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

被引：1

作者：

Singh, Sanjula D. ^{[1
,2
,3
]}

Rivier, Cyprien A. ^{[4
,5
]}

Papier, Keren ^{[6
,21
]}

Chemali, Zeina ^{[1
,2
,7
]}

Gutierrez-Martinez, Leidys ^{[1
,2
,3
]}

Parodi, Livia ^{[1
,2
,3
,8
,9
]}

Mayerhofer, Ernst ^{[1
,2
,3
,8
,9
]}

Senff, Jasper ^{[1
,2
,3
,10
]}

Clocchiatti-Tuozzo, Santiago ^{[4
,5
]}

Nunley, Courtney ^{[1
]}

Newhouse, Amy ^{[1
,7
,11
]}

Ouyang, An ^{[1
]}

Westover, M. Brandon ^{[1
,2
]}

Tanzi, Rudolph E. ^{[1
,2
]}

Lazar, Ronald M. ^{[12
]}

Pikula, Aleksandra ^{[13
,14
]}

Ibrahim, Sarah ^{[13
,15
,16
,17
]}

Brouwers, H. Bart ^{[18
]}

Howard, Virginia J. ^{[19
]}

Howard, George ^{[19
]}

Yechoor, Nirupama ^{[1
,2
,3
]}

Littlejohns, Thomas ^{[6
]}

Sheth, Kevin N. ^{[4
,5
]}

Rosand, Jonathan ^{[1
,2
,3
,8
]}

Fricchione, Gregory ^{[1
,20
]}

Anderson, Christopher D. ^{[1
,2
,3
,8
,9
]}

Falcone, Guido J. ^{[4
,5
]}

机构：

[1] Massachusetts Gen Hosp, Henry & Allison McCance Ctr Brain Hlth, Boston, MA 02114 USA

[2] Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02114 USA

[3] Broad Inst Massachusetts Inst Technol MIT & Harvar, Cambridge, MA 02142 USA

[4] Yale Sch Med, Dept Neurol, New Haven, CT 06510 USA

[5] Yale Ctr Brain & Mind Hlth, New Haven, CT 06511 USA

[6] Univ Oxford, Nuffield Dept Populat Hlth, Oxford, England

[7] Massachusetts Gen Hosp, Div Neuropsychiat, Boston, MA USA

[8] Massachusetts Gen Hosp, Ctr Genom Med, Boston, MA 02114 USA

[9] Brigham & Womens Hosp, Dept Neurol, Boston, MA 02115 USA

[10] Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, Utrecht, Netherlands

[11] Massachusetts Gen Hosp, Dept Med, Boston, MA USA

[12] Univ Alabama Birmingham UAB, McKnight Brain Inst, Heersink Sch Med, Dept Neurol, Birmingham, AL USA

[13] Univ Hlth Network, Krembil Brain Inst, Jay & Sari Sonshine Ctr Stroke Prevent & Cerebrova, Toronto, ON, Canada

[14] Univ Toronto, Temerty Fac Med, Dept Med, Div Neurol, Toronto, ON, Canada

[15] Toronto Gen Hosp Res Inst, Program Hlth Syst & Technol Evaluat, Toronto, ON, Canada

[16] Univ Toronto, Dalla Lana Sch Publ Hlth, Inst Hlth Policy Management & Evaluat IHPME, Toronto, ON, Canada

[17] Univ Toronto, Ctr Adv Collaborat Healthcare & Educ CACHE, Toronto, ON, Canada

[18] Elisabeth Tweesteden Ziekenhuis, Dept Neurosurg, Tilburg, Netherlands

[19] Univ Alabama Birmingham, Sch Publ Hlth, Dept Biostat, Birmingham, AL USA

[20] Massachusetts Gen Hosp, Benson Henry Inst Mind Body Med, Boston, MA USA

[21] Nuffield Dept Populat Hlth, Canc Epidemiol Unit, Oxford, England

来源：

FRONTIERS IN PSYCHIATRY | 2024年 / 15卷

基金：

美国国家卫生研究院; 英国惠康基金;

关键词：

depression; -; epidemiology; prevention; risk factor; brain health; stroke; dementia; RISK; ASSOCIATION; PREVALENCE; DISORDERS; SCALE; MODEL;

D O I：

10.3389/fpsyt.2024.1373797

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

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.

引用

页数：15

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