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Celebrating What's Right With Aging: Inside the Minds of Super Agers

Some people in their 80s and 90s show shockingly little decline in their brainpower. Scientists are beginning to understand what makes them different and how the rest of us might benefit

spinner image a woman with a glowing brain
Mark Ross Studio / Getty

You can find Vernon Smith hard at work at his computer by 7:30 each morning, cranking out 10 solid hours of writing and researching every day.

His job is incredibly demanding — he is currently on the faculty of both the business and law schools at Chapman University. But the hard work pays off: Smith’s research is consistently ranked as the most-cited work produced at the school — a testament to his ongoing academic influence and success. He manages his job and research work while also coauthoring books and traveling around the country to deliver lectures.

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It’s a remarkable level of productivity, made all the more remarkable by one simple fact: Vernon Smith is 96 years old.

Smith, who was awarded the Nobel Prize in Economic Sciences at the tender age of 75, says he feels the same passion as he did then, and even as he did when he embarked on his career more than seven decades ago.

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Vernon Smith, 96, has a Nobel Prize in Economic Sciences.
Reason Foundation

“Except for the fact that I don’t actually do experiments myself anymore — my coauthors do those — I think I’m as good or better than ever, partly because I have knowledge across several areas that my younger [colleagues] are in the process of acquiring themselves,” says Smith. “So we’re a good match.”

What accounts for Smith’s extraordinary mental capabilities as he nears 100? Why is he thriving cognitively while so many of his contemporaries are grappling with physical and mental decline?

And what can we do to make sure that our 90s and beyond are just as fulfilling?

The puzzle of the super ager

Researchers are attempting to answer these questions by studying people like Smith, who is one of 1,600 participants in the University of California, Irvine’s 90+ Study, a research project examining both successful aging and dementia in people age 90 and older. Scientists and gerontologists are recruiting individuals who demonstrate remarkable memory and evaluating their physical health and their lifestyles. The researchers observe the brains of their subjects using MRIs and scans, test for biological markers and conduct postmortem studies on those who have donated their brains after death (many study participants do) — all in an effort to understand this small but extraordinary group of men and women who, like Smith, are now categorized as “super agers.”

“Super ager” is used to describe someone over 80 with an exceptional memory — one at least as good as the memories of people who are 20 to 30 years younger.

Many people think they have good memories, but super agers are actually quite rare, says cognitive neuroscientist Emily Rogalski, who leads the SuperAging Research Initiative­ across five cities around the United States and Canada. She is also the director of the Healthy Aging & Alzheimer’s Research Care (HAARC) Center at the University of Chicago. Fewer than 10 percent of the individuals who sign up to participate in her studies have the memory and mental capacity to meet the scientific criteria for being a super ager, she says.

spinner image scientist emily rogalski speaking at the conference for the national alzheimers coordinating center
Scientist Emily Rogalski speaks at a conference for the National Alzheimer’s Coordinating Center.
Courtesy the National Alzheimer’s Coordinating Center

“We don’t often celebrate what’s going right in aging, only what’s going wrong,” says Rogalski, who was one of the first researchers to use the term “super ager.” “We’re still at the beginning of this journey, but super agers provide a great opportunity for teaching us quite a bit.”

It’s a critical mystery to crack. As 73 million boomers hit their 80s, and as medical advances expand the opportunity to live longer and longer lives, conquering the onset of dementia has never been more important. “Brain aging needs to match longevity,” says Matt Huentelman, who leads genetics studies for the SuperAging Research Initiative. “Today your body may make it to 100, but your brain poops out at 80.”

Super brains and the people who own them

Most of us have brains that will age and change in similar and predictable ways. Memory peaks between the ages of 30 and 40. Overall brain volume begins to atrophy in our 50s, particularly in the areas of the brain linked to complex thought processes and learning. Changing hormones, deteriorating blood vessels and difficulty managing blood glucose — the brain’s primary fuel — lead us toward the cognitive decline associated with aging. These factors explain why we may have trouble retrieving a word or remembering a name to match a face as we get older, and why multitasking and processing new information become more challenging.

spinner image m r i scans comparing normal cognitive decline versus a super ager
Courtesy of Dr. Adam Martersteck and Dr. Emily Rogalski

But the brains of super agers behave differently.

