2023-07-22 03:20:00
Although aging affects everyone, its damage appears more slowly in some people. This evidence has led many scientists to study what differentiates those people who seem protected from the passage of time in search of biological traits or ways of living that might be replicated to democratize their gifts. One of these groups are the “super-elderly” (superagers in English), people who, at the age of 80, maintain a memory of their own thirty years younger. The term was minted in 2012 by a team led by Emily Rogalski, from Northwestern University, in Chicago (USA). Then, they saw that they had a thicker cerebral cortex and that they showed resistance to some damage, such as cortical atrophy, that appears over the years. However, it does not seem that they had superior cognitive abilities during their youth. Rather, they seemed to resist aging better, due to physical or lifestyle factors.
This same week, the journal Lancet Healthy Longevity published an article in which it is observed that the superelderly, in addition to having better memory, move faster and have better mental health. The work, which took data from the cohort of the Vallecas Project, dedicated to identifying early markers of Alzheimer’s, saw, thanks to diagnostic imaging technologies, that these people have more gray matter in key areas of the brain. The reason, probably, is that it deteriorates more slowly than in the general population, as they verified following five years of follow-up of super-elderly people and normal people.
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Marta Garo-Pascual, co-author of the study and researcher at the Queen Sofia Foundation Alzheimer Center in Madrid, states that this type of study “brings closer to solving the big unanswered question regarding the super-elderly, whether they are more resistant to age-associated memory decline or whether they have mechanisms to deal with this decline better than others.” The greater presence of gray matter would indicate that they have a protective factor that slows down the damage, but it is also known that these people have more social ties or maintain an interest in learning new things for a longer time. Since studies like the one by Garo-Pascual and his colleagues are observational, it is difficult to establish which comes first, whether it is healthy habits that allow us to stay young or if it is a natural youth that allows us to maintain activity and connection with the world’s news.
Emily Rogalski, a decade following pioneering the study of the super-elderly, continues to work in the field, although she argues that these types of people “are few and hard to find.” At the moment, in her opinion, these individuals would not be of a single type. Some “have a brain structure that seems resistant to neuropathologies, but there are others that are more resilient, that receive the damage, but compensate for it in other ways. Life experience may be just as important as genetic factors,” she adds.
The professor of the University of Barcelona, David Bartrés considers useful “the study of superagers because it helps us to identify what is different in these people and what we can promote in the general population. Thanks to these studies, we know that there are modifiable factors, such as taking care of vascular health, nutrition, sleeping well, perhaps exercising to improve motor skills and taking care of anxiety or treating depression, which are important to avoid cognitive deterioration and diseases such as dementias”, he explains.
Bartrés recognizes that understanding that a factor is modifiable does not make it easy to change, and for this reason he stresses the importance of personalizing the introduction of changes. Along these lines, Garo points to the paradoxical results of his study: “[Los superancianos] They say they get the same amount of exercise as typical people, but activities like climbing stairs or gardening may not be considered exercise by them.” Exercise, which helps control blood pressure or blood glucose levels and improves mental well-being, should act on highly relevant factors in cognitive decline. These results coincide with those of the study of people over 100 years of age, who, in many cases, do not have particularly healthy lifestyles.
Another aspect that Bartrés has worked on is the assessment of psychological aspects, such as having a purpose in life, in resilience to cognitive decline. “People with more purpose, which for each person can be different, from being a parent, to work or helping others, have less stress and better tolerate changes typical of Alzheimer’s disease,” he says. In one of their studies, they have observed that, although there are vascular changes in the white matter of the brain, such as those that begin to appear following the age of 40 and cause cognitive deterioration, these changes affect less those with a clearer sense of life. “We have seen, for example, that there is better connectivity between areas of the brain, which can compensate for the damage observed,” he points out. Although giving meaning to one’s life is something personal, there are psychological therapies that can help to identify or rediscover this meaning.
Contrary to what has been identified in the case of super-elderly people, who accumulate damage more slowly, there are cases in which physical deterioration is compensated by what is called resilience. Education is one of these resilience factors and is likely to be behind the 30% drop over 15 years in the proportion of people with dementia in the US, along with other factors such as control of cardiovascular problems. At the opposite extreme, there are studies who estimate that illiterate people have three times the risk of dementia.
Despite the interest in studying this group of people with privileged aging, Garo-Pascual acknowledges that they have not found “the formula for being a superager.” “We made a model with many variables, most of them related to lifestyle, but we were only 66% accurate in classifying a person as superelderly. 34% escapes us, ”she explains. “In this model, a component is missing that might be important, which is genetics, and it might explain that part that we did not identify,” she says. It is known that different variants of genes such as APOE increase or decrease the probability of suffering from Alzheimer’s, and some of these beneficial versions have already been found in studies with people over a century old.
Rogalski believes that knowledge like this “is already being used to find therapeutic targets and develop drugs, although it is still in a very early stage.” He also points to the importance of life choices that may seem simple and free, but are actually complicated, such as “having strong relationships with others and a positive outlook on life,” both of which are very common among superelders. The scarcity of these individuals makes it necessary to gather them in international studies and this will be one of the next steps to try to unravel their secrets.
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