Sickle cell disease causes brain aging years earlier

A new study from Washington University School of Medicine in St. Louis has made a startling discovery: People with sickle cell disease exhibit brain aging patterns that make their brains look an average of 14 years older than their actual age. Research also shows that financial hardship, even in otherwise healthy people, can significantly accelerate brain aging by up to seven years.

The findings, published January 17 in JAMA Network Open, provide important insights into how chronic disease and socioeconomic challenges affect brain health and cognitive function, potentially opening up new avenues for intervention and treatment.

Beyond stroke risk: understanding cognitive challenges

While sickle cell disease has long been known to increase the risk of stroke, many patients experience cognitive difficulties even if they do not experience a stroke. These challenges can impact memory, concentration, learning, and problem-solving abilities, creating barriers in educational and professional settings.

“Our study explains how chronic disease and low socioeconomic status can lead to cognitive problems,” said Dr. Andrea Ford, professor of neurology and chief of the Division of Stroke and Cerebrovascular Disease at Washington University School of Medicine. “We found that these factors may influence brain development and/or aging, ultimately affecting the mental processes of thinking, memory, and problem solving.”

Integrated research design

The research team surveyed more than 200 young black adults from the St. Louis area and surrounding areas in eastern Missouri and southwestern Illinois. The study included participants with and without sickle cell disease and used brain MRI scans and cognitive tests to assess brain age and function.

Using a sophisticated brain age prediction tool developed from MRI scans of more than 14,000 healthy people, the researchers calculated each participant’s brain age and compared it to their actual age. The results were shocking: People with sickle cell disease consistently showed significantly older brain patterns, which were associated with lower cognitive test scores.

The impact of poverty on brain health

Perhaps equally important are the study’s findings regarding socioeconomic status. Even among healthy individuals who experienced poverty, researchers found that brain aging patterns were, on average, seven years later than chronological age. Greater financial deprivation is associated with greater apparent brain aging.

Dr. Ford explained that children who experience chronic economic deprivation and poverty experience cognitive challenges that impact their academic performance. Research shows that these early life challenges can have lasting effects on brain development.

Looking to the future

The team didn’t stop with these preliminary findings. They are currently conducting follow-up scans and cognitive tests on the same participants three years after the first assessment. This longitudinal approach aims to determine whether the observed older-looking brains age prematurely or reflect developmental delays in early life.

“A single brain scan can only help measure a participant’s brain age at that moment,” Dr. Ford noted. “But multiple time points can help us understand whether the brain is stable, initially capture differences that are present since childhood or in premature aging, and be able to predict the trajectory of someone’s cognitive decline.”

This could have significant implications for patient care. Dr. Ford, who treats patients at Barnes-Jewish Hospital, said identifying people at greatest risk of future cognitive impairment through a single MRI scan could become “a powerful tool in helping patients with neurological disorders.”

These findings highlight the complex interplay between chronic disease, socioeconomic factors, and brain health, emphasizing the need for a comprehensive approach to health care that considers both medical and social determinants of health.