  • Super ager brains are shrink-resistant. That is, they shrink at a slower rate than the brains of similarly aged people and maintain volume in the areas associated with memory and focus. The SuperAging Research team identified a potential “brain signature” for super agers: They found that the anterior cingulate cortex, which impacts thinking, memory and decision-making, is thicker in super agers — sometimes thicker even than it is in most people in their 50s and 60s. In fact, in some super agers, the brain regions linked to memory storage and retrieval were so well preserved that they were indistinguishable from those in young adults, says Brad Dickerson, a behavioral neurologist and director of the Frontotemporal Disorders Unit at Massachusetts General Hospital and a professor of neurology at Harvard Medical School.
  • Super ager brains have supersize memory cells. The neurons around the brain responsible for memory are significantly larger in super agers than they are in their peers and even in individuals 20 to 30 years younger. These neurons also tend to be free of so-called tau tangles, the webs of proteins that collect inside neurons in the brains of people with Alzheimer’s disease and other kinds of dementia.
  • Super ager brains have more “social intelligence cells.” They contain a higher volume and density of spindle-shaped von Economo neurons — cells that have been linked to social intelligence and awareness. These specific cells help facilitate rapid communication across the brain, providing an enhanced ability to navigate the outside world.

These factors seem to combine in a way that keeps the brains of super agers from declining with age — and we’re not just talking about what happens when they get to their 80s and 90s. Indeed, by their mid-60s, super agers may already have a huge advantage over their peers. In 2016, Dickerson’s team used neuroimaging to identify the specific type of brain activity involved in memory in younger super agers (ages 60 through 80). Participants were given a list of 16 unrelated words, which they were then asked to repeat back 20 minutes later. An average 25-year-old can usually recall 14 of the words, and the average 75-year-old will remember nine. But the super agers in the study remembered just as many words as the 25-year-olds. Another study found similar results. Super agers who took a tough memory task test while in an MRI scanner were able to learn and recall new information as well as study participants who were 25 years old.

Super ager speaks

Dr. Ruth Westheimer, 95, sex therapist, talk show host, author of two new books, including the revised The Art of Arousal

Secret weapon: A love of life ... and talking

“When I was 10 years old, my family made the sacrifice of sending me to Switzerland. That’s how I survived [the Holocaust]. For six years, I was in an orphanage in Switzerland, hoping the parents could get out. They did not, but my love for life and my attitude towards life is because of my early years. Also, I exercise. And I exercise my mouth. I talk day and night. It exercises my brain.”

Decoding the magic formula

But why are super agers resistant to age-related decline, to the point where their brains at 90 function better than the average 60-year-old brain? There seem to be three factors at play.

  • Cognitive reserve. It’s not that their brains don’t age; it’s that super agers seem to be able to overcome the wear and tear that cognitively average people succumb to: age-related issues like inflammation or clogged blood vessels. In fact, postmortem studies of the brains of super agers reveal that some had the clinical pathology of Alzheimer’s but never experienced any of the symptoms.  

That is, some brains may have an added power that allows them to keep functioning well despite the presence of disease or the markers of cognitive decline. Since longer life and healthier cognition seem to run in families, it may be that this ability is genetic, but scientists don’t yet know. That said, genes are like programs on a computer: Having super ager genes is the first step, but genes can be “turned on” or “turned off” by environmental factors and lifestyle choices.

  • Life achievement. People with higher education levels or greater career attainment tend to have greater cognitive reserve, says Yaakov Stern, professor of neuropsychology at the Columbia University Vagelos College of Physicians and Surgeons, who studies this aspect of brain health. But we don’t know yet whether educational and career success increases the chance of becoming a super ager or whether the natural cognitive advantages these folks have simply make them more likely to succeed. Interestingly, a recent study conducted at Massachusetts General Hospital at Harvard Medical School found that higher educational achievement and more years of schooling could act as a protective factor and slow down cognitive impairment and Alzheimer’s, even in individuals with strong genetic risks for dementia.

