The Answer to Alzheimer's Could Lie in SuperAgers

When searching for a cure for Alzheimer’s, most scientists look at existing brain degeneration and try to figure out how to fix it. What might we find out if we looked instead at the brains of people with superior brain health?

That’s what a group of researchers at the University of Chicago asked themselves. They chose elderly people with exceptional memories to see why their brains perform so well. Their findings may lead to new strategies to save cognition and uncover new treatments for Alzheimer’s disease.

Key Takeaways

SuperAgers have unique brain structures. Their brains show thicker areas involved in memory, attention, and decision-making compared with typical older adults.
SuperAgers show dramatically lower levels of tau protein tangles—a key driver of Alzheimer’s-related brain damage.
Researchers believe stress resilience and life experiences may help explain why some people maintain extraordinary brain health into their 80s and beyond.

What's a SuperAger?

The term SuperAgers refers to people over the age of 80 whose memories are as good as those people who are 20 to 30 years their junior. The moniker was coined in 2007 by scientists at the Northwestern Mesulam Center for Cognitive Neurology and Alzheimer's Disease. To determine differences between the brains of SuperAgers and those of other healthy people of the same age, as well as between those of people with cognitive impairment, researchers have conducted a series of studies. Their results are impressive to say the least.

SuperAgers Have Larger, Thicker Brains

In one study, the researchers compared brain scans of 12 SuperAgers with scans of 10 cognitively normal people of the same age and of 14 people aged 50 to 65. They found that the cingulate cortex, a region important for memory, attention, cognitive control, and motivation, was thicker in SuperAgers than in their same-age peers.

Surprisingly, a small area of the anterior cingulate cortex, which is involved in complex functions such as emotion, empathy, impulse control, and decision-making, had greater thickness in SuperAgers than in even their middle-aged counterparts.

Northwestern researchers also discovered that SuperAgers have three to five times as many von Economo neurons as age-matched controls. These are rare, spindle-shaped cells mostly populated in the anterior cingulate cortex. They are linked to social intelligence and awareness.

The SuperAgers even had more of these neurons than younger adults had.

In another investigation, the Northwestern team measured changes in brain volume over 18 months. Normal elderly participants saw a 2.24 percent volume loss, but SuperAgers lost less than half of that, suffering only a 1.06 percent volume loss. Then they tested for brain-cell-choking proteins, which are linked to Alzheimer's disease.

87 Percent Fewer Tau Tangles

Tau protein is important for transporting nutrients to neurons and for cell communication. In Alzheimer's disease, tau forms tangles that lead to brain cell death. In fact, tau has long been considered a key marker for dementia, more so than the better-known amyloid plaques.

In their post-mortem study, SuperAgers had 87 percent fewer tau tangles in the anterior cingulate cortex than aged-matched controls and 92 percent fewer tangles than those with mild cognitive impairment. In this post-mortem study, researchers investigated the extent of amyloid plaque and tau tangle buildup in the entorhinal cortex, an area of the brain largely responsible for memory. They found that SuperAgers had almost a threefold fewer tangles than their age-matched peers and a hundredfold fewer tangles than those with Alzheimer's.

Lead author Tamar Gefen commented, "The results suggest resistance to age-related tau degeneration in the cortex may be one factor contributing to preserved memory in SuperAgers. "There is a strong relationship between tau tangles and memory loss, and these findings in a unique SuperAging cohort could guide research in a new direction." When it came to amyloid plaques, the SuperAgers had the same plaque density as the cognitively healthy elderly group. This adds to the growing evidence we’ve long reported in this newsletter: amyloid is not the driver of memory loss.

Taking a Holistic Approach

Next, Professor Gefen wants to explore genetic, molecular, and biochemical factors that may play a role in the brains of SuperAgers, but she’s also interested in environmental and lifestyle factors. "...we must take their personal narratives (history, proclivities, behaviors, cultures) into account when making conclusions about their unique neuro-anatomic profiles."

One lifestyle factor that Professor Geffen and her team have already identified in SuperAgers is resilience. They've discovered SuperAgers have great resilience in the face of stress. Northwestern team member Dr. Emily Rogalski explained, saying, "We all encounter stress and have the opportunity to react in different ways. One reaction can be to rise above it, and it seems like these SuperAgers are particularly good at really identifying the best in a situation and figuring out how to move on."

Carl Lowe

Carl Lowe has decades of experience writing about health and nutrition for many publications, including Prevention Magazine and Self Magazine (where he served as the food and nutrition editor). He has authored and edited over 10 books about natural health, nutrition, and other subjects. He edited The Columbia University College of Physicians and Surgeons Complete Home Medical Guide and was the nutrition editor for a Time-Life book series on health and nutrition. As a musician, he played viola with the Yale Symphony and bass with the Tommy Dorsey Band, and he has appeared on national TV.

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