基于参与者回答得出的脑部护理评分与COSMOS研究中的中风事件之间的关联。

Assocation Between a Brain Care Score Derived from Participant Responses and Incident Stroke from the COSMOS Study.

作者信息

Senff Jasper R, Tack Reinier W P, Tan Benjamin Y Q, Kimball Tamara N, Prapiadou Savvina, Choksi Devanshi, Ranman Tanzeela H, McVeigh Taylor M, Shadyab Aladdin H, Brouwers H Bart, Manson JoAnn E, Sesso Howard D, Anderson Christopher D, Rosand Jonathan, Singh Sanjula D, Rist Pamela M, Yechoor Nirupama

机构信息

Brain Care Labs at Massachusetts General Brigham, Boston, MA, USA (JRS, RWPT, BYQT, TNK, SP, DC, THR, TMM, CDA, JR, SDS, NY).

Department of Neurology, Massachusetts General Brigham, Boston, MA, USA (JRS, RWPT, BYQT, TNK, SP, DC, CDA, JR, SDS, NY).

出版信息

Am J Lifestyle Med. 2025 Aug 22:15598276251368345. doi: 10.1177/15598276251368345.

DOI:10.1177/15598276251368345

PMID:40881260

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12373657/

Abstract

OBJECTIVE

The Brain Care Score (BCS), previously validated to predict the risk of age-related brain diseases, incorporates 12 modifiable risk factors, including blood pressure and laboratory measurements. In the U.S., fewer than 50% of individuals recall these measurements, limiting the BCS's accessibility. This study aims to evaluate the predictive validity and discriminatory power of a BCS derived from participant responses for incident stroke.

METHODS

We performed retrospective analyses using the prospectively collected COSMOS data. The BCS, ranging 0-19 points, was calculated from modifiable risk factors derived from participant responses only. A Cox proportional hazard model, adjusted for sex and age was used to estimate the association between a higher BCS, indicating better brain health, and incident stroke.

RESULTS

Among 17 150 participants (median age 70.8, 59.6% female) free of stroke and TIA at baseline and with complete BCS data, 187 (1.1%) experienced a stroke during a mean follow-up duration of 3.6 (SD:0.7) years. A 5-point higher BCS was associated with a 36% lower stroke risk (HR:0.64 [95%CI:0.48-0.84], c-statistic:0.68).

DISCUSSION

A BCS derived from participant responses showed similar predictive performance and discriminatory ability compared to previous validation studies that use physical and laboratory measurements. Future studies could consider incorporating the BCS derived from participant responses when physical and laboratory measurements are not readily available.

摘要

目的

脑健康评分（BCS）先前已被验证可预测与年龄相关的脑部疾病风险，它纳入了12个可改变的风险因素，包括血压和实验室检测指标。在美国，不到50%的人能记起这些检测指标，这限制了BCS的可及性。本研究旨在评估基于参与者回答得出的BCS对新发中风的预测效度和区分能力。

方法

我们使用前瞻性收集的COSMOS数据进行回顾性分析。BCS范围为0至19分，仅根据参与者回答得出的可改变风险因素计算。采用经性别和年龄调整的Cox比例风险模型来估计较高的BCS（表明更好的脑健康状况）与新发中风之间的关联。

结果

在17150名基线时无中风和短暂性脑缺血发作（TIA）且有完整BCS数据的参与者中（年龄中位数70.8岁，女性占59.6%），187人（1.1%）在平均3.6（标准差：0.7）年的随访期间发生了中风。BCS每高5分，中风风险降低36%（风险比：0.64 [95%置信区间：0.48 - 0.84]，c统计量：0.68）。