Brain Care Score Shows Greater Stroke Prevention Benefits in Black Adults

A new study has found that the Brain Care Score (BCS), a tool developed at Mass General Brigham, can accurately predict stroke risk across racial groups in the U.S. Results published today in Neurology show that behavioral changes to improve BCS scores could particularly improve stroke prevention among Black individuals. 

“Black adults in the United States face a two- to threefold higher risk of stroke compared to White adults,” said Sanjula Dhillon Singh, MD, PhD, principal investigator in the Brain Care Labs at Massachusetts General Hospital and Harvard Medical School. “Our findings show that the Brain Care Score provides a practical framework to better understand and address this disparity—by identifying modifiable behaviors that lower stroke risk.”

The Brain Care Score was originally developed as a tool to predict the risk of age-related brain diseases based on multiple risk factors including blood pressure, blood sugar, cholesterol, diet, exercise, sleep, stress and social relationships. After answering a questionnaire, the BCS generates a single score ranging from zero to 21 points, where higher scores are linked to a lower risk of brain conditions including stroke, dementia, and depression.

“The Brain Care Score integrates physical, lifestyle, and social-emotional factors into one measure of brain health,” said Evy M. Reinders, MD, postdoctoral fellow at the department of neurology of Massachusetts General Hospital and first author of the study. “Our analyses suggest that improving everyday behaviors could yield particularly large benefits for groups at higher risk of stroke, such as Black adults.”

The study analyzed data from over 10,000 participants in the REGARDS study, which included a large cohort of Black and White adults living in the U.S. aged 45 and older. With a median follow-up of nearly 16 years, the study found that higher BCS scores were linked to lower risk of stroke for all individuals, with a stronger effect seen among Black participants. Results showed that a five-point increase in the BCS score was linked to a 53% lower risk of stroke among Black individuals and a 25% lower risk among White individuals. 

While this observational study cannot establish the causes of stroke risk among participants, these findings highlight the importance of addressing social and behavioral factors when striving to reduce differences in stroke rates in diverse populations. Importantly, the BCS is designed not just as a predictive risk score, but also as a tool for primary care providers to help patients improve their brain health. A previous study led by Singh had shown that at least 60% cases of stroke, 40% of dementia and 35% of late-life depression are linked to risk factors that can be modified. 

“Confirming its predictive power in diverse populations is essential if we are to make progress in ensuring that everyone everywhere has an opportunity to protect their brain health,” said Jonathan Rosand, MD, director of the Brain Care Labs and founder of the Global Brain Care Coalition, an initiative with the mission to reduce the rates of dementia, stroke and depression by 30% in 2050.