{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:06:50Z","timestamp":1790309210280,"version":"4.1.0"},"reference-count":0,"publisher":"Hematology Section, Dept. of Radiological Science and Hematology, Catholic University, Rome, Italy","issue":"1","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mediterr J Hematol Infect Dis"],"abstract":"<jats:p>Background. Thalassemia major and sickle cell disease now present as lifelong chronic conditions, with median survival extending into the 50s and 60s. This unprecedented shift transforms hemoglobinopathies from childhood emergencies into models of accelerated aging and cumulative multimorbidity, yet clinical literature remains pediatric-focused, leaving hematologists and internists unprepared for the functional and cognitive decline, vulnerability, and geriatric syndromes that characterize later life in these populations.Content. This review synthesizes evidence on the intersection of disease-driven pathology (anemia, hemolysis, vasculopathy), treatment burden (transfusion-related iron overload, chelation nephrotoxicity), and aging biology (weakness, indicators of aging, organ reserve depletion) in patients aged 45 years and older. We distinguish disease-specific priorities: thalassemia faces myocardial and hepatic iron deposition and endocrine failure, while sickle cell disease confronts cerebrovascular disease, chronic pain, and pulmonary complications.\nCritically, we reframe the clinical target from survival and organ-specific metrics to functional endpoints, disability prevention, cognitive health, and quality of life. A conceptual mapping links hemoglobinopathy mechanisms to established gerontology constructs (inflammaging, cellular senescence, vascular aging), revealing shared pathways between genetic disease and age-related decline.Conclusions. Three adjustments are necessary: (1) monitoring must detect treatable complications early rather than recording cumulative damage; (2) therapeutic decisions must weigh treatment acceptance, comorbidity burden, and life expectancy rather than defaulting to pediatric protocols; (3) care systems must embed palliative principles, shared decision-making, and multidisciplinary coordination into primary networks. Future research must prospectively characterize aging cohorts, test interventions to slow functional decline, and prioritize patient-reported outcomes and disability prevention alongside mortality.<\/jats:p>","DOI":"10.4084\/mjhid.2026.039","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:56:24Z","timestamp":1777636584000},"page":"e2026039","source":"Crossref","is-referenced-by-count":1,"title":["AGING WITH THALASSEMIA AND SICKLE CELL DISEASE: A GERONTOLOGICAL MODEL OF ACCELERATED MULTIMORBIDITY AND FUNCTION-CENTERED CARE BEYOND MIDLIFE"],"prefix":"10.4084","volume":"18","author":[{"given":"SOPHIA","family":"DELICOU","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Ilias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasia","family":"Kapota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Papatheodorou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Moraki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Xydaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Mika","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota","family":"Giannou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Kouroukli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros","family":"Aforozis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myrto","family":"Palkopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Savvidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iliana","family":"Mani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantina","family":"Aggeli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Koskinas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2554","published-online":{"date-parts":[[2026,4,30]]},"container-title":["Mediterranean Journal of Hematology and Infectious Diseases"],"original-title":[],"link":[{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/6303\/4880","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/6303\/4881","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/6303\/4897","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/download\/6303\/4880","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:56:24Z","timestamp":1777636584000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mjhid.org\/mjhid\/article\/view\/6303"}},"subtitle":["Thalassemia and Sickle Cell Diseases: Effect of Aging"],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.4084\/mjhid.2026.039","relation":{},"ISSN":["2035-3006"],"issn-type":[{"value":"2035-3006","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]}}}