I would like to be a "cognitive super ager." Hopefully piano and walking etc. will help!

The Secrets of ‘Cognitive Super-Agers’

I will C&P to avoid the paywall.

The Secrets of ‘Cognitive Super-Agers’

By studying centenarians, researchers hope to develop strategies to ward off Alzheimer’s disease and slow brain aging for all of us.

Jane E. Brody

By Jane E. Brody
June 21, 2021, 5:00 a.m. ET

One of my greatest pleasures during the Covid-19 shutdowns was having the time to indulge in hourlong phone conversations with friends and family whom I could not see in person. Especially uplifting were my biweekly talks with Margaret Shryer, a twice-widowed 94-year-old Minneapolitan.

I met Margaret in Minneapolis in 1963, six months after her first husband was killed by a drunken driver. With four small children to support, this young widow wasted no time getting qualified to teach German to high school students. Margaret and I are kindred spirits who bonded instantly, and despite living half a country apart since 1965, we’ve remained devoted friends now for 58 years.

My conversations with Margaret are substantive and illuminating, covering topics that include politics, poetry, plays and philosophy as well as family pleasures and problems. I relish her wisdom and sage advice. I especially delight in the fact that she seems not to have lost an iota of her youthful brain power. She’s as sharp now as she was when we first met decades ago.

Recent findings about the trajectories of human cognition suggest that if no physical insult, like a stroke, intervenes in the next six years, Margaret is destined to be a cognitively sharp centenarian.

Fewer than 1 percent of Americans reach the age of 100, and new data from the Netherlands indicate that those who achieve that milestone with their mental faculties still intact are likely to remain so for their remaining years, even if their brains are riddled with the plaques and tangles that are the hallmarks of Alzheimer’s disease.

Findings from the Dutch study may eventually pave a path for many more of us to become “cognitive super-agers,” as researchers call people who approach the end of the human life span with brains that function as if they were 30 years younger.

One day everyone who is physically able to reach 100 may also be able to remain mentally healthy. By studying centenarians, researchers hope to identify reliable characteristics and develop treatments that would result in healthy cognitive aging for most of us. Meanwhile, there is much we can do now to keep our brains in tiptop condition, even if reaching 100 is neither a goal nor a possibility.

These hopeful prospects stem from the study of 340 Dutch centenarians living independently who were tested and shown to be cognitively healthy when they enrolled. The 79 participants who neither died nor dropped out of the study returned for repeated cognitive testing, over an average follow-up of 19 months.

The research team, directed by Henne Holstege at Vrije University in Amsterdam, reported in JAMA Network Open in January that these participants experienced no decline in major cognitive measures, except for a slight loss in memory function. Basically, the participants performed as if they were 30 years younger in overall cognition; ability to make decisions and plans and execute them; recreate by drawing a figure they had looked at; list animals or objects that began with a certain letter; and not becoming easily distracted when performing a task or getting lost when they left home.

Even those with genes linked to an elevated risk of developing Alzheimer’s disease were able to perform well on the tests.

Nearly a third of the participants agreed to donate their brains after death. Brain autopsies of 44 of the original centenarians revealed that many had substantial neuropathology common to people with Alzheimer’s disease although they had remained cognitively healthy for up to four years beyond 100.

Dr. Thomas T. Perls, a geriatrician at Boston University who directs the New England Centenarian Study who wrote an accompanying editorial, said in an interview that the Dutch participants represented “the crème de la crème” of centenarians who had averted the onset of Alzheimer’s disease by at least 20 to 30 years. They seemed to be either resistant to the disease or cognitively resilient, somehow able to ward off manifestations of its brain-damaging effects. Perhaps both.

Resistance, Dr. Perls explained, may reflect a relative absence of brain damage conferred by a person’s genes or lifestyle. Or they may have “protective biological mechanisms that slow brain aging and prevent clinical illness,” he said.

Resilience, on the other hand, characterizes people with normal cognitive abilities even though their brains may have damage typical of Alzheimer’s, the leading cause of dementia. In addition to plaques and tangles, such changes include loss of neurons, inflammation and clogged blood vessels.

People with cognitive resilience are able to accumulate “higher levels of brain damage before clinical symptoms appear,” the Dutch team reported.

Yaakov Stern, neuropsychologist and director of cognitive neuroscience at Columbia University College of Physicians and Surgeons, said that while resistant individuals may be spared much of the brain pathology typical of Alzheimer’s disease, resilient individuals have what researchers call a cognitive reserve that enables them to cