Abstract Details

Title A Brain Care Score to Mitigate the Genetic Risk of Adverse Brain Health Outcomes

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S16 - Stroke Management and Outcomes (2:48 PM-3:00 PM)

Poster/Presentation
Number 010

Background The 21-point BCS is a novel tool derived through a modified Delphi process, developed to encourage lifestyle adjustments to lower dementia, stroke, and late-life depression risks. A lower BCS is associated with a higher risk of these outcomes.

Objective Investigate whether the association between Brain Care Score (BCS) and outcomes is independent of genetic predisposition for the same outcomes and whether improving the BCS among UK Biobank (UKB) participants could mitigate the effect of high genetic risk of dementia, stroke, and depression.

Design/Methods Data from 176,693 UKB participants with primary care records were utilized. Polygenic risk scores (PRS) for stroke and depression were generated using PRS-CS and GWAS summary data. APOE genotype determined all-cause dementia risk, stratified by APOE e4 alleles. Baseline and 12-year follow-up BCS data were collected. Sex and age-adjusted Cox Proportional Hazard models were performed to assess associations between BCS at baseline and changes in BCS over time with stroke, depression, and dementia stratified by tertiles of genetic risk.

Results Even among those with high genetic risk, participants with high BCS exhibited lowered hazards: stroke (HR: 0.55; 95%CI 0.48-0.62), depression (HR: 0.48; 95%CI 0.45-0.52), and dementia (HR: 0.80; 95%CI 0.70-0.91). Similarly, a 5-point longitudinal increase in total BCS during follow-up lowered the risks among those at the highest genetic risk of stroke (HR: 0.69; 95%CI 0.59-0.81) and depression (HR:0.57; 95%CI 0.51-0.63).

Conclusions A higher BCS mitigates conferred genetic risk for stroke, dementia, and depression. Improvements in the BCS over the 12-year observation period were shown to lessen genetic risk effects for these adverse brain health outcomes, adding further weight to the utility of the BCS as a tool for brain care.

Authors/Disclosures
Tamara N. Kimball, MD (Mass General Brigham) PRESENTER	Dr. Kimball has nothing to disclose.
Ernst Mayerhofer, MD	Dr. Mayerhofer has nothing to disclose.
Jasper R. Senff, MD (McCance Center for Brain Health)	Dr. Senff has nothing to disclose.
Sandro Marini	No disclosure on file
Cyprien Rivier, MD (Yale University)	Dr. Rivier has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pyxis Partners.
Christina Kourkoulis	No disclosure on file
Tin Oreskovic (Big Data Institute, Nuffield Department of Population Health)	No disclosure on file
Sinclair Carr	No disclosure on file
Guido J. Falcone, MD (Yale School of Medicine)	The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.
Nirupama Yechoor, MD (MassGeneral Brigham)	Dr. Yechoor has nothing to disclose.
Jonathan Rosand, MD (Massachusetts General Hospital)	Dr. Rosand has received personal compensation for serving as an employee of Massachusetts General Hospital. Dr. Rosand has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly and Co. Dr. Rosand has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Rosand has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for National Football League. The institution of Dr. Rosand has received research support from NIH. The institution of Dr. Rosand has received research support from American Heart Association. Dr. Rosand has received personal compensation in the range of $0-$499 for serving as a Peer reviewer with National Institutes of Health. Dr. Rosand has a non-compensated relationship as a Trustee with Columbia University that is relevant to AAN interests or activities.
Sanjula D. Singh, MD, PhD	Dr. Singh has nothing to disclose.
Livia Parodi	No disclosure on file
Christopher D. Anderson, MD, PhD, FAAN (Brigham and Women's Hospital)	The institution of Dr. Anderson has received research support from Bayer AG. The institution of Dr. Anderson has received research support from American Heart Association. The institution of Dr. Anderson has received research support from National Institutes of Health. An immediate family member of Dr. Anderson has received publishing royalties from a publication relating to health care.