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Although aging affects everyone, some people experience damage more slowly. This evidence has prompted many scholars to explore what makes those people who seem immune to the passage of time in search of biological traits or lifestyles that can be replicated to democratize their gifts. One such group is the “super elders” (super old people in English), people who, at age 80, retain a memory typical of people thirty years younger. The term was coined in 2012 by a group led by Emily Rogalsky from Northwestern University in Chicago (USA). Then they saw that they had a thicker cerebral cortex and that they showed resistance to some of the damage, such as cortical atrophy, that comes with age. However, they do not appear to have superior cognitive abilities when young. Rather, they seemed to resist aging better due to physical factors or lifestyle.
This week magazine Lancet Healthy Longevity published an article noting that super-aged people, in addition to better memory, move faster and have better mental health. The work, which used data from the Vallecas Project cohort dedicated to identifying early markers of Alzheimer’s disease, showed, thanks to diagnostic imaging technologies, that these people have more gray matter in key areas of the brain. The reason is probably that it worsens more slowly than in the general population, as was confirmed after five years of follow-up of super-aged people and normal people.
Marta Garo-Pascual, co-author of the study and researcher at the Alzheimer’s Center of the Reina Sofia Foundation in Madrid, says this type of study “gets closer to solving the big unanswered question about super-aged people, whether they are more resistant to age-related memory decline or whether they have mechanisms to cope with this deterioration better than others.” A greater presence of gray matter indicates that they have a protective factor that slows down damage, but these people are also known to have more social connections or to retain interest in learning new things for longer. Because research like that of Garo-Pascual and colleagues is observational, it’s hard to tell which comes first: healthy habits keep us young, or natural youth keep us active and connected to world news.
Emily Rogalsky, ten years after she pioneered the study of super-aged people, continues to work in this field, although she claims that such people are “few and hard to find.” At the moment, in his opinion, these individuals would not be the same type. Some “have a brain structure that seems to be resistant to neuropathology, but there are others that are more resistant and take damage but compensate in other ways. Life experience can be just as important as genetic factors,” he adds.
University of Barcelona professor David Bartres finds it useful to “study super old people because it helps us identify what makes these people different and what we can promote to the general population. Through these studies, we know that there are modifiable factors, such as vascular health, proper nutrition, good sleep, perhaps exercise to improve motor skills and anxiety or depression treatment, that are important in preventing cognitive decline and diseases such as dementia,” he explains.
Bartre acknowledges that understanding that a factor is modifiable does not make it easier to change it, and for this reason he emphasizes the importance of personalizing change. In the same vein, Garo points to the paradoxical results of his research: “(Over-aged people) claim that they do the same amount of exercise as ordinary people, but it is possible that they do not consider activities such as climbing stairs or gardening to be exercise.” Exercise, which helps control blood pressure or blood glucose levels and improves mental well-being, should act on very important factors of cognitive decline. These results are consistent with those of people over 100 years of age, who in many cases do not lead a particularly healthy lifestyle.
Another aspect that Bartres worked on is the assessment of psychological aspects, such as the presence of a purpose in life, resistance to cognitive impairment. “People with a larger purpose, which can be different for each person, from being a parent to working or helping others, experience less stress and better tolerate the changes that are typical of Alzheimer’s,” he says. In one of their studies, they noticed that although there are vascular changes in the white matter of the brain, such as those that begin to appear after the age of 40 and cause cognitive decline, these changes affect those who have a clearer sense of life less. “For example, we have seen that connectivity between brain regions is better, which can compensate for observed damage,” he notes. While giving meaning to life is something personal, there are psychological therapies that can help define or rediscover that meaning.
Contrary to what has been found in the case of super-aged people, in whom damage accumulates more slowly, there are cases where physical deterioration is compensated by what is called vitality. Education is one of these resilience factors and is likely responsible for the 30 percent decline in the proportion of people with dementia in the US over 15 years, along with other factors such as cardiovascular disease control. Studies show that illiterate people are three times more likely to develop dementia.
Despite the interest in studying this group of people with a privileged age, Garo-Pascual admits that they have not found the “formula of being.” superstar“. “We created a model with many variables, most of which were related to lifestyle, but we were only 66% accurate in classifying a person as ultra-old. 34% eludes us,” he explains. “This model is missing a component that could be important, namely genetics, that could explain the part that we have not identified,” he says. Variants of genes, such as APOE, are known to increase or decrease the likelihood of Alzheimer’s disease, and some of these beneficial variants have already been found in studies in people over 100 years of age.
Rogalsky believes that such knowledge “is already being used for therapeutic purposes and drug development, although it is still at a very early stage.” It also points to the importance of making life choices that may seem easy and free but are actually complex, such as “having strong relationships with others and a positive attitude towards life”, which are very common traits among super-aged people. The scarcity of these people makes it necessary to collect them in international studies, and this will be one of the next steps to try to unravel their secrets.
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