Study finds brain care score can predict risk of stroke across racial groups

Mass General Brigham

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A new study from Mass General Brigham found the Brain Care Score (BCS) is a strong predictor of stroke across different racial groups in the U.S. The findings, published in Neurology, the medical journal of the American Academy of Neurology, suggest that improvements in the BCS could have particularly meaningful benefits for stroke prevention among Black individuals.

“Black adults in the United States face a two- to threefold higher risk of stroke compared to white adults,” said senior author Sanjula Dhillon Singh, MD, PhD, MS, a principal investigator in the Brain Care Labs within the Mass General Brigham Department of Neurology. “Our findings show that the Brain Care Score provides a practical framework to better understand and address this disparity — by identifying modifiable behaviors that lower stroke risk.”

The Brain Care Score, originally developed at the McCance Center for Brain Health, is a tool that summarizes data across physical, lifestyle, and social-emotional factors. It creates a single score based on these factors, which include blood pressure, blood sugar, nutrition, alcohol consumption, social relationships, stress and more. A higher score indicates a lower risk of age-related brain diseases, including stroke, dementia, and depression.

The study analyzed data from 10,861 participants in the federally funded Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a large national cohort of Black and white U.S. adults aged 45 and older. None of the participants had a prior stroke at baseline, and all had complete data for the twelve lifestyle, physical, and social-emotional factors that make up the BCS, which ranges from 0 to 21 points, with higher scores indicating healthier behaviors.

Over a median of 15.9 years of follow-up, higher Brain Care Scores were associated with significantly lower stroke risk in both racial groups. A five-point higher BCS was linked to a 53% lower risk of stroke among Black individuals and a 25% lower risk among white individuals, even after adjusting for demographics and socioeconomic factors.

“The Brain Care Score integrates physical, lifestyle, and social-emotional factors into one measure of brain health,” said Evy M. Reinders, MD, postdoctoral fellow and first author of this study. “Our analyses suggest that improving everyday behaviors could yield particularly large benefits for groups at higher risk of stroke, such as Black adults.”

While the study was observational and cannot establish causality, the findings reinforce the importance of addressing social and behavioral determinants of health to reduce stroke disparities.

“This is a landmark publication for the Brain Care Score,” said Jonathan Rosand, MD, MSc, Director of the Brain Care Labs at Mass General Brigham and Founder of the Global Brain Care Coalition. “Confirming its predictive power in diverse populations is essential if we are to make progress in ensuring that everyone everywhere has an opportunity to protect their brain health.“

The research was supported by the National Institutes of Health and the American Heart Association. The funders had no role in study design, data collection, analysis, or reporting.

Authorship: In addition to Singh, Reinders, and Rosand, authors include Jasper R Senff, Reinier WP Tack, Benjamin YQ Tan, Tamara N. Kimball, Savvina Prapiadou, Marie-Gabrielle Duperron, Devanshi Choksi, Katelin Sherman BSc; Sophia Mendez BA; Riley Moran BSc; Ayneisha Tinoble BSc; Meara Maulik; Virginia Howard, Ronald M. Lazar, Christopher D Anderson, and George Howard.

Disclosures: The authors declare no conflicts of interest related to this manuscript.

Funding: National Institute of Health and American Heart Association. The funder had no role in this study's design, data collection, data analysis, and reporting.

Paper cited: first name, last name [first author] et al. “Association of Modifiable Risk Factors Measured with the Brain Care Score and Incident Stroke in the REGARDS Cohort” Neurology DOI: 10.1212/WNL.0000000000214488

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About Mass General Brigham

Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations with several Harvard Medical School teaching hospitals. For more information, please visit massgeneralbrigham.org.

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Journal

Neurology

DOI

10.1212/WNL.0000000000214488 

Method of Research

Observational study

Subject of Research

People

Article Title

Association of Modifiable Risk Factors Measured with the Brain Care Score and Incident Stroke in the REGARDS Cohort

Article Publication Date

18-Dec-2025

 

Fertility remains high in rural Tanzania despite access to family planning

YOU CAN LEAD A HORSE TO WATER...

University of Illinois College of Agricultural, Consumer and Environmental Sciences

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image: 

Families in Sub-Saharan Africa continue to have many children.

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Credit: Aine Seitz McCarthy.

URBANA, Ill. – Fertility rates in much of Sub-Saharan Africa remain high, despite declining child mortality and improved access to contraceptives and female education — factors that generally lead to smaller families and improved economic conditions in developing countries. A new study from the University of Illinois Urbana-Champaign looks at men’s and women’s desired fertility in rural Tanzania, gauging some of the factors that influence how many children they want. 

