A new study from Washington University School of Medicine in St. Louis has uncovered a striking discovery: people with sickle cell disease show brain aging patterns that make their brains appear an average of 14 years older than their actual age. The research also revealed that economic hardship, even in otherwise healthy individuals, can accelerate apparent brain aging by up to seven years.
The findings, published January 17 in JAMA Network Open, offer crucial insights into how both chronic illness and socioeconomic challenges can impact brain health and cognitive function, potentially opening new pathways for intervention and treatment.
Beyond Stroke Risk: Understanding Cognitive Challenges
While sickle cell disease has long been known to increase stroke risk, many patients face cognitive difficulties even without experiencing a stroke. These challenges can affect memory, focus, learning, and problem-solving abilities, creating obstacles in both educational and professional settings.
“Our study explains how a chronic illness and low socioeconomic status can cause cognitive problems,” says Dr. Andria Ford, professor of neurology and chief of the section of stroke and cerebrovascular diseases at WashU Medicine. “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.”
Comprehensive Study Design
The research team examined more than 200 young, Black adults from the St. Louis region and surrounding areas in eastern Missouri and southwestern Illinois. The study included participants both with and without sickle cell disease, using brain MRI scans and cognitive tests to assess brain age and function.
Using a sophisticated brain-age prediction tool developed from MRI scans of over 14,000 healthy individuals, researchers calculated each participant’s brain age and compared it to their actual age. The results were striking: sickle cell patients consistently showed significantly older brain patterns, which correlated with lower cognitive test scores.
Poverty’s Impact on Brain Health
Perhaps equally significant was the study’s finding regarding socioeconomic status. Even among healthy individuals experiencing poverty, researchers found brain aging patterns averaging seven years beyond actual age. More severe economic deprivation correlated with more advanced apparent brain aging.
Dr. Ford explained that children exposed to long-term economic deprivation and poverty experience cognitive challenges that affect their academic performance. The study suggests these early life challenges may have lasting effects on brain development.
Looking to the Future
The research team isn’t stopping with these initial findings. They’re currently conducting follow-up scans and cognitive tests on the same participants three years after their first assessment. This longitudinal approach aims to determine whether the observed older-appearing brains are aging prematurely or reflect stunted development from early life.
“A single brain scan helps measure the participants’ brain age only in that moment,” Dr. Ford notes. “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.”
The implications could be significant for patient care. Dr. Ford, who treats patients at Barnes-Jewish Hospital, suggests that identifying those at greatest risk for future cognitive disability through a single MRI scan could become “a powerful tool for helping patients with neurological conditions.”
These findings underscore the complex interplay between chronic illness, socioeconomic factors, and brain health, highlighting the need for comprehensive approaches to healthcare that consider both medical and social determinants of health.