SuperAgers have a brain that can resist Alzheimer’s

Imagine being in your eighties and remembering things as clearly as someone in their fifties. That’s the reality for a remarkable group of people scientists call SuperAgers. For 25 years, researchers at Northwestern Medicine have followed them, trying to understand how their minds resist time.

SuperAgers defy the typical story of aging. Their sharp recall is matched by lively personalities and strong social connections.

“It’s really what we’ve found in their brains that’s been so earth-shattering for us,” said Dr. Sandra Weintraub, professor of psychiatry and behavioral sciences and neurology at Northwestern University Feinberg School of Medicine.

How SuperAgers stay sharp

Most people experience a steady decline in memory as the years pass, but SuperAgers are the exception.

“Our findings show that exceptional memory in old age is not only possible but is linked to a distinct neurobiological profile. This opens the door to new interventions aimed at preserving brain health well into the later decades of life,” said Dr. Weintraub.

Their stories and brain scans are now part of a special issue of Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. The work also marks anniversaries of national research efforts into Alzheimer’s disease.

What’s inside a SuperAger brain

The term “SuperAger” was coined by Dr. M. Marsel Mesulam in the late 1990s. Since then, nearly 300 participants have joined the program, and 77 have donated their brains for study after death.

Some of these brains carry the same Alzheimer’s-related plaques and tangles found in many older adults, while others are almost completely free of them. Yet both groups show equally strong memory performance.

“What we realized is there are two mechanisms that lead someone to become a SuperAger,” explained Dr. Weintraub. “One is resistance: they don’t make the plaques and tangles. Two is resilience: they make them, but they don’t do anything to their brains.”

This means there isn’t just one formula for preserving memory – there may be multiple biological paths to the same outcome.

Traits that stand out

In memory tests, SuperAgers consistently perform like people decades younger, recalling at least 9 out of 15 words after a delay. Brain scans reveal that their cortex (the brain’s outer layer) remains thick and healthy rather than thinning with age.

Remarkably, a region called the anterior cingulate cortex is sometimes thicker than in adults 20 to 30 years younger. This area is important for decision-making, emotion, and motivation.

Under the microscope, their brains hold more von Economo neurons (special cells tied to social behavior) and larger neurons in the entorhinal cortex, which is key to memory. These differences may help protect cognitive function, even in the presence of age-related changes.

Lifestyle habits among SuperAgers vary dramatically. Some eat well, exercise regularly, and follow classic health advice.

Others have smoked, enjoyed drinks, or avoided structured workouts. Yet one trait appears almost universal: they are highly social, rating their relationships positively and staying engaged with others. From book clubs to volunteer work, their calendars tend to be full.

Giving back to science

Each year, SuperAgers return for evaluations and some choose to donate their brains.

“Many of the findings from this paper stem from the examination of brain specimens of generous, dedicated SuperAgers who were followed for decades,” said Dr. Tamar Gefen, an associate professor at Feinberg.

“I am constantly amazed by how brain donation can enable discovery long after death, offering a kind of scientific immortality.”

One participant, followed for more than two decades, kept her memory scores steady from her sixties into her eighties. Even after serious illness, her mind stayed alert, her conversations animated. After her passing, her brain revealed minimal damage from age-related disease – a rare and inspiring sight.

The full journey of this research, and the people behind it, is detailed in “The First 25 Years of the Northwestern SuperAging Program” by Mesulam, Weintraub, Gefen, and Geula.

For anyone wondering whether a clear, vibrant mind can last a lifetime, the answer from these extraordinary individuals is a resounding yes.

The study is published in the journal Alzheimer s & Dementia.

Image Credit: Shane Collins, Northwestern University

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