“This conversation about fertility preferences is very important to the demographic transition of Sub-Saharan Africa. Families may adopt family planning practices in the short term, yet still plan to have more children in the long term, presenting a puzzle for researchers and policy makers,” said corresponding author Catalina Herrera Almanza, assistant professor in the Department of Agricultural and Consumer Economics, part of the College of Agricultural, Consumer and Environmental Sciences at Illinois.

She co-authored the study with Aine Seitz McCarthy, associate professor of economics at Lewis & Clark College.

“There is evidence that people in poor, rural areas are having large families because they want to, not because they don’t have enough access to contraception. For households that depend on agricultural labor, wanting more children can make economic sense,” McCarthy said. “Men typically want more children than women, but we found that the husband’s preferences can strongly influence their wife’s.”

The researchers evaluated the results of a 15-month family planning program for rural households in Tanzania’s Meatu district, conducted in partnership with the country’s Ministry of Health and the Meatu District Hospital. Local women were trained to provide education on birth spacing, the safety of contraceptives, and free birth control options available from public dispensaries.

The study followed 515 households in 12 villages, randomly assigned to one of three groups: joint consultations for couples, individual consultations for wives only, and a control group. Before and after the program, each spouse was asked privately and separately by a person of their own gender how many additional children they wanted.

Participants were, on average, 37 years old for men and 30 for women, and already had five children. Before the intervention, 89% of women were not using contraception.

“The program triggered the opportunity for these men and women to learn about their spouse’s fertility preferences. Most of them had never talked about it before — about two-thirds of couples had never discussed how many children they wanted,” Herrera Almanza said.

The researchers found that men, on average, wanted 4 more children, while women would like 2.4. However, after participating in the couples consultations, both spouses’ fertility preferences increased. After the joint counseling, husbands desired an additional 0.77 children, while there were no differences for men who did not receive counseling.

Women who participated in joint counseling increased their desired fertility by 1.6 children. In contrast, women in the individual group reported lower desired fertility after the program. Furthermore, women in the couples’ group overestimated their husbands’ desire for more children after the consultations, while this was not the case for the individual group.

The researchers found the results were driven by women in polygamous marriages, which was nearly a third of the sample.

“In polygamy, this can be strategic behavior where women want children because there is no old-age security, and land inheritance follows the sons. A wife with more children might be able to claim more resources,” Herrera Almanza said.

Older women were also more likely to increase their fertility preferences, perhaps reflecting a strategic desire to have as many children as possible while they can.  

The researchers speculated that power imbalances in the relationship might influence the result, causing women to say they want more children simply to appease their husbands.

“This increase in desired additional fertility might seem to be ‘cheap talk’ that may not be backed up by actual desire to increase your fertility. For example, women who are in a domestic violence situation may be fearful and therefore be willing to go along with what their husbands are saying. However, we didn’t find any evidence of that being the case. If anything, women who are more empowered in their household were more likely to increase their fertility preferences,” Herrera Almanza said.

People were overall very responsive to learning about contraceptives, but they want to use them to space their children out, not to have fewer children. 

This is aligned with the policy of Tanzania’s Ministry of Health in Tanzania, which recommends spacing children two years apart to improve the health of both babies and mothers.

Many countries in Africa have a large proportion of young people, and this leads to policy discussions about addressing the demographic dividend by delaying the first birth for young women and men, so they can be more productive. Teen pregnancy is high, which decreases the chances of completing high school, Herrera Almanza explained. 

The study highlights the dichotomy between uptake in contraceptives and preference for large families.

“If the policy goal is to address the women's desired fertility and have healthier birth spacing, then it would make more sense to have joint family planning consultations, but to avoid asking couples about the number of children they want, and allow those discussions to happen more organically,” McCarthy said.

While this study only measured fertility preferences, the researchers are in the process of conducting follow-up interviews with participants, and preliminary results suggest that women are having the children they indicated they would.

The study, “Strategic responses to disparities in spousal desired fertility: experimental evidence from rural Tanzania”, is published in the Journal of Population Economics [DOI: 10.1007/s00148-025-01142-y].

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Journal

Journal of Population Economics

DOI

10.1007/s00148-025-01142-y 

Article Title

Strategic responses to disparities in spousal desired fertility: experimental evidence from rural Tanzania

 

Uncovering how parasitic plants avoid attacking themselves to improve crop resistance

Researchers from Japan uncovered how glucosylation of lignin-derived signals enables parasitic plants to avoid attacking themselves and related plants

Nara Institute of Science and Technology

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A field of the parasitic weed Striga, one of the most destructive agricultural pests worldwide. The molecular mechanism described in this study was uncovered using the model parasitic plant Phtheirospermum japonicum. The findings provide insights into how parasitic plants distinguish self from non-self, offering potential strategies to protect crops from parasitic weeds such as Striga.

