A Brain Care Score for Risk of Late-life Depression: Data from the UK Biobank Cohort
Sanjula Singh1, Cyprien Rivier4, Tin Oreskovic5, Sinclair Carr6, Keren Papier5, Zeina Chemali3, Leidys Gutierrez-Martinez1, Akashleena Mallick7, Livia Parodi1, Ernst Mayerhofer1, Jasper Senff8, Christina Kourkoulis1, Sandro Marini1, Santiago Clocchiatti-Tuozzo9, Courtney Nunley1, Amy Newhouse3, An Ouyang2, Brandon Westover1, Ronald Lazar10, Aleksandra Pikula11, Sarah Ibrahim11, Bart Brouwers12, Virgina Howard13, George Howard14, Nirupama Yechoor15, Cornelia van Duijn5, Thomas Littlejohns5, Kevin Sheth16, Jonathan Rosand3, Gregory Gricchione3, Christopher Anderson17, Guido Falcone18
1Henry and Allison McCance Center for Brain Health, 2Department of Neurology, Massachusetts General Hospital, 3Massachusetts General Hospital, 4Yale University, 5Nuffield Department of Population Health, University of Oxford, 6Institute for Health Metrics and Evaluation, University of Washington, 7Massachusetts General Hospital- Harvard Medical School, 8McCance Center for Brain Health, 9Yale University, Department of Neurology, 10University of Alabama At Birmingham, 1113Division of Neurology, Department of Medicine, University, University of Toronto, 12Department of Neurology and Neurosurgery, University Medical Center Utrecht, 13Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, 14UAB School of Public Hlth, 15MassGeneral Brigham, 16Yale UniversityDivision of Neuro and Critical Care, 17Brigham and Women's Hospital, 18Yale School of Medicine
Objective:
Whether or not Brain Care Score (BCS) components are associated with longitudinal changes in mood disorders is not clear. For this study, we tested the hypothesis that the BCS also significantly correlates to late-life depression incidence in the UKB.
Background:
The 21-point BCS, developed via a modified Delphi process with practitioners and patients, is a novel instrument designed to motivate behavioral and lifestyle changes, ultimately aiming to decrease incidence of dementia and stroke
Design/Methods:
The BCS was derived from UKB participants (using both the hospital and general practitioners cohort) aged 40-69 years, at baseline (2006-2010). After excluding patients with prevalent psychiatric disorders, we performed multivariable Cox proportional hazard regression models between the BCS and risk of incident late-life depression, adjusting for sex and stratified by age groups (<50, 50-59, >59 years).
Results:
The total BCS (median: 12; IQR:11-14) was derived for 416,370/502,408 (83%) UKB participants with complete data (mean age: 57; females: 54%). After exclusion of 50,395 participants who had mood or psychiatric disorders other than depression, a total of 365,975 participants were included in our analysis. In total, 6,628 incident cases of late-life depression were documented during the median follow-up period of 13 years. Each five-point increase in BCS was associated with a 59% (HR: 0.41, 95% CI: -0.03-0.85) decreased incidence of late-life depression among UKB participants aged <50, 35% (HR: 0.65, 95% CI: 0.57-0.74) among those aged 50-59; and 28% (HR: 0.72, 95% CI: 0.65-0.79) lower risk among those aged >59).
Conclusions:
In addition to its associations with dementia and stroke incidence, the BCS strongly correlates with late-life depression incidence in the UK Biobank. Additional research is needed to understand the association between BCS elements and late life depression in additional, diverse cohorts.