The Brain Secrets of People with Exceptional Memory.
Research from 25 years of the superagers program
By Austin Perlmutter, MD
One of the biggest brain myths is that all people will suffer similar decline in brain function as they age. But why do some people make it to their 80s and beyond with the memory of people decades younger? This is one of the questions being explored by researchers at Northwestern’s medical school with the “superager” program. To qualify as a superager, people must be at least 80 years old but have performance on a memory test equivalent to those aged 56-66. After 25 years, the program has included 101 superagers aged 81-111 years old, and now, the team has published research on key things that make superager brains different from the average person. In this article, we’re covering 4 of the most important findings from this work, along with a discussion of what this could mean.
1. Superagers had less thinning of the brain’s cortex
When looking at brain imaging scans from superagers compared to age-matched controls, researchers saw a difference in the degree of thinning of the cortex. For context, the cortex is the thin layer of gray matter on the top of our brains that tends to shrink with age and especially in dementia. Shrinkage of the cortex is associated with worse memory, impairments in language and alterations in behavior.
In the brain scans of superagers, there were several key findings beyond a general preservation of the cortex. First, when analyzed over an 18-month period, the speed with which their cortex shrank was slower than peers, suggesting that superagers didn’t just start with a thicker cortex, but rather kept it better than average people. Second, in a region of the cortex called the anterior cingulate, superagers had exceptional thickness- even thicker than people aged 50-60 years old. The anterior cingulate is notable in that it’s linked to emotional, cognitive and interpersonal brain function.
2. Superagers had preservation of cholinergic brain systems.
One of the key neurotransmitters in the brain is acetylcholine, where it helps control memory, learning and sleep cycles. Damage to the brain systems involved in producing acetylcholine is one of the key findings in Alzheimer’s dementia, and a mainstay of Alzheimer’s treatment includes drugs designed to block the breakdown of acetylcholine.
In superagers, key neurons involved in acetylcholine signaling showed less evidence of structural issues than in controls. Interestingly, superagers also had less density in neurons that break down acetylcholine. All of this suggests that superagers may have a more functional acetylcholine system in regions of the brain affected by Alzheimer’s dementia.
3. Superagers had more von Economo neurons in the anterior cingulate cortex
A remarkable type of neuron found at higher levels in the anterior cingulate is the von Economo cell. These neurons are linked to interpersonal behaviors, and have been identified in whales, elephants and great apes, among other species. Notably, superagers had lots of von Economo neurons in the anterior cingulate, equivalent to people much younger. Unlike the age-related changes in cortical thinning, research suggests that superagers might simply be born with more of these neurons.
Superagers had less inflammatory cells in their white matter
In our brains, there is an ongoing and critical dance between inflammatory and anti-inflammatory pathways. The cell that is at the center of this dance is called a microglial cell. Higher activation of microglial cells contributes to inflammation in the brain and is linked to dementia, depression and other brain disease.
In superagers, researchers found lower levels of activated microglial cells in the white matter of the brain. Importantly, this is the opposite of what is typically seen in brain aging. As inflammation may be a key driver of both brain aging and dementia, this finding is significant.
The question that will result from the superager research are is course, what can we all do to increase the odds that we will become superagers ourselves? Interestingly, this cohort of superagers didn’t have any signals around lifestyle factors other than, they tended to be more social. Other research has shown that our social connections are one of the best predictors of longevity and impacts dementia risk. Yet some of the findings from this data (e.g., von Economo neurons) indicate that superagers may have a biological predisposition to social interaction, rather than growing into it over time.
In the coming months, I’ll continue to provide updates on this important research (be sure you're subscribed below to get access!) In the interim, here’s a reminder of 8 powerful, evidence-based tools you can employ today to help fight brain aging and decrease dementia risk.
Exercise regularly
Eat a minimally processed diet like the Mediterranean or MIND pattern diet
Prioritize good sleep
Get outside and into nature
Engage in stress-reduction practices
Socialize with people and animals you care about (key distinction here, is they fill your cup rather than drain it)
Decrease exposure to air pollutants
Follow up with your care team to work on your hearing, vision, blood pressure and blood sugar levels.
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This content is for informational and educational purposes only and does not constitute medical advice. Please consult with a qualified healthcare provider before making significant changes to your diet or lifestyle.
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