Sharp-Minded Even in Their 80s: What Is a “SuperAger,” the Kind of Person Everyone Aspires to Be?

Mutsuko Ohnishi, MD, Internal medicine physician in Boston, USA

Contents

1. What Is a SuperAger?

2. What Happens in the Brain?

3. Can New Neurons Be Generated in the Adult Brain?

4. What Did the Researchers Investigate?

5. New Neurons Can Develop Even in the Adult Brain

6. What Happens in the Brain of a Person with Alzheimer’s Disease?

7. Four Habits Shared by SuperAgers8. It Is Never Too Late to Improve Your Lifestyle

“It seems I’ve become so forgetful lately. I guess it’s just old age.”

Comments like this are far from uncommon. For a long time, we have accepted the conventional belief that memory inevitably declines with age.

However, one research program has approached aging from a somewhat different perspective. It is the SuperAging Program at the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease at Northwestern University in the United States. (Note 1)

This program differs from conventional aging research in its perspective. Most studies of aging investigate what is lost as people grow older and which functions decline. This program, however, takes the opposite approach.

It begins with a different set of questions: Why do some people retain their memory even as they grow older? What continues to function well during the aging process?

Researchers refer to these individuals as SuperAgers.

What Is a SuperAger?

The research team’s definition of a SuperAger is remarkably simple. (Note 2)

They are 80 years of age or older. They possess memory performance comparable to that of individuals 20 to 30 years younger.

In other words, although they are over the age of 80, they demonstrate memory ability comparable to that of people in their fifties or sixties.

The concept was proposed by neurologist Dr. M. Marsel Mesulam, and research continues today through Northwestern University’s SuperAging Program.

How is this remarkable ability measured?

The researchers use several neuropsychological tests. Among them, one of the most important is the Delayed Recall Test.

The test is conducted as follows:

1. Participants memorize a list of words.2. After a period of time has passed, they are asked to recall the words.3. The number of words they can remember is measured.

This is a standard test used to evaluate episodic memory, or the ability to remember events and personal experiences.

Normally, episodic memory tends to decline with age. SuperAgers, however, are different. In the studies, SuperAgers scored 9 or more out of a possible 15 points on this test, a level considered comparable to the average performance of individuals in their fifties and sixties.

What Happens in the Brain?

Researchers have identified several distinctive characteristics in the brains of SuperAgers.

First, the cortical thinning that typically occurs with advancing age in older adults is scarcely observed in SuperAgers.

Furthermore, the anterior cingulate cortex, a brain region involved in decision-making and the integration of emotions, has been reported to be as thick as that of younger individuals, and in some cases even thicker.

Researchers have also reported that von Economo neurons, which are believed to be associated with social behavior and empathy, are more numerous in SuperAgers than in typical older adults.

The researchers suggest that the brains of SuperAgers may possess two important characteristics: resistance and resilience.

Resistance refers to a condition in which the pathological changes associated with Alzheimer’s disease, such as β-amyloid and tau protein, are relatively limited.

Resilience refers to the preservation of brain function even when such pathological changes are present.

In other words, SuperAgers may possess both brains that are less likely to develop disease and brains that are able to withstand disease once it occurs.

Can New Neurons Be Generated in the Adult Brain?

The research team has also addressed another important question.

Can new neurons be generated in the hippocampus, a brain region that plays a critical role in memory, even in adulthood?

The findings were published in Nature on February 25, 2026. (Note 3)

The question has long been controversial because researchers have remained divided over whether adult neurogenesis truly occurs in the human brain.

Animal studies have confirmed that new neurons are generated in the hippocampus. In humans, however, some studies have concluded that adult neurogenesis does occur, whereas others have found little evidence supporting its existence.

One reason for this disagreement lies in the difficulty of conducting research on the human brain.

Most human studies rely on postmortem brain tissue, and the results are highly influenced by factors such as the time elapsed after death, the condition in which the tissue has been preserved, how newly generated neurons are distinguished from morphologically similar cells, and which analytical methods are employed.

Differences in these methodological factors are thought to be one of the major reasons why this issue has remained controversial.

What Did the Researchers Investigate?

The research team conducted a detailed examination of the hippocampus obtained from deceased individuals and compared the following five groups:

1. Young adults (YA): Individuals aged 20–40 years with preserved cognitive function.2. Healthy older adults (HA): Older individuals whose cognitive function was preserved at an age-appropriate level.3. Preclinical Alzheimer’s disease (PCI): Individuals in the transitional stage toward Alzheimer’s disease.4. Alzheimer’s disease (AD): Individuals diagnosed with Alzheimer’s disease.5. SuperAgers (SA): Individuals who met the criteria for SuperAgers.

In other words, the researchers compared brains representing a broad spectrum of conditions, ranging from young adults to individuals with Alzheimer’s disease.

New Neurons Can Develop Even in the Adult Brain

The researchers employed an advanced technique known as single-nucleus multiomics analysis. This method simultaneously examines each individual cell nucleus to determine which genes are being expressed (snRNA-seq) and which regions of DNA are accessible, or “open” (snATAC-seq). In this study, more than 350,000 cell nuclei were analyzed.

One of the study’s most important findings was the identification, within the hippocampus, of molecular and cellular evidence indicating a developmental trajectory in which new neurons are generated and subsequently mature.

Using a plant as an analogy, the process can be illustrated as follows:

1. Neural stem cells (seeds)2. Neuroblasts (sprouts)3. Immature neurons (young trees)4. Mature neurons (fully grown trees)

Importantly, this pattern was observed not only in the hippocampi of young adults but also in those of older adults.

