Figure 1.

The biological and environmental contributors to cognitive decline in sickle cell disease. Cognitive decline in individuals with sickle cell disease (SCD) is complex with diverse biological and environmental contributors. The biological components include chronic hemolytic anemia, cerebral hypoxemia, vasculopathy, including overt stroke and silent cerebral infarctions, and systemic and neuroinflammation. Societal and environmental components span from childhood household income, parental educational attainment, and chronic school absenteeism to a lack of funding for SCD research and societal implicit bias. As illustrated through the circular model, all of these contributors are interconnected and influence one another.

Source: Created with BioRender.com.