Summary: MRI scans revealed that adults with sickle cell disease have brains that appear 14 years older than their actual age, highlighting how chronic oxygen deprivation and socioeconomic factors contribute to premature brain aging and cognitive challenges.

Key Takeaways

  • Sickle Cell Disease and Brain Aging: MRI scans revealed that adults with sickle cell disease have brains that appear, on average, 14 years older than their actual age, correlating with cognitive difficulties such as impaired memory, focus, learning, and problem-solving.
  • Impact of Economic Deprivation: The study found that poverty contributes to accelerated brain aging, with healthy individuals in severe deprivation showing brains that appear up to seven years older, further compounding the cognitive challenges in sickle cell patients.
  • Future Research and Interventions: Follow-up brain scans aim to determine whether the older brain appearance in sickle cell patients stems from early stunted development or premature aging, providing insights that could inform treatments and preventive measures to preserve cognitive function.

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A study led by researchers at Washington University School of Medicine in St. Louis has found that adults with sickle cell disease have older-looking brains, providing insight into the cognitive challenges faced by these individuals. Using MRI scans, the study revealed that participants with sickle cell disease had brains that appeared, on average, 14 years older than their actual age. This finding helps explain why patients, even those without a history of stroke, often struggle with memory, focus, learning, and problem-solving.

Illness and Poverty Impact Brain Aging

Sickle cell disease, a chronic genetic condition, causes misshapen blood cells to restrict oxygen delivery to organs, heightening the risk of stroke and cognitive disabilities. However, cognitive difficulties are also common in sickle cell patients without a history of stroke, raising questions about how the disease impacts the brain.

The study, published in JAMA Network Open, also highlights the impact of economic deprivation on brain aging. Among healthy individuals living in poverty, the researchers observed that their brains appeared an average of seven years older than their actual age, with more severe deprivation linked to greater aging effects.

“Our study explains how a chronic illness and low socioeconomic status can cause cognitive problems,” says Andria Ford, MD, professor of neurology and chief of the section of stroke and cerebrovascular diseases. “We found that such factors could impact brain development and/or aging, which ultimately affects the mental processes involved in thinking, remembering, and problem-solving. Understanding the influence that sickle cell disease and economic deprivation have on brain structure may lead to treatments and preventive measures that potentially could preserve cognitive function.”

Premature Brain Aging and Cognitive Decline

The study involved over 200 young Black adults, with and without sickle cell disease, from the St. Louis region. Each participant underwent MRI scans and cognitive tests. The researchers, including Yasheng Chen, DSc, associate professor of neurology and senior author of the study, used a brain-age prediction tool based on MRI scans from more than 14,000 healthy individuals. By comparing estimated brain age with actual age, they found that sickle cell patients with older-looking brains scored lower on cognitive tests.

Healthy brains naturally shrink with age, but premature shrinkage often signals neurological conditions like Alzheimer’s disease. In sickle cell patients, chronic oxygen deprivation may stunt brain growth from birth, while poverty exacerbates these effects by hindering early brain development. “A smaller brain that appears older can also result from stunted growth early in life,” Ford says.

Follow-Up Scans to Track Brain Aging

As part of the same study, the researchers are conducting follow-up brain scans and cognitive tests on the same participants three years later. This will help determine whether the older-looking brains are due to stunted development early in life or premature aging over time.

“A single brain scan helps measure the participants’ brain age only in that moment,” Ford says. “But multiple time points can help us understand if the brain is stable, initially capturing differences that were present since childhood, or prematurely aging and able to predict the trajectory of someone’s cognitive decline. Identifying who is at greatest risk for future cognitive disability with a single MRI scan can be a powerful tool for helping patients with neurological conditions.”

The study’s findings underscore the importance of addressing the dual impact of chronic illness and socioeconomic deprivation on brain health and cognitive function. Researchers hope this work will inform interventions to mitigate these effects and improve outcomes for vulnerable populations.