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Researchers at Washington University School of Medicine in St. Louis have conducted a groundbreaking study revealing that adults with sickle cell disease exhibit signs of accelerated brain aging, which may illuminate the cognitive difficulties faced by this population. Comparative brain images indicate that healthy individuals have larger brains with more white matter, while those suffering from sickle cell disease show marked differences.
Sickle cell disease is a serious condition characterized by abnormally shaped, sticky red blood cells that impede the flow of oxygen to vital organs, thereby increasing the risk of stroke and subsequent cognitive impairment. Even in the absence of stroke events, many individuals with this illness report significant difficulties in memory, attention, and problem-solving abilities, presenting challenges both academically and professionally.
The study, recently published on January 17 in JAMA Network Open, involved a collaborative team of doctors and researchers dedicated to understanding the cognitive impact of sickle cell disease. They found evidence suggesting that individuals with this chronic illness have brains that appear older than their chronological age, a phenomenon also noted among individuals facing economic hardships.
“Our findings shed light on how both chronic illness and socioeconomic disadvantages can adversely affect cognitive function,” noted Andria Ford, MD, a neurology professor and the study’s lead author. “It appears that these factors could hinder brain development and speed up the aging process, affecting cognitive tasks integral to learning and everyday functioning. Recognizing these influences may pave the way for new treatments and preventive strategies aimed at preserving cognitive health,” she added.
The research involved over 200 young Black adults from St. Louis and its neighboring areas, some with sickle cell disease and others without. Participants underwent MRI scans and cognitive assessments, with brain age calculated using an established prediction tool derived from MRI scans of more than 14,000 healthy individuals.
The results were striking, revealing that individuals with sickle cell disease exhibited brain ages averaging 14 years older than their actual ages. Furthermore, those with older-looking brains performed worse on cognitive assessments.
The correlation between socioeconomic status and brain aging was also significant. Healthy individuals facing economic hardship experienced an average gap of seven years between their predicted brain age and their actual age. The results reinforced the understanding that greater economic deprivation correlates with older-appearing brains.
As individuals age, typical brain shrinkage occurs, but accelerated shrinkage can signal neurological conditions like Alzheimer’s. This premature aging can stem from factors such as inadequate developmental support, particularly in those with sickle cell disease who have chronically reduced oxygen supply to the brain since birth, as well as children who face prolonged poverty, both of which can hinder cognitive development and academic performance.
In a follow-up effort, the research team plans to conduct additional cognitive tests and brain scans of both healthy and sickle cell disease participants three years after the initial assessments. This longitudinal study aims to determine whether the observed brain aging is due to premature degeneration or developmental stunting.
“A single MRI scan can provide a snapshot of an individual’s brain age at one moment in time,” explained Ford, who also works with patients at Barnes-Jewish Hospital. “However, tracking changes over time can help us discern whether a brain remains stable, retain differences that originated in childhood, or is undergoing accelerated aging, potentially forecasting future cognitive decline. This capability to identify individuals at increased risk for cognitive disability through initial MRI scans can significantly enhance patient care for those affected by neurological issues,” she concluded.
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