• Posted January 24, 2025

Premature Aging in Brains of Sickle Cell Patients

People with sickle cell disease often struggle with memory, focus, learning and problem solving, setting them back in school and the workplace.

That could be because their brains are older than expected for their age, a new study published recently in JAMA Network Open says.

Brain scans reveal that sickle cell patients have brains that appear an average 14 years older than their actual age, researchers reported.

Sickle cell patients with older-looking brains score lower on cognitive tests, researchers found.

People also tended to have older brains if they came from an impoverished household, even if they didn’t have sickle cell disease.

“Our study explains how a chronic illness and low socioeconomic status can cause cognitive problems,” lead researcher Dr. Andria Ford, chief of the section of stroke and cerebrovascular diseases at Washington University School of Medicine in St. Louis, said in a news release.

“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, among others,” she added.

Sickle cell disease is a genetic disorder that causes red blood cells to become stiff and misshapen. Normally round and flexible, the cells instead take on a rigid crescent shape.

These sickle-shaped cells get stuck more easily in blood vessels, blocking blood flow. They also die off sooner than normal red blood cells, causing anemia.

For the study, researchers performed magnetic resonance imaging (MRI) scans of the brains of 230 young Black adults living in St. Louis and the surrounding region. Of the participants, 123 had sickle cell disease.

Researchers calculated each person’s brain age using DeepBrainNet, a computer program previously trained to evaluate brain aging with MRI scans from more than 14,000 healthy people.

Results showed that sickle cell patients suffer from premature brain aging, and that the aging affects their performance on cognitive tests. The older a person’s brain, the lower they scored.

People experiencing poverty also had older brains, on average seven years older than their actual age. The more severe a person’s poverty, the older their brains appeared.

Researchers suspect that the brains of sickle cell patients appear older because the disease chronically deprives a growing baby’s brain of oxygen, possibly affecting its development from birth.

Likewise, long-term poverty could affect a child’s brain development, researchers added.

Brains normally shrink as they age, but premature shrinkage is associated with illnesses like Alzheimer’s disease, researchers said.

“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,” Ford said.

Researchers plan to continue the study by performing cognitive tests and MRI scans on the same people three years after their first round, to further track their brain aging.

“A single brain scan helps measure the participants’ brain age only in that moment,” Ford concluded. “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.”

More information

The Cleveland Clinic has more on sickle cell disease.

SOURCE: Washington University School of Medicine in St. Louis, news release, Jan. 17, 2025