For more than 25 years, specialists at Northwestern Medicine have been studying people aged 80 and older who maintain high mental activity, aiming to understand how some individuals manage to keep their minds sharp in old age.

These participants, known as “SuperAgers,” achieve memory test results comparable to those of people at least 30 years younger. This challenges the widespread belief that cognitive decline is an inevitable part of aging. Over years of observation, researchers have identified lifestyle habits and personality traits that set SuperAgers apart from their peers, including strong social engagement and openness. However, the most significant discoveries have come from studying their brains.

Research has shown that exceptional memory in old age is linked to specific neurobiological characteristics. These findings open up possibilities for developing new approaches to support cognitive resilience and reduce the risk of Alzheimer’s disease and other forms of dementia.

Main Research Findings

• Memory: SuperAgers consistently score at least 9 out of 15 points on delayed word recall tests, which matches the performance of people aged 50–60.
• Brain Structure: These individuals show little to no thinning of the brain’s cortex, a typical sign of aging. In some cases, the anterior cingulate cortex is even thicker than in young adults, a region associated with decision-making, emotions, and motivation.
• Cellular Features: SuperAgers have more von Economo neurons, which are linked to social behavior, as well as larger entorhinal neurons, which play a key role in memory.
• Social Connections: Most SuperAgers are highly social and maintain close relationships, regardless of differences in lifestyle or physical activity levels.

Biological Mechanisms

Researchers have identified two possible mechanisms that may help preserve cognitive function in old age:

• Resilience: The absence of amyloid plaques and tau tangles, which are associated with Alzheimer’s disease.
• Resistance: Even when these proteins are present, they do not negatively affect the brain.

Program History and the Importance of Brain Donation

The term “SuperAger” was introduced in the late 1990s. Since 2000, 290 people have participated in the program, and after their passing, 77 donated brains have been studied. Some of these brains contained amyloid and tau proteins, while others did not. Brain donations have been crucial for many discoveries, allowing research to continue even after participants’ deaths.

Outlook

SuperAger research could lead to new strategies for protecting brain health and help more people maintain mental clarity as they age. These discoveries may change how we study brain aging and contribute to the development of methods to slow down or prevent dementia, including Alzheimer’s disease and frontotemporal degeneration.

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In Brief:

• SuperAgers are people over 80 whose memory rivals that of individuals 30 years younger.
• They are characterized by high sociability and mental activity, and their brains can resist the buildup of proteins linked to Alzheimer’s disease.
• The data obtained may help create new methods for preventing dementia and supporting cognitive health in old age.