Healthy lifestyle choices can offset genetic risk for brain diseases

Christopher D. Anderson, MD, MSc, chief of the Division of Stroke and Cerebrovascular Diseases at Brigham and Women’s Hospital and associate neurologist in the Department of Neurology and Center for Genomic Medicine at Massachusetts General Hospital, is the corresponding author and Jonathan Rosand, MD, MSc, co-founder of the McCance Center for Brain Health and neurologist in the Department of Neurology and Center for Genomic Medicine at Massachusetts General Hospital, is author of an article published November 6, 2024 in Neurology^®the medical journal of the American Academy of Neurology, “Health-related behaviors and the risk of common age-related brain diseases on the severity of genetic risk.”

How would you summarize your research for a lay audience?

In this study, we investigated whether healthy lifestyle choices, as measured by a Brain Care Score (BCS), can reduce the risk of stroke, late-life depression (LLD), and dementia in individuals genetically predisposed to these conditions. Developed by researchers at Mass General Brigham, the BCS is a brain health tool that measures healthy lifestyle choices in the form of a score that then reflects the combined risk for the most common causes of age-related brain health problems.

From the data we analyzed, we found that in individuals with higher BCS, reflecting healthier habits, the risk of stroke, LLD and dementia decreased significantly, even if they had a higher genetic predisposition to these conditions. This protective lifestyle effect was strong enough to offset the increased risk from genetics. Our findings suggest that individuals who adopt healthy lifestyles can protect their brain health regardless of their genetic risk.

How does your new research differ from your previous publications?

In previous research, we found that higher BCS is associated with a reduced risk of stroke, LLD and dementia. In this study, we found that this association extends to individuals genetically predisposed to these brain disorders.

How did you conduct your study?

In this study, we investigated whether an individual’s BCS influences the genetic risk of stroke, LLD and dementia. After analyzing data from more than 368,000 individuals in the UK Biobank, we found that higher BCS significantly reduced the risk of stroke, late-life depression and dementia in individuals who had inherited an increased genetic risk for these conditions. Strikingly, we found that even a small five-point increase in BCS, through steps such as quitting smoking or controlling blood pressure, is strongly associated with a lower risk of brain disease.

What are the implications?

Our work highlights how powerful healthy lifestyle choices can be, even for those of us who, because of our genes, are at greater risk of deteriorating brain health as we age. For all of us, including those at higher genetic risk, the BCS provides a simple and direct guide to what we can do to protect our brains as we age. Patients may feel empowered to continue modifying their behavior to improve their health outcomes, regardless of their genetic risk.

What are the next steps?

We are working to update the BCS to make it even easier to use, so people can identify areas where they can improve their brain care without needing detailed information about their medical history. We’re also exploring how we can best engage communities around the world with brain care tools that can help them care for their brains, prevent dementia, stroke and depression, and thereby help themselves and their loved ones thrive.

Authorship: In addition to Anderson and Rosand, Mass General Brigham authors include Sandro Marini, Tamara N. Kimball, Ernst Mayerhofer, Reinier WP Tack, Jasper R. Senff, Savvina Prapiadou, Jonathan Duskin, Christina Kourkoulis, Nirupama Techoor, Rudolph E. Tanzi , Sanjula D. Singh and Livia Parodi.