By Namirah Jamshed, M.D., Director, Geriatric Medicine Fellowship Program
Internal Medicine - Geriatrics, UT Southwestern Medical Center
There is an assumption that, as we age, our memory inevitably slips. Maybe you’ve even experienced this firsthand: calling a grandchild by the wrong name, misplacing the TV remote on a regular basis, or walking into a room and realizing you can’t remember why you did.
Don’t panic. These are minor blips on the memory continuum – and vastly different from neurodegenerative conditions such Alzheimer’s disease. But while most people consider the occasional memory lapse a normal part of growing older, we all know at least a few 80- or 90-year-olds who represent the other end of the spectrum: a subgroup of people affectionately referred to as “super-agers.”
These older individuals have the same memory and cognitive function as someone 20 or 30 years their junior.
Evidence shows super-agers perform better on word recall tests compared to their peers, and it also suggests their brains atrophy, or shrink, at a slower rate. Scientists used MRI scans and discovered the regions of the brain considered important to memory, attention, cognitive control, and motivation appeared thicker in super-agers than in others in the same age group.
For the fortunate few who seem to retain their brainpower and defy the odds, age really is just a number. But what does this mean for the rest of us? Is it possible to change our habits earlier in life to reap the benefits later by becoming a super-ager?
The truth is we need more definitive research – at this point we don’t really know how common it is to be a super-ager. What we do know, however, is that while genetics likely play a role, studies show super-agers tend to share several similar characteristics and behaviors, all of which you can adopt to put your brain to the test.
What traits do super-agers have in common?
1. Sociability
Probably the most prominent through line of healthy aging is having strong social connections, and super-agers tend to maintain strong relationships and active social lives. On the other side, social isolation has been linked to a greater risk of dementia, high blood pressure, heart disease, anxiety, and depression.
A national poll found that feelings of loneliness spiked among adults aged 50-80 in 2020 during the height of the COVID-19 pandemic in the U.S., and though a 2023 follow-up survey showed that sense of seclusion has receded, it has not returned to pre-pandemic levels.
Fortunately, there are ways of establishing or rebuilding those bonds by reaching out to old acquaintances and joining new social spaces. It might also mean accepting your age and physical limitations by finally agreeing to get those hearing aids or use a cane to walk. Too many people see these accessories as a sign of weakness or giving up, but actually the opposite is true. They help us remove barriers – if you can hear better, you can engage in more conversations; if you can walk farther, your body will get the benefits of added exercise. Super-agers see hearing aids and canes for what they are: tools to support us, not shame us.
2. Focus
The brain, much like muscles, requires regular stimulation to maintain its function. Stimulating your mind will keep those synapses firing, help maintain your mental dexterity, and support the brain’s capacity to form new neural connections. The type of activity matters, too, so it’s best to choose one that challenges you and keeps you engaged. Games such as crossword puzzles, sudoku, and solitaire are popular examples. The beauty of modern technology means these activities are very accessible and require little else than a smartphone, tablet, or computer. (If you don’t have one at home, you can use a computer at the public library!)
Some more hands-on options include playing an instrument, sewing, painting, building model planes, and gardening. Not only do these activities require complex neural processes, but they also flex those fine motor skills. What’s more, these are activities around which communities can form, and the advent of social media has made it easier than ever to find local groups with your shared interest.
3. Autonomy
Scientific literature suggests super-agers are more physically independent than average older adults. One study from Spain, which included 64 super-agers and 55 older adults of more typical cognitive abilities, found that super-agers performed better on tests of mobility, agility, and balance and were less likely to have a history of glucose disorders and high blood pressure. And although these super-agers did not report exercising more than their peers, researchers found they were generally more active in middle age.
As a physician, I generally advise my patients to consider regular exercise as a stepping stone toward better mental and physical health. While it may not be a cure-all, its benefits are undeniable: reduced stress, improved mood and sleep quality, better heart health, and stronger muscles and bones. (Yes, it is possible to be a physical super-ager, too.)
Those who might be worried about straining themselves will be relieved to know there are several low-impact activities that can improve your coordination, balance, and focus while minimizing the risk of a fall or fracture. Tai chi, yoga, and gardening are just a few excellent ways to engage the body and mind.
Using AI and removing barriers to transform health care
I have worked in geriatric medicine for more than 15 years, and one thing I can say for certain is older patients’ needs are different from other age groups. Not only do they require different medications, dosages, and treatments, but they also may have mobility issues, unreliable transportation, an altered schedule, or other barriers to care.
Just as we give special considerations to pediatric patients, we should take a more tailored approach to older adults, especially as they grow in population. The number of Americans 65 years and older spiked in the last decade, jumping from 40.3 million in 2010 to 55.8 million in 2020, according to the U.S. Census Bureau. One projection predicts that figure will reach 85 million by 2050.
The good news is that physicians and health systems are paying attention. At UT Southwestern, we launched the home-based primary care program, Care of the Vulnerable Elderly (COVE), which aims to reduce unnecessary hospital readmissions and emergency trips.
What’s more, the growing popularity of AI technology marks the introduction of new and innovative tools. In addition to helping physicians take notes, AI-powered virtual assistants now help monitor and track health information, remind patients of appointments and medications, and even provide companionship and entertainment options. Companies have already unveiled devices capable of initiating conversation, offering brain-boosting games and activities, and tracking changes in health.
There is no way to predict the future or guarantee that the U.S. will be able to cultivate a larger population of super-agers, but by studying the biology, genetics, and lifestyle habits of this group, we may be able to help our patients achieve better cognitive and physical health, plus a higher quality of life, well into their 80s, 90s, and beyond.
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