Proposed model for managing SCD in an adult. (A) The traditional single disease–focused framework of comorbidity in which comorbid conditions are considered disease pairs, such as SCD and diabetes mellitus, SCD and cardiovascular disease, and SCD and kidney disease. Most clinical practice guidelines are based on this framework. (B) Multimorbid conceptual framework demonstrating a more patient-centric approach to managing the adult with SCD in the context of physiological aging conditions adding to the accumulating sickle-related complications and social determinants of health. CNS, central nervous system; CVD, cardiovascular disease; DM, diabetes mellitus.