On the other hand, it may be that the natural mental abilities of super agers make them more likely to set off on advanced studies or successful career trajectories, or to grab those late-career brass rings. It’s one of the factors researchers are planning to study when looking at the impact of socioeconomics on super aging.

  • Lifestyle. This may be the big one. Several clues are starting to emerge that point to parallels between the lifestyles of super agers. Healthy-aging researchers have identified four common habits.

A physically and intellectually active lifestyle.

The willingness or ability to constantly challenge oneself.

An active social life and a wide social network.

Moderation in all indulgences, allowing for the occasional glass of wine, for example.

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In fact, while myriad studies now underway are probing the biological, genetic and scientific underpinnings of super agers, lifestyle and environment remain significant and consistent factors that most likely contribute to superior aging.

In addition to maintaining the four habits above, super agers make other lifestyle choices that seem to have a significant impact. Eating a Mediterranean diet (lots of produce, not too much red meat), exercising daily and actively managing stress levels and mental health issues are all shown to have a positive impact on cognition. Conversely, studies have documented the negative impacts of loneliness and social isolation, and even poor hearing and vision, on cognitive health. Passively sitting back watching television? Not on the list of things to do if you want to be a super ager.

Super ager speaks

Norman Lear, 101, award-winning television producer and screenwriter (All in the Family, One Day at a Time)

Secret weapon: Gratitude

“I can only attribute [being a super ager] to what is known in common parlance as the luck of the draw. … I would add one factor only, and that is gratitude. The hour-by-hour feeling of appreciation for the gifts with which we are born or have had the ability to accumulate.”

Having a strong social network doesn’t mean that you’ll never get Alzheimer’s disease, says Rogalski of the SuperAging Research Initiative. But maintaining strong social networks could be on the list of healthy choices, like eating a certain diet and not smoking. [See “7 Secrets of the Super Agers.”]

Researchers concede there is much they still don’t know about exactly what makes a super ager. For example, the medical problems and health-related concerns of super agers are comparable to the health profiles of normal agers. According to Rogalski, studies have shown that the use and types of medications super agers take are pretty much the same as those used by people with average memory for their age. And there are super agers who have a range of diseases, from lymphoma to osteoarthritis; many use wheelchairs, despite their excellent cognitive health.

“Not all cognitive super agers are also physically exceptional,” says researcher Angela Roberts of the Canadian Centre for Activity and Aging.

Roberts and her team have been collecting data on lifestyle factors by using wearable sensors to study super agers. While findings are still preliminary, they have found that super agers in the study do 60 minutes of moderate to vigorous physical activity a day, and sometime as much as 90 minutes, which is well above the 150 minutes a week that’s generally recommended for older adults. The sensors also show that super agers tend to get higher-quality, uninterrupted regular sleep than non-super agers.

Researchers are now starting to look at other factors, including the vascular and cardiac health of super agers versus non-super agers, given that vascular health is critical to how the brain ages. They suspect that the cardio-vascular system of a super ager may be more “dynamic” than typical in people their age. They also hypothesize that super agers could have a protective pathway of sorts that may affect the development of dementia and other aspects of health.

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“The idea is, as we age, our entire system becomes less dynamically responsive,” says Roberts. “We are exploring the genetic and lifestyle factors that help people age exceptionally from a cognitive perspective.”

Hitting the big 100

Some scientists believe that the best chance of understanding super agers may come from studying the oldest individuals in this cohort. That’s the premise behind the SuperAgers Family Study, which was started last year led by the American Federation for Aging Research and the Albert Einstein College of Medicine in collaboration with the Boston University College of Medicine. It has an ambitious goal: to enroll 10,000 individuals 95 and older — and their children. The mission is to identify inherited and behavioral and environmental factors that protect against human aging and related diseases as individuals near the century mark.

Super ager speaks

William Shatner, 92, actor, author and (at age 90) astronaut

Secret weapon: Passion for the future

“My concern is about my children and grandchildren and the life they will lead, given what we know is happening. Traveling into space was a gigantic emotional experience. The truth of it is, I felt great grief as I realized how so many things are going extinct while you and I are talking. I saw the beauty of the world and the harshness of space and realized what we are doing to our Earth is ugly."

