Brain Care Score: A Predictor of Stroke Risk Across Racial Groups

A new analysis shows the Brain Care Score (BCS) predicts stroke risk across Black and white U.S. adults and identifies modifiable, high‑yield prevention targets—linking the BCS directly to actionable risk assessment in clinical practice.

In a prospective analysis of 10,861 U.S. adults from a national cohort, investigators followed participants for a median of 15.9 years to evaluate incident stroke and its association with composite behavioral and clinical measures. The cohort included Black and white adults without prior stroke at baseline; the primary endpoint was incident stroke confirmed during follow‑up. Predictive performance was reported as percent reduction in stroke risk per five‑point higher BCS, which served as the main outcome metric for model evaluation.

Per the study, a five‑point higher BCS was associated with a 53% lower stroke risk among Black participants and a 25% lower risk among white participants — a larger relative benefit in the higher‑risk group.

Nutrition, physical activity, stress management, and vascular‑risk control are the principal, modifiable components included in the BCS and account for most score variation. Changes in these behaviors shift the composite score and are linked to commensurate changes in predicted stroke risk; this association is predictive rather than proof of causation. Framed this way, lifestyle and vascular‑risk interventions represent pragmatic, immediate clinical targets to lower BCS and potentially reduce stroke risk.

The report also noted that targeted BCS improvements correspond to substantially greater relative risk reductions in Black adults. Clinicians can use the BCS to stratify patients—particularly Black adults with higher baseline risk—for prioritized counseling, focused lifestyle intervention, and closer follow‑up. Incorporating routine BCS assessment into risk reviews allows monitoring of score trends and helps target high‑yield prevention efforts immediately.

Key Takeaways:

• BCS predicted incident stroke across Black and white adults; each five‑point improvement was associated with larger relative risk reductions, making the score a practical triage tool for prevention.
• The largest relative benefit was observed among Black adults, supporting equity‑focused prioritization of preventive counseling and resource allocation.
• Routine BCS measurement and trend monitoring can guide targeted lifestyle and vascular‑risk interventions now—an actionable step clinicians can implement during standard risk reviews.