Study finds more clues as to why ‘SuperAgers’ have better brains

Originally Published: 13 JUL 23 18:30 ET

Updated: 13 JUL 23 18:45 ET

By Sandee LaMotte, CNN

(CNN) — In the largest observational study to date on “SuperAgers” — people in their 80s who have brains as sharp as those 30 years younger — researchers in Spain found key differences in lifestyle that may contribute to these older adults’ razor-sharp minds.

SuperAgers in the study had more gray matter in parts of the brain related to movement, and they scored higher on agility, balance and mobility tests than typical older adults — even though the physical activity levels of the two groups were the same.

“Though superagers report similar activity levels to typical older people, it’s possible they do more physically demanding activities like gardening or stair climbing,” said senior author Bryan Strange, director of the Laboratory for Clinical Neuroscience at the Technical University of Madrid, in a statement.

“From lower blood pressure and obesity levels to increased blood flow to the brain, there are many direct and indirect benefits of being physically active that may contribute to improved cognitive abilities in old age.”

The study, published Thursday in The Lancet Healthy Longevity journal,  followed 64 SuperAgers and 55 cognitively normal older adults who were part of the Vallecas Project, a long-term research project on Alzheimer’s in Madrid.

In a battery of tests, the Spanish SuperAgers scored lower than typical older adults in levels of depression and anxiety, the study found. Mental health issues such as depression are known risk factors for developing dementia.

SuperAgers also told researchers they had been more active in midlife, had been happy with the amount of sleep they got, and were independent in their daily living. Poor sleep is a key risk factor for cognitive decline.

“This study adds to what we already know — SuperAging isn’t just the ability to perform well on a cognitive test,” said Angela Roberts, an assistant joint professor of communication and computer science at Western University in London, Ontario, in an email. She was not involved in the study.

“It is associated with slower and less pronounced brain atrophy in regions critical for memory and language and possibly slower age-related declines in walking and mobility,” said Roberts, also a principal investigator of the Northwestern SuperAging Research Program, a clinical trial led by the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease at Northwestern University’s Feinberg School of Medicine in Chicago.

The study is good news for people in their 30s and 40s who may want to improve their health by incorporating more exercise, stress reduction and other healthy habits, said Dr. Jo Robertson, national screening and trials coordinator for the Australian Dementia Network at the University of Melbourne, in an email.

“The take-home point here for people in midlife is that they need to be enthusiastically modifying lifestyle factors known to have an impact — increasing physical fitness, reducing cardiovascular risk, optimizing mental health and getting appropriate care for any mood disorders — to improve their long-term brain health,” said Robertson, who also was not involved in the study.

What is a SuperAger?

Most people’s brains shrink as they grow older. In SuperAgers, however, studies have shown the cortex, responsible for thinking, decision-making and memory, remains much thicker and shrinks more slowly than those in their 50s and 60s.

To be a SuperAger, a term the Northwestern SuperAging program coined, a person must be over 80 and undergo extensive cognitive testing. Acceptance in the study occurs if the person’s memory is as good or better than cognitively normal people in their 50s and 60s — only 10% of people who apply qualify.

“SuperAgers are required to have outstanding episodic memory — the ability to recall everyday events and past personal experiences — but then SuperAgers just need to have at least average performance on the other cognitive tests,” cognitive neuroscientist Emily Rogalski, a professor of psychiatry and behavioral sciences at the Feinberg School, told CNN in an earlier interview.

“It’s important to point out when we compare the SuperAgers to the average agers, they have similar levels of IQ, so the differences we’re seeing are not just due to intelligence,” said Rogalski, who developed the SuperAging project.

SuperAgers share similar traits, say experts who study them. They tend to be positive. They challenge their brain every day, reading or learning something new. Many continue to work into their 80s.

SuperAgers are also social butterflies, surrounded by family and friends, and can often be found volunteering in the community. And as the current study found, they also stay active physically.

More gray matter in certain parts of the brain

All participants in the Spanish research underwent brain scans, blood tests and other lifestyle and cognitive assessments when they entered the study and were reexamined annually for four years.

Brain scans showed SuperAgers had greater gray matter volume than typical older adults in areas of the brain responsible for cognitive functioning, spatial memory and overall memory. In addition, some of the most impressive changes in gray matter volume were in areas of the brain connected to motor activity or movement as well as memory.

Interestingly, the study found SuperAgers were just as likely to have the same levels of APOE genes —  including APOE4, a red flag risk for Alzheimer’s disease — as normally aging adults. However, that finding is not new, experts say.

“SuperAgers perform better on a range of measures — memory, physical condition, speed and mental health — regardless of the levels of blood biomarkers of Alzheimer’s disease,” said Robertson, who is a senior clinical neuropsychologist at Melbourne Health in Australia.

Earlier research has found a genetic predisposition for the ability to keep the mind sharp well into old age. Examination of donated brains of SuperAgers have found bigger, healthier cells in the entorhinal cortex – one of the first areas of the brain affected by Alzheimer’s.

Brains of SuperAgers also had many more von Economo neurons, a rare type of brain cell thought to allow rapid communication across the brain. So far, the corkscrew-like von Economo neuron has only been found in humans, great apes, elephants, whales, dolphins and songbirds.

“The story here is not simply that (SuperAgers) are at lower risk of developing dementia,” Roberts said. Instead, she said, they may have added protective factors — genetic or lifestyle or even a positive emotional outlook — that help protect them in the face of these risk factors.

“This is a key reason to study SuperAgers — as they may help us to uncover protective mechanisms that act on known dementia risk factors … to lessen or minimize the risk of age-related cognitive decline and brain changes,” Roberts said.

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