About one in 4,000 Americans are age 100 or older, according to Census Bureau statistics. And some of these individuals have the cognitive functioning of people who are 30 years younger, says Thomas T. Perls, a geriatrician at Boston University and the founder and director of the New England Centenarian Study.

“They’re the crème de la crème of our population,” says Perls. “What’s special in these people is that they have some protective genes that slow aging and decrease the risk for age-related diseases like Alzheimer’s.”

Indeed, findings from a recent study of centenarians in the Netherlands showed that if someone reaches 100 with their cognitive abilities intact, they are likely to remain cognitively superior, except for slight memory loss. This was true even if an examination of their brains after death showed the tau and amyloid plaque associated with Alzheimer’s.

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Phil Horowitz, 102, recently completed his memoir, written from memory from the time he was 7 years old.
Courtesy Phil Horowitz

Turning 100 was a big deal for Boca Raton, Florida, super ager Phil Horowitz and his family, including his two children, six grandchildren, five great-grandchildren and far-flung network of nieces and nephews. (Disclosure: Horowitz, now 102, is this writer’s uncle.)

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Frances Ito, 91, stays active in her community through volunteering. She also gardens and attends film classes.
Dario Griffin

Longevity runs in Horowitz’s family. His mother lived until she was 104; his youngest siblings, a set of twins, are both still alive at 100, and his two other siblings lived well into their 90s. But none have the cognitive health or vitality that Horowitz does. The centenarian retired to Florida some years ago with his wife, Estelle, who died two years ago. Now he lives alone, but his children fly down often and a grandson who lives nearby visits all the time. Horowitz also plays poker and teaches Yiddish once a week to a group of residents in his assisted living facility.

Last year he completed his memoir, in longhand (he admits he started on a computer, but after mistakenly erasing everything, he went the old-fashioned route). “I have a good memory for dates,” he says, “so I decided to write my memoir chronologically, starting when I was 7 years old.”

The importance of passion

At 91, Frances Ito packs her schedule with gardening, online tai chi, weekly jam sessions with other musicians, art projects, Bible class via Zoom, volunteering at her church, exercising and moviemaking, which she took up in her late 70s. During the pandemic, Ito discovered the joy of reading, and she finished 20 books (“biographies, nonfiction and histories”). Despite cardiac issues and a few other health problems, Ito’s vitality and engagement earned her a spot in a University of Southern California super agers program. From learning the ukulele — as an homage to her home state of Hawaii — to growing fruits and vegetables on her drought-resistant front lawn, Ito refuses to surrender to aging. She’s having too much fun. Her latest film, The Purpose Driven Life, about her experiences as a super ager, was released in May.  

“I think the secret is attitude,” says Ito of her cognitive health.

Perhaps. What we do know is that becoming a super ager is the result of a complex combination of factors that account for superior memory and cognitive health.

“The hard part is proving it,” says Claudia Kawas, an investigator for UC Irvine’s 90+ Study. “Everyone wants it to be one thing, like blueberries or crossword puzzles. I don’t think it’s that simple. A good diet matters. Get as much education as you can. It doesn’t mean Nobel laureates don’t get Alzheimer’s, but at a lower rate. It confers lifelong prevention through some mechanism that we don’t understand yet.”

Currently, there is no way to predict with any certainty if a younger person—in their 40s, 50s or even 60s — will be a super ager. “Those are open questions at this point — but future directions for sure,” says Huentelman of the SuperAging Research Initiative. More likely is that within the next decade, researchers will learn which genes may play a role in making someone a super ager, so we can better understand the optimal pathways for aging well and how we can slow or prevent other age-related diseases like dementia. “We will know how they stay on that course and what components might be identifiable based on lifestyle and other factors,” says Roberts of the Canadian Centre for Activity and Aging.

Indeed, look at Nobel winner Smith, who has spent his life working on economic theorems and academics and has three degrees, including a doctorate from Harvard in economics. His passion remains his profession. He wouldn’t consider retiring.

“Why would I do that?” says Smith. “I’d just do the same thing I’m doing now and wouldn’t get paid for it. I have an ancestor who lived to be 105. I want to live at least to 106.”

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