Insights from Latest Study Uncover the Cognitive Advantage of 'Superagers'

What’s the secret to aging well? Superagers may be able to tell you.

Superagers are people in their 80s with the memory function of people decades younger. New research sought to understand why and how this demographic ages differently.

The new study found that the most plausible aging mechanism in superagers is resistance to age-related changes in the brain, as their rate of aging is slower than in typical older adults. The research team also found that superagers are associated with better mental health and mobility than others in their age group.

This study is one of the largest observational studies to date on superagers, and the first to examine the brain structure of superagers over time.

Study author and associate professor of computational neuroscience and neuroimaging at Jena University Hospital, Christian Gaser, PhD, told Health that the longitudinal design of the study is crucial in understanding whether or not superagers are actually resistant to age-related memory decline or whether they simply have better coping mechanisms than their peers.

“Our findings suggest that superagers are resistant to these processes,” he said, “although the exact reasons for this are still unclear.”

Gaser and colleagues looked at superagers and typical older adults who were part of the Vallecas Project cohort in Madrid, an ongoing project designed to help identify early indicators of Alzheimer’s disease.

The 1,213 participants were between 70 and 85 years old with no neurological or severe psychiatric disorders. Of those analyzed, researchers identified 64 superagers and 55 typical older adults based on how they did in a test used to assess people’s memory function.

Compared to older adults who performed within a normal range for their age and education, superagers did at least as well as someone 30 years younger who had the same education level.

Based on all of the information, researchers used a machine learning computer model to identify factors associated with superagers.

Marta Garo-Pascual, the first author of the study and a PhD candidate doing research at the Universidad Politécnica de Madrid, explained that grey matter declines with normal age.

Grey matter makes up the outer layer of the brain (the cortex), which plays an important role in memory.

Previous studies show that superagers have more grey matter than typical aging adults; MRI scans proved the same in this study. The scans also showed that superagers’ overall level of grey matter in key areas degenerated more slowly over five years than in typical older adults.

“Analysis of grey matter in the brain focuses on neurons, which are crucial components of the brain and play a fundamental role in its functioning,” said Gaser. “Neurons are closely involved in memory formation and learning processes.”

While the researchers found that superagers had lower rates of anxiety and depression, Garo-Pascual said their study cannot claim causality.

“Therefore, we cannot tell which is the direction of the association between mental health and memory function…mental health is a risk factor for dementia, but mental health problems are also a symptom for dementia,” she told Health.

Martine Sanon, MD, associate professor of geriatrics and palliative medicine at Mount Sinai, said it is well understood by geriatricians that people who have a good cognitive and functional baseline tend to have a more favorable prognosis as they age and are more resilient.

She said cognitive, physical, and emotional wellness are all somewhat related and interconnected.

“The ability to preserve all of these essential aspects of life plays a significant role in shaping an individual’s quality of life as they age,” she said.

Additionally, it does not surprise her that the recent study suggests that superagers move more quickly than typical older adults.

“It would make sense to me that those individuals who can preserve this, from a functional standpoint (i.e, faster gait speed, strength, and activity) are more resilient and somewhat protected from cognitive decline, and anxiety and depression, which we tend to see later in life,” said Sanon.

Why an increased speed of movement positively impacts memory function is unknown and future research should attempt to elucidate this relationship, noted Garo-Pascual.

Researchers tried to use 89 demographic, lifestyle, and clinical predictors to identify any factors associated with superagers.

“Using these 89 variables, a machine learning model was only able to distinguish superagers from typical older adults 66% of the time,” Gaser said.

This suggests that superaging may be influenced by additional genetic factors.

While the superager phenotype could be predetermined by a genetic component, Garo-Pascual added that in order to conclusively study the genetic variants associated with a given phenotype, researchers need to study a very large sample of participants, which means researchers studying superagers will have to pool together their data.

Gaser noted that it’s not clear whether all people have the potential to become superagers. However, he said lifelong learning, social activities, being more active, and maintaining independence in daily life may all help in potentially becoming a superager.

“A more active lifestyle in midlife and activities, such as playing an instrument, will also be important,” he said.

Garo-Pascual added that science does prove that control of psychiatric symptoms, maintenance of agility, control of hypertension and glucose levels, together with a musical interest could help to maintain a healthy memory with age.

Sanon agreed. She said staying active and challenging the mind and body can help maintain cognition reserve, and vice versa.

“[Better] cognition can lead to more active and engaged older adults,” Sanon said. “I do think it really has to be an instilled part of an individual’s lifestyle to actively engage to make the most of their healthcare quality of life.”

While some of the hypotheses shared in the study are plausible, such as slow degeneration of grey matter, increased brain mass, less age-related brain atrophy, and genetics, Sanon said there are many other factors to take into consideration, including phenotype, genotype, brain structure, life experiences, education, and family support.

While the comprehensive research provides valuable insights into superagers, she noted that observational studies have limitations.

“There are certainly several factors that can contribute to preventing and delaying cognitive decline, and it may be individualized,” Sanon said. “Regardless, strategies to maintain a healthy cognitive and functional baseline is beneficial to everyone to lead longer and more fulfilling life as we age.”