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Credit: Satoko Yoshida from Nara Institute of Science and Technology, Japan

Ikoma, Japan—Parasitic plants are notorious agricultural pests that drain nutrients from crops and cause economic losses of more than USD 1 billion due to yield losses every year. Yet these plants almost never attack themselves or closely related plants. Scientists have long suspected that parasitic plants can recognize “kin,” but the molecular basis for this self-protection has remained unclear.

Now, a team of researchers at the Nara Institute of Science and Technology (NAIST) in Japan has uncovered the mechanism that allows parasitic plants to distinguish self from non-self. Their findings, published in the journal Science on October 23, 2025, point to new strategies for protecting crops from these parasitic plants.

The study was led by Professor Satoko Yoshida, who heads the Laboratory of Plant Symbiosis and included Professor Takayuki Tohge at NAIST, Dr. Ken Shirasu at the RIKEN Center for Sustainable Resource Science, and Professor Yuki Tobimatsu at Kyoto University.

“Parasitic plants, such as Striga and Orobanche, cause major crop losses. Understanding their self-recognition system offers a path to engineering crops that appear as kin and escape attack,” says Yoshida.

Parasitic plants invade their hosts using a specialized organ called the haustorium, which connects them to the host’s vascular system. The formation of this organ is triggered by chemical cues known as haustorium-inducing factors (HIFs), which are derived from lignin, a fundamental component of all plant cell walls. Because all plants, including parasites, produce these lignin-based signals, a key question arises: how do parasitic plants keep their own HIFs from triggering haustoria formation on their own roots?

To explore this, the researchers studied the parasitic plant Phtheirospermum japonicum. They searched for mutants unable to avoid self-parasitism and identified a mutant called spontaneous prehaustorium (spoh1), which formed prehaustoria on its own roots without any external signal, as if it could no longer recognize itself.

Genetic analysis revealed that this defect results from a mutation in a single gene, PjUGT72B1, which encodes a glucosyltransferase enzyme. When the researchers reintroduced a normal copy of the gene, the mutant plants stopped spontaneously forming prehaustoria. When PjUGT72B1 was removed, healthy plants began forming prehaustoria on their own roots, showing that the gene is essential for suppressing inappropriate haustorium development.

The team found that PjUGT72B1 acts as a molecular switch. It attaches a glucose molecule to the plant’s own HIFs inside its roots in a process called glucosylation. This modification neutralizes the signals and prevents them from activating haustorium formation. In the spoh1 mutant, which lacks this glucosyltransferase enzyme, active HIFs accumulate and leak out, causing the plant to form invasive structures on itself.

By revealing how parasitic plants suppress their own haustorium-inducing signals, this study opens a new avenue for crop protection. Strategies that alter HIF production or glucosylation could help develop crops that naturally repel parasitic weeds.

“Divergent substrate specificities of UGT72B1 between the parasite and the host enable discrimination of kin from potential hosts, suggesting a strategy to engineer crops that are effectively invisible to parasitic weeds,” says Yoshida.

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Resource

Title: Glucosylation of endogenous haustorium-inducing factors underpins kin avoidance in parasitic plants

Authors: Lei Xiang, Songkui Cui, Simon B. Saucet, Moe Takahashi, Shoko Inaba, Bing Xie, Mario Schilder, Shota Shimada, Mengqi Cui, Yanmei Li, Mutsumi Watanabe, Yuki Tobimatsu, Harro J. Bouwmeester, Takayuki Tohge, Ken Shirasu, and Satoko Yoshida

Journal: Science

DOI: 10.1126/science.adx8220

Information about the Laboratory of Plant Symbiosis can be found at the following website: https://bsw3.naist.jp/yoshida/index-en.html

About Nara Institute of Science and Technology (NAIST)

Established in 1991, Nara Institute of Science and Technology (NAIST) is a national university located in Kansai Science City, Japan. In 2018, NAIST underwent an organizational transformation to promote and continue interdisciplinary research in the fields of biological sciences, materials science, and information science. Known as one of the most prestigious research institutions in Japan, NAIST lays a strong emphasis on integrated research and collaborative co-creation with diverse stakeholders. NAIST envisions conducting cutting-edge research in frontier areas and training students to become tomorrow's leaders in science and technology.

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Journal

Science

DOI

10.1126/science.adx8220 

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Glucosylation of endogenous haustorium-inducing factors underpins kin avoidance in parasitic plants