The authors concluded that these findings provide important evidence supporting the existence of adult hippocampal neurogenesis in humans.

What Happens in the Brain of a Person with Alzheimer’s Disease?

In contrast, changes in the process of neurogenesis were observed in the hippocampus of individuals with Alzheimer’s disease.

The researchers found that the number of neural stem cells increased, whereas the numbers of neuroblasts and immature neurons decreased.

In other words, the situation resembled having seeds that fail to grow into plants. This suggests that although the machinery required to generate neurons remains present, the maturation process may be impaired.

Another particularly interesting finding was that similar changes were already detectable during the transitional stage before a clinical diagnosis of Alzheimer’s disease.

One of the most notable observations involved changes in chromatin accessibility.

DNA is folded into a structure known as chromatin. The way chromatin is folded determines whether genes remain accessible for transcription or are closed and inaccessible. In other words, the genetic blueprint itself is not damaged; rather, the relevant pages of the blueprint may simply be closed.

The mechanisms that regulate how genes are used in this manner are collectively known as epigenetics.

The study suggests that these epigenetic alterations may play an important role before detectable changes in neurogenesis occur.

Put another way, the brain may not be irreversibly damaged; instead, it may be trapped in a state in which it is unable to fully utilize its inherent capacity. If this is indeed the case, future therapies may not need to alter genes themselves but instead reopen molecular switches that have become closed.

The researchers also identified two distinctive features in the hippocampi of SuperAgers:

a relatively larger population of immature neurons, and a unique pattern of open chromatin regions.

The paper refers to this pattern as a “resilience signature.”

In other words, the brains of SuperAgers may preserve the molecular signatures associated with neurogenesis to a greater extent than those of typical older adults.

Four Habits Shared by SuperAgers

How, then, do SuperAgers manage to preserve their memory as they grow older?

More than 25 years of research have revealed several characteristics that they tend to share. (Note 4)

1. They remain physically active.

SuperAgers tend to lead active lifestyles. Even exercising about twice a week may help reduce the future risk of dementia. Physical activity increases the supply of oxygen to the brain, improves cardiovascular function, maintains muscle strength, and helps prevent falls, thereby supporting overall health. In addition, studies have reported that obesity (a body mass index of 30 or higher) is associated with a threefold increase in the risk of Alzheimer’s disease.

2. They continually challenge their brains.

Mental activity is just as important as physical activity. SuperAgers tend to seek out new experiences. Examples include reading new books, attending educational courses, learning unfamiliar subjects, and engaging in puzzles or games. Rather than limiting themselves to familiar activities, they stimulate their brains by taking on tasks that are somewhat challenging.

3. They maintain strong social connections.

SuperAgers are reported to have strong social relationships. Research has shown that their brains contain relatively large numbers of von Economo neurons. Anatomical studies have reported that SuperAgers possess approximately four to five times more of these neurons than other people of the same age.

4. They enjoy life—in moderation.

SuperAgers are not necessarily ascetic. Some enjoy an alcoholic drink every evening, while others enthusiastically pursue their hobbies. Studies have reported that people who consume alcohol in moderation have approximately a 23% lower risk of Alzheimer’s disease and memory impairment. The key, however, is moderation. Excessive alcohol consumption, on the other hand, increases the risk of dementia.

It Is Never Too Late to Improve Your Lifestyle

So, when should these lifestyle habits begin?

First, lifestyle during middle age plays an important role in determining brain health later in life. Numerous epidemiological studies have reported that lifestyle habits and vascular risk factors between the ages of 40 and 60 are associated with the risk of developing dementia in old age.

One of the best-known studies is the CAIDE study conducted in Finland. (Note 5) This study followed middle-aged individuals with an average age of approximately 50 years for about 20 years. The results showed that vascular risk factors during middle age—including hypertension, obesity, and hypercholesterolemia—were strongly associated with the subsequent development of dementia.

Another important Finnish study, the FINGER study, investigated the effects of a multidomain lifestyle intervention—including physical exercise, dietary improvement, cognitive training, and vascular risk management—in 1,260 adults aged 60 to 77 years. (Note 6)

Participants who received the lifestyle intervention for two years demonstrated significantly better performance on cognitive tests over a seven-year follow-up period than those who received only general health advice.

Based on these findings, the researchers concluded that combining multiple healthy lifestyle habits may help improve or maintain cognitive function.

There is another encouraging finding as well.

It suggests that, for the brain, it may never be “too late.”

The Rush Memory and Aging Project, a long-term study conducted in the United States, has followed older adults with an average age of approximately 80 years to investigate the relationship between lifestyle and cognitive function over many years. (Note 7)

The study found that individuals who remained physically active, mentally engaged, and socially connected experienced slower cognitive decline and had a lower risk of developing Alzheimer’s disease than those who did not maintain these activities.

The message conveyed by these studies is that aging does not necessarily mean decline.

Brain health may be protected through lifestyle.

Aging well may not simply be a matter of good fortune. It may, in fact, be a biologically attainable choice.

References

(Note 1) Learn About SuperAging

(Note 2） What makes a SuperAger?

(Note 3） Human hippocampal neurogenesis in adulthood, ageing and Alzheimer’s disease

(Note 4） 4 Habits of ‘SuperAgers’Help Protect Yourself From Dementia

(Note 5） Risk score for the prediction of dementia risk in 20 years among middle aged people: a longitudinal, population-based study

(Note 7） A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial

(Note 8） Overview and Findings from the Rush Memory and Aging Project

This article was originally published in Japanese by Mainichi Medical on March 12, 2026.