The Brain Health Index: Integrating vulnerability, resilience, and cognitive function into a unified measure of cognitive health and risk of neurodegenerative disease

IF 11.1 1区医学 Q1 CLINICAL NEUROLOGY

Alzheimer's & Dementia Pub Date : 2025-09-24 DOI:10.1002/alz.70723

Michael J. Kleiman, Gregory Gibbs, Mahesh S. Joshi, James E. Galvin

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引用次数: 0

Abstract

INTRODUCTION

Assessing brain health and identifying cognitive impairment risk remains challenging, with only 11.4% of MCI cases receiving timely diagnoses. We developed the Brain Health Index (BHI), integrating the Vulnerability Index, Resilience Index, and Number Symbol Coding Task into a unified metric.

METHODS

We evaluated 469 participants (258 congnitively normal [CN], 140 mild cognitive impairment [MCI], 49 Alzheimer's disease and related dementias [ADRD]) using comprehensive clinical, cognitive, and biomarker assessments. After empirically-derived weighting, BHI thresholds were developed. Cross-sectional associations and longitudinal analyses were performed, with threshold validation for risk stratification.

RESULTS

BHI demonstrated strong correlations with cognitive (Montreal Cognitive Assessment [MoCA] r² = 0.408), functional (Functional Activities Questionnaire [FAQ] r² = 0.278), and biomarker (neurofilament light chain [NfL] r² = 0.073) measures. Complete mediation was observed for NfL and glial fibrillary acidic protein (GFAP) changes over 1 year. Threshold analysis revealed 89.2% of low BHI participants had cognitive impairment, with only one ADRD case in the high BHI group.

DISCUSSION

The BHI provides a brief, validated, comprehensive brain health metric with clinical utility for risk stratification and intervention monitoring.

Highlights

Assessing brain health status and identifying individuals at risk for cognitive impairment remains a significant challenge, particularly in early prodromal and symptomatic stages when current therapies may be most effective and patients may be eligible for clinical trials.
We created a unified metric, the Brain Health Index (BHI), combining resilience and vulnerability factors with cognitive performance that divided individuals into high, indeterminant, and low risk groups.
The BHI demonstrated strong correlations with cognitive, functional, and biomarker measures.
The BHI had a 16-fold increase in identifying individuals who were likely to have cognitive impairment.
The BHI provides a brief, validated, comprehensive brain health metric with clinical utility for risk stratification and intervention monitoring.

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脑健康指数：将脆弱性、恢复力和认知功能整合为认知健康和神经退行性疾病风险的统一衡量标准

评估大脑健康和识别认知障碍风险仍然具有挑战性，只有11.4%的轻度认知障碍病例得到及时诊断。我们开发了脑健康指数（BHI），将脆弱性指数、弹性指数和数字符号编码任务整合为一个统一的指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.