Your Brain Can Really Score with These Lifestyle Changes

The most common age-related brain disorders worldwide are stroke, dementia, and late-life depression, which is associated with cognitive decline. These conditions share risk factors that can be controlled, including physical activity, nutrition, and tobacco smoking.

Based on these modifiable factors, a Brain Care Score (BCS) can help you gauge your brain health and risk of common brain disorders (Singh 2024).

The BCS results range from 0-21 and are based on:

4 physical components

• Blood pressure
• Hemoglobin A1c
• Cholesterol
• Body Mass Index (BMI)

5 lifestyle elements

• Nutrition
• Alcohol intake
• Smoking
• Aerobic activities
• Sleep

3 social-emotional factors

• Stress
• Relationships
• Purpose in life

Data gathered from over 400,000 participants in the UK biobank study found that each 5-point increase in baseline BCS score was associated with a 33% reduced risk of late-life depression and a 27% reduced risk of combined outcomes, including dementia, late-life depression, and stroke. Optimal results based on BCS criteria include (Singh 2024):

• Blood pressure below 120/80 mmHg
• Hemoglobin A1C below 5.7%
• Total cholesterol below 190 mg/dL (4.92 mmol/L)
• BMI between 18.5 and 25 kg/m2
• 3 or more of the following:
  • 5 servings of fruit and vegetables per day
  • 2 servings of lean protein per day
  • 3 or more servings of whole grains per day
  • Less than 1,500 mg of sodium per day
  • Less than 36 ounces of sugar-sweetened beverages (soda, juice, etc.) per week
• Alcohol intake: 0-1 drinks per week
• Tobacco smoking: Never smoked or quit more than a year ago
• Aerobic activity: At least 150 minutes of moderate physical activity (ex. walking) or 75 minutes of high-intensity physical activity per week
• Sleep: 7-8 hours per night
• Stress: Manageable levels of stress that rarely make it difficult to function
• Social relationships: At least 2 people besides a spouse or children, that you feel close to and could discuss private matters with or call upon to help
• Meaning in life: You generally feel that your life has meaning and/or purpose

Brain Care Score Questionnaire

Optimal Takeaways and key actions to improve your BCS (Mass General)

• Control your blood pressure
  • Only ~25% of adults with high blood pressure have it under control
  • Controlling blood pressure can dramatically reduce your risk of dementia and stroke
  • Maintain a healthy weight, minimize sodium from processed foods, be active, e.g., walk, dance, or bike regularly, use weight lifting to build muscle, limit alcohol intake to 0-1 drink per day, and address stress with deep breathing or meditation to control stress hormones that can increase blood pressure.
  • Avoid overeating and other unhealthy habits
• Adopt a Mediterranean-style diet and include:
  • More leafy greens, at least 1 cup raw or a half cup cooked daily
  • Colorful fruits & veggies, e.g., avocadoes, berries, blueberries, broccoli, eggplant, and red peppers
  • Extra virgin olive oil
  • Seafood high in omega-3 EPA and DHA e.g., wild salmon, sardines, cod, mussels, and oysters
  • Nuts, seeds, and beans/legumes, aim for a total of one half to one whole cup daily, e.g., almonds, cashews, walnuts, pumpkin seeds, black beans, and lentils
  • Spices and herbs, e.g., cinnamon, cloves, nutmeg, turmeric, ginger, and saffron
  • Fermented foods, e.g., buttermilk, yogurt, curd, kefir, kombucha, and kimchi
  • Dark chocolate
• Avoid alcohol and smoking
• Exercise
  • At least 150 minutes per week but set reasonable goals for where you are at the moment
• Get quality sleep
  • Prioritize sleep, using a sleep diary to evaluate your sleep schedule and how it may affect your daytime alertness
  • Maintain a comfortable sleep environment and be consistent with bedtime and number of hours set aside for sleep
  • Avoid reading, working, and screen time in bed if sleep is suboptimal
  • Avoid alcohol, caffeine, and other stimulants within six hours of bedtime
  • Try something relaxing before bed, such as a hot bath or mindfulness practice
• Reduce stress
  • Meditation or relaxation techniques can help control your response to stress and minimize its negative effects
  • Self-reflection and evaluating your thoughts, feelings, and behaviors can help manage stress and improve brain health
• Build healthy relationships
• Learn new things
• Strive for meaning and purpose in life

The Sustainable Mediterranean Diet

Source: Serra-Majem, Lluís et al. “Updating the Mediterranean Diet Pyramid towards Sustainability: Focus on Environmental Concerns.” International journal of environmental research and public health vol. 17,23 8758. 25 Nov. 2020, doi:10.3390/ijerph17238758 This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license

References

Singh, Sanjula D et al. “The predictive validity of a Brain Care Score for late-life depression and a composite outcome of dementia, stroke, and late-life depression: data from the UK Biobank cohort.” Frontiers in psychiatry vol. 15 1373797. 23 Jul. 2024, doi:10.3389/fpsyt.2024.1373797 This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).

Massachusetts General Hospital. Interested in improving your McCance Brain Care Score? https://www.massgeneral.org/neurology/mccance-center/research/brain-care-now

McCance Brain Care Score. https://www.massgeneral.org/assets/mgh/pdf/neurology/mccance-center/brain-care-score.pdf

NPR. You can reduce your risk of dementia. Here's how to get started. Nov25 2024. https://www.npr.org/sections/shots-health-news/2024/11/22/nx-s1-5050956/health-brain-dementia-sleep-diet-alzheimers