” Isaacson said. But that’s not always the case, he added, so try to accept that you’re not feeling OK and talk with your doctor about treatment options such as therapy or antidepressants.

The latter could have an added benefit for your cognitive function as you age, as some early research has started to indicate that some antidepressants, such as escitalopram, may slow the accumulation of beta-amyloid-protein in the brain, Isaacson added. An elevated amount of amyloid is a hallmark sign of Alzheimer’s disease.