Seventeen modifiable factors have been identified that can lower people’s risk of age-related brain diseases such as stroke, dementia, and late-life depression, according to researchers at Harvard-affiliated Mass General Brigham.

The study found a reduced risk of all three conditions by modifying any one of the 17 factors. The results, which provide evidence to inform novel tools, such as the Brain Care Score, are published in the Journal of Neurology, Neurosurgery, and Psychiatry.

The researchers systematically searched the scientific literature for previously published meta-analyses of risk factors associated with stroke, dementia, and late-life depression. Then, they combined these data to identify modifiable risk factors (i.e., those that can be altered through behavioral change) shared amongst at least two out of the three diseases. They also estimated the relative impact of each risk factor on measures of quality of life and early death.

Altogether, the researchers identified risk factors shared by at least two of the diseases, including blood pressure, kidney disease, fasting plasma glucose, total cholesterol, alcohol use, diet, hearing loss, pain, physical activity, purpose in life, sleep, smoking, social engagement, and stress. Of these, high blood pressure and severe kidney disease had the biggest impact on the incidence and burden of stroke, dementia, and late-life depression.

In contrast, physical activity and engagement in leisure activities with a cognitive aspect (e.g., puzzles) were associated with a lower risk of disease, though the researchers suspect that these associations may be symptomatic rather than causal, since individuals with brain disease may be less capable of engaging in physical and cognitive leisure activities.

“Dementia, stroke, and late-life depression are connected and intertwined, so if you develop one of them, there’s a substantial chance you may develop another one in the future,” said first author Jasper Senff, postdoctoral fellow at the Singh Lab at the Brain Care Labs at Mass General Hospital and at Harvard Medical School. “And because they share these overlapping risk factors, preventive efforts could lead to a reduction in the incidence of more than one of these diseases, which provides an opportunity to simultaneously reduce the burden of age-related brain diseases.”

Mass General Brigham researchers developed and validated the Brain Care Score to measure efforts to protect brain health and offer guidance on how to improve it.  The researchers have updated the Brain Care Score to reflect the latest scientific findings. They emphasize the need for more studies on modifiable risk factors of late-life depression and call for a randomized controlled trial to test an intervention using the Brain Care Score.

“Healthcare is increasingly complex. But these findings remind us that preventing disease can be very simple. Why? Because many of the most common diseases share the same risk factors,” said Jonathan Rosand, a professor of neurology at Harvard Medical School, founder of the Global Brain Care Coalition, and the JP Kistler Endowed Chair in Neurology at MGH.