Even with Genetic Predisposition, Lifestyle Choices Impact Risk of Later Brain Disease

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Even with Genetic Predisposition, Lifestyle Choices Impact Risk of Later Brain Disease
3d illustration of the human brain with visible blood vessels illustrating Alzheimer's disease and dementia.
Credit: Lars Neumann/Getty Images

Healthier midlife behaviors lead to better outcomes for age-related brain diseases even in people with genetic predisposition, research using data from the U.K. Biobank showed. A team led by researchers at Massachusetts General Hospital (MGH) in Boston found that after about 12 years of follow-up, each 5-point improvement in subjects’ Brain Care Score (BCS) was tied to a reduced risk of dementia, stroke, and depression.

The study appeared in Neurology and was led by senior author Christopher D. Anderson, MD, an associate professor of neurology at Harvard Medical School and an associate neurologist at Massachusetts General Hospital. 

BCS is a brain health tool that ranks behaviors and clinical measurements with the aim of encouraging lifestyle adjustments to lower the incidence of age-related brain disease. 

“Our findings suggest that individuals who adopt healthy lifestyle choices can protect their brain health, regardless of their genetic risk,” the researchers wrote in a release.

The team measured healthy lifestyle choices using BCS. The 21-point score assesses blood pressure, hemoglobin A1C levels, cholesterol levels, body mass index, weekly diet, alcohol consumption, smoking habits, aerobic activity, sleep habits, stress levels, social relationships, and feelings of meaning or purpose in life.

This analysis included over 360,000 U.K. Biobank participants. Median age was 58 years, and almost half were men. Polygenic risk scores were used to calculate genetic risk for stroke and depression. For dementia, APOE status was used. 

Individuals with a higher BCS had a significant decrease in their risk of stroke, depression, and dementia even when they had a higher genetic predisposition to these conditions. This protective lifestyle effect was strong enough to offset the increased risk from genetics. 

In previous research, the team found a higher BCS is associated with decreased risk of stroke, depression, and dementia. In this study, the association extends to individuals who are genetically predisposed to these brain conditions.

“Our work emphasizes how powerful healthy lifestyle choices can be, even for those of us who, because of our genes, are at higher risk of deterioration in our brain health as we age. For all of us, including those with higher genetic risk, the BCS offers a simple and direct guide to what we can do to protect our brains as we age. Patients can feel empowered to continue to modify behaviors to improve their health outcomes, regardless of their genetic risk,” they wrote.

The team is working to update BCS to make it even more user-friendly, allowing people to identify areas where they can improve their brain care without requiring detailed information about their medical histories. They are also “studying how best to engage communities around the world with brain care tools that can enable them to take good care of their brains, prevent dementia, stroke, and depression, and thereby help themselves and their loved ones to flourish.”

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