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Abstract Details

Association Between a Brain Care Score and Risk of Cerebrovascular Events in American Women
General Neurology
S11 - Global Health and Neuroepidemiology (11:51 AM-12:03 PM)
004
The McCance Brain Care Score (MBCS) is a novel tool derived through a modified Delphi process to motivate lifestyle changes to reduce the risk of CVE based on prior studies. However, few studies have determined the association between the MBCS and incident CVE. Studying this potential association is important given the higher risk of stroke among women and the potential for unique risk profiles given physiologic and pharmacologic hormonal changes across the lifespan. 
To assess the association between a novel tool and incident cerebrovascular events (CVE).
The study population was participants in the Women’s Health study (WHS) who had available risk factor information needed to calculate the modified MBCS 5 years after enrollment and no prior history of CVE. In the WHS-adaptation of the MBCS, higher scores suggest better brain health. Participants were followed from MBCS assessment until first CVE (Stroke or Transient Ischemic Attack), end of study, loss to follow-up, or death, whichever occurred first. CVE were confirmed by medical record review. Cox proportional hazards models were used to examine the association between the MBCS, modeled as a continuous variable, and incident CVE adjusted for potential confounders.

In total, 22,965 women were eligible with a median age of 58.0 (IQR 54.0-63.9) and median MBCS of 15 (14-17). There were 1,364 (5.9%) incident CVE events during a median follow-up of 22.5 (16.8-23.6) years. A one-point higher baseline MBCS was associated with 11% decreased risk of incident CVE after adjusting for age, postmenopausal status, and use of hormonal replacement therapy (HR=0.89; 95%CI=0.87-0.91). This association remained significant after adjusting for comorbidities, race, educational attainment, and income (HR=0.90; 95%CI=0.88-0.93).

Higher baseline MBCS was associated with a decreased risk of incident CVE among women. Future studies are needed to understand how longitudinal changes in the MBCS impact risk of CVE. 
Authors/Disclosures
Leidys Gutierrez-Martinez (Massachusetts General Hospital)
PRESENTER
The institution of Dr. Gutierrez-Martinez has received research support from American Heart Association.
Pamela Rist (Brigham & Women's Hospital) The institution of Dr. Rist has received research support from National Institutes of Health. The institution of Dr. Rist has received research support from Brigham and Women's Hospital.
No disclosure on file
No disclosure on file
No disclosure on file
Jonathan Rosand (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.
Christopher Anderson (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.
Nirupama Yechoor (MassGeneral Brigham) Dr. Yechoor has nothing to disclose.