Super-agers: What we can learn from octogenarians who defy cognitive decline

With approximately 7% of the older Australian population demonstrating cognitive abilities similar to people several decades younger, scientists are scrambling to unlock the secrets of these so-called “super-agers”. Here’s what they know.

By Sabrina Rogers-Anderson

Imagine having the cognitive ability of a 50-year-old when you blow out the candles on your 80th birthday cake. Would you use your powers for good or evil?

Researchers around the world are fascinated by the elusive group of smarty-pants who seem to defy the laws of ageing.

While the concept of super-ageing does sound a little sci-fi, research indicates that it’s a reality for about 8.6% of older Australian women and 5.3% of older Australian men.

That said, because definitions of super-ageing vary wildly, we do need to take these statistics with a grain of salt.

What is a super-ager?

The Northwestern University SuperAging Research Program (NUSAP) has been around for 25 years and is credited with coining the term super-ageing.

NUSAP defines super-agers as people aged 80 and up who have the memory performance of someone in their 50s and 60s.

But other super-ageing researchers have different definitions, which can make comparing study results challenging.

“I think I’ve compiled 21 different definitions so far,” says Dr Alice Powell, neurologist, geriatrician and super-ageing researcher at UNSW Sydney’s Centre for Healthy Brain Ageing (CHeBA).

“Most of them have focused on memory, but there are a few different ways of looking at it. I'm using a three-pronged approach and one of them is looking at people who are doing very well for their age, such as an 80-year-old who is doing much better than other 80-year-olds. And I'm not just looking at memory, but also other cognitive domains like language abilities, visuospatial abilities, executive function and attention.

“Another approach is looking at older people who are doing as well as people in their 40s in different cognitive domains. And the final one, which I find quite interesting, is looking at people who maintain their cognitive abilities regardless of where they start. They don't have cognitive impairment and they maintain their ability over years of testing.”

What do super-agers have in common?

Spanish researchers have been following 1230 adults aged 70 and over since 2011 in an effort to understand the mechanisms behind super-ageing.
Known as the Vallecas Project, the longitudinal study has made several important discoveries. They found that super-agers:

• Have higher volumes of grey matter in parts of the brain associated with memory and slower loss of that grey matter
• Are more resistant to age-related structural changes in white matter (which is also involved in memory)
• Have better mobility, agility and balance
• Have fewer glucose disorders and high blood pressure issues
• Were more active during midlife (but don’t necessarily do more exercise now)
• Have better mental health
• Are more likely to have a musical background

While these results are fascinating, it’s important to note that they’re observational rather than causal. That means that trying to control the factors outlined above won’t turn you into a super-ager because they haven’t been shown to cause super-ageing.

“There's definitely also a genetic component to super-ageing, but we haven't identified all of the genes,” explains Dr Powell.
Interestingly, the researchers found no significant differences in super-agers’:

• Years of education
• Diet
• Amount of sleep
• Alcohol and tobacco use
• Blood biomarkers of dementia

“There are a few interesting findings from this study,” says Dr Powell. “Super-agers and their peers had the same sort of sleep duration, but the super-agers perceived it as better. It also appears that middle age is the time to change your lifestyle because it seems to have the most impact.”

The Vallecas Project findings echo and build on the results of the original Northwestern SuperAging Project published in 2014, which found that super-agers aged 80 and over:

• Had brains that looked like those of a typical 50 to 60-year-old
• Experienced a slower rate of brain atrophy than their peers
• Had more positive social relationships

What can we learn from super-agers?

While more research is needed to identify the causes of super-ageing, Dr Powell believes we have the ability to halt cognitive decline.

“When the brains of centenarians are autopsied, they actually do have neurodegenerative disease in their brain, but they've managed to withstand the effects of it,” she explains. "A major report found that 40% of dementia was due to preventable lifestyle factors, so we can make changes that will protect our brains.

As a clinician, I always tell my patients that there are three main ways to be active and they’re all interconnected. The first is cognitive activity, which involves doing things that are a bit challenging or learning something new.

Then there’s social activity or social engagement, which involves making quality connections rather than meeting a lot of people. And, of course, physical activity. If you can combine all three, you’re on the right track.”