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Need another jolt of motivation to shore up a resolution to shed weight, sleep more soundly, boost nutrition or exercise levels, or cut back on alcohol? Then you'll be pleased to learn that any (and all) of these efforts can also add up to better brain health.

An international study led by researchers at the McCance Center for Brain Health at Massachusetts General Hospital devised and validated a Brain Care Score (BCS) card that makes it easy to total up what you're doing well and where you might do better. The prize is a healthier brain — specifically a lower risk for dementia and strokes.

Designed to predict how current habits might impact future brain health, the user-friendly scorecard is apparently the first of its kind, says Dr. Andrew Budson, a lecturer in neurology at Harvard Medical School.

"It's a real service that the researchers have developed a scale like this and completed the first study to determine if scoring worse on this scale raises your risk for dementia and stroke," says Dr. Budson, who wasn't involved in the analysis. "On one hand, no one's done something quite like this before. On the other, however, it's really wrapping together health factors everyone has known for a number of years in new packaging."

What's included on the scorecard?

Called the McCance Brain Care Score, the card tallies points from 12 physical, lifestyle, and social-emotional domains.

Physical components relate to

Lifestyle components include

Social-emotional factors inquire about

Each response is given a score of 0, 1, or 2, with the highest possible score totaling 21. Higher scores suggest better brain care.

"All these physical and lifestyle factors can contribute to the risk of dementia to some extent through strokes," Dr. Budson says. "Those that aren't a risk through strokes are usually related to the fact that a healthy brain is a brain that's using all of its parts. Engaging in healthy relationships and meaningful activities helps us maintain good brain structure and function."

What did the analysis involve?

The study was published online in Frontiers of Neurology in December 2023. It involved nearly 399,000 adults ages 40 through 69 (average age 57; 54% women) who contributed personal health information to the UK Biobank.

During an average follow-up period of 12.5 years, participants recorded 5,354 new cases of dementia and 7,259 strokes. Researchers found that participants with higher Brain Care Scores at the study's start had lower risks of developing dementia or strokes over time.

These threats to health and independence take a stunning — and growing — toll on people in the US. Dementia affects one in seven Americans, a rate expected to triple by 2050. Meanwhile, more than 795,000 people in the United States suffer a stroke each year, according to the CDC.

What did the study find?

Each five-point step higher in the BCS rating assigned when the study began was linked to significantly lower risks of dementia and stroke, with those odds varying by age group:

But those brain disease benefits appeared to diminish for those older than 59 at the study's start. This group experienced only 8% lower odds of dementia and a 33% lower risk of stroke with each five-point higher score on BCS. Study authors theorized that some of these participants may have already been experiencing early dementia, which is difficult to detect until it progresses.

"I feel very comfortable that the study's conclusions are entirely correct, because all the factors that go into its BCS are well-known things people can do to reduce their risk of stroke and dementia," Dr. Budson says.

What are the study's limitations?

However, Dr. Budson notes that the study did have a couple of limitations,. The UK Biobank fell just short of collecting all the components of the BCS in its dataset, lacking meaning-of-life questions. So its scores ranged from 0 to 19, not up to 21. "It's a practical limitation, but it should be acknowledged that so far, there have been no studies to validate the actual 21-point scale they're recommending we use," he says.

The analysis also evaluated participants' scores at just one point in time instead of several, Dr. Budson says. Future research should determine whether people can lower their stroke and dementia risk by improving their BCS over time with behavior and lifestyle changes.

How can you play this game at home?

While better brain health may be the clear prize of a higher score, it's far from the only benefit. That's because improving any health component of the BCS also benefits our overall well-being.

"By improving these factors, not only will people help their brain, but they'll also help their heart and reduce their risk of cancer," Dr. Budson adds. "These factors will absolutely also improve your psychological health, which is certainly an important part of brain health."

The scale's simple breakdown of health factors also makes it easy to focus on tweaking one or two without getting overwhelmed.

"Let's say someone's nutrition isn't perfect — and they know it — but they're not willing to change their diet. Fine. They can then decide to do more aerobic exercise, for example, or to stop drinking, or to get the sleep their body needs," he says.

What one change could put you on a path to better brain health?

