Cognitive trajectories and spectrum of neuropathology in SuperAgers: The first 10 cases

Abstract

On average, memory capacity is significantly higher in populations of 50-60 year olds than in populations of 80 year olds. We define SuperAgers as individuals 80 or older whose episodic memory capacity is at least as good as that of cognitively average individuals in their 50s and 60s. SuperAgers therefore have memory capacity that is superior for age. Previous work showed that SuperAgers have greater cortical volumes and greater resistance to age-related cortical atrophy than "cognitively average" individuals of the same age. Here we report on the cognitive, personality, and neuropathologic characteristics of the first 10 autopsy cases in the Northwestern SuperAging Program. During the follow-up period, seven SuperAgers maintained episodic memory performance within or above the average range for 50-65 year-old norms and all 10 SuperAgers maintained episodic memory scores within normal limits for their own age. Openness to experience scores tended to be high on the NEO-PI-R measure of personality. The 10 autopsy specimens showed variable findings within the spectrum of Alzheimer pathology. The hippocampus and entorhinal cortex contained neurofibrillary degeneration mostly in the Braak II-III stages. However, even these limbic areas contained many healthy appearing neurons and the neocortex was generally free of neurofibrillary degeneration. In contrast, neocortical areas in at least five of the cases contained moderate to high densities of neuritic plaques. These findings need to be placed in context by comparing them to the neuropathology of cognitively average individuals of the same age. Future research on SuperAgers is likely to offer insights into factors that either prevent the emergence of involutional changes in the brain or that makes cognitive function more resistant to their consequences.

Brain morphology, cognition, and β-amyloid in older adults with superior memory performance

“…This is an important finding underscoring that SA do not avoid all pathological, age-related brain changes. Recent work with post-mortem tissue of highly successful agers is congruent with our findings, showing that Aβ pathology was observed in 5 of 10 individuals (Rogalski et al, 2018). The link between Aβ burden and cognition has been explored and the growing consensus is that the correlation, at least in cross-sectional comparisons, is weak (Hedden et al, 2013; Jansen et al, 2018).…”

The “SuperAgers” construct in clinical practice: neuropsychological assessment of illiterate and educated elderly

“…Cognitive reserve is pointed as the main reason in the multifactorial approach for the prevention of cognitive decline, justifying the superior cognitive tasks of SuperAgers compared to individuals of the same age, being this reserve developed throughout life and culminating in greater neuroplasticity (Gu et al, 2018;Kumar et al, 2017;Rajji, 2018;Rogalski et al, 2018). Stern (2002) defined cognitive reserve as the brain's ability to deal with damage or pathologies while maintaining functional cognitive levels.…”

SuperAging – společnost a lidé: úvod do problematiky

“…Biologické souvislosti SuperAgingu se teprve postupně stávají námětem studií. Byly popsány strukturální rozdíly v mozcích SuperAgerů oproti kontrolám (Gefen et al, 2015;Rogalski et al, , 2018, méně depozit beta-amyloidu či tau proteinu, tj. mozkomíšních biomarkerů typických pro Alzheimerovu nemoc (Gefen et al, 2015;Rogalski et al, 2013).…”