Association Between Brain Care Score and Cognitive Performance: Findings From a Community-Based Cohort in Singapore

The Brain Care Score (BCS) is a recently developed tool that measures modifiable risk factors for brain health. This study evaluated the association between BCS and cognitive performance in a community-based cohort from Singapore.

Data were drawn from the Health District @ Queenstown baseline study, a representative multiethnic community cohort. The BCS (range 0-21; higher scores = healthier profiles) was derived from baseline questionnaires across physical, lifestyle, and socioemotional domains. Cognitive recall was assessed with the five-item word recall test, and executive function with the Eriksen flanker task.

A total of 5224 participants (mean age 52.8 ± 17.5 years; 53.1% women) were surveyed between September 2023 and May 2024. Participants with impairment had lower mean BCS than those without (14.9 ± 3.1 vs. 16.2 ± 2.8; p < 0.001). Each one-point BCS increase was linked to 5% lower odds of impaired recall (odds ratios [OR] 0.95; 95% confidence intervals [CI] 0.92-0.98; p = 0.002), whereas per five-point higher BCS corresponded to 23% lower odds (OR 0.77; 95% CI 0.66-0.91; p = 0.002). Each one-point BCS increase was also associated with a 0.03-point higher executive function score (β 0.03; 95% CI 0.01-0.05; p = 0.02), with per five-point higher BCS yielding a 0.15-point higher score (β 0.15; 95% CI 0.03-0.27; p = 0.02). Associations were stronger among younger, Chinese, and higher income participants.

Higher BCS was associated with better cognitive performance. These findings support its use as a potential community-based tool for brain health risk assessment in Asian populations.