If he had to choose just one factor to improve brain health, Dr. Budson would focus on meaning of life, "which means you generally feel your life has meaning or purpose," he says. To do that, he suggests giving deep, quiet thought to what you wish your life's purpose to be, whether you expect to live a long time or just a few years.

"Once you have a purpose, then you have a reason to follow through with assessing all the other items on the BCS scale and seeing what you can do so you'll be around longer, and be competent and capable longer, to help fulfill the meaning and purpose of your life," he says.

Source: Harvard Health Publishing

If your doctor recommends surgery, there's a lot to think about and many questions to answer. Do I really need this surgery? Should I get a second opinion? Will my insurance cover my operation? How long will my recovery take?

But here's something you might not have considered: does the sex of your surgeon affect the chances that your operation will go well? According to a study in JAMA Surgery, it just might.

How a surgeon's sex might affect surgical outcomes

The study looked at information drawn from more than 1.3 million adults and nearly 3,000 surgeons who performed one of 21 common elective or emergency surgeries in Canada between 2007 and 2019. The range of surgeries included appendectomies, knee and hip replacements, aortic aneurysm repairs, and spinal surgeries.

The researchers compared how often unfavorable outcomes (surgical complications, readmissions to the hospital, or death) occurred within 30 days of surgery among four patient groups:

Here's what they found:

The study was not designed to determine why these results were observed. However, its authors suggested that future research should compare specific differences in care, patient-surgeon relationships, measures of trust, and styles of communication between the four patient groups. It's also possible female surgeons follow standard guidelines more closely than their male counterparts. Physicians differ widely in how closely they adhere to guidelines, though it's unclear whether this might vary by physician sex. 

Does other research suggest the sex of a doctor and patient matter?

This is not the first study to suggest physician sex matters when it comes to the quality of medical care. Other examples include a previous study of common surgeries, research regarding elderly patients admitted to the hospital, and patients with heart attacks. Each study found that patients of female physicians tended to fare better than those of male physicians. Similar results were reported for a review of research on patients with cardiovascular disease.

In this latest research there's an added twist: most of the difference in outcomes was among female patients cared for by male physicians. So, there's reason to take a good hard look at why this may be the case. What are female surgeons doing differently — especially with their female patients — that leads to better outcomes compared with male surgeons?

It's a sensitive subject

Let's face it: even raising the possibility that a surgeon's sex matters could make some doctors defensive, particularly those whose patients had worse outcomes. Most doctors likely believe that they provide high-quality care to all of their patients, regardless of a patient's sex. To suggest otherwise will predictably invite more than the usual amount of scrutiny and criticism of the research.

Of course, it's fair to raise questions and to be skeptical of a single study. For example, is it possible that male surgeons took on or were assigned more complex cases? Or, perhaps the non-surgeon members of the surgical teams, such as nurses, trainees, and physician assistants who provide care before, during and after surgery, had something to do with the results. While this study attempted to account for these and other factors, it was an observational study, for which it's often impossible to completely control for confounding factors.

The bottom line

There's little chance to do much planning if your surgery is an emergency. Even if your surgery is elective, in many countries — including Canada, where this study took place — most surgeons are male. That's true even in places where medical schools have similar numbers of male and female students. Any potential advantage may disappear if there's little chance of receiving care from a female surgeon.

A surgeon's expertise and experience with specific procedures matter most. It's impractical to pick your surgeon solely by sex, even in light of this latest research.

But if the patients of female surgeons truly have better outcomes than patients operated on by male surgeons, it is imperative to understand why. Sorting out what female surgeons are doing well (or what male surgeons aren't doing as well) is a worthy goal that could improve outcomes for all patients, regardless of their sex and that of their doctors.

Follow me on Twitter @RobShmerling

Source: Harvard Health Publishing

Source: Harvard Health Publishing

An infamous bandit, known for flaunting ransom payments on social media, went live on TikTok from his hideout on Wednesday.

A security analyst and counter-insurgency expert in the Lake Chad area Zagazola Makama shared a photo of the armed bandit engaging with viewers during the live video session. The armed man is seen engaging directly with viewers during a live video session on his TikTok account.

The incident highlights TikTok’s growing popularity among young Nigerians, particularly in the north, and its unintended use by t3rrorists to disseminate h+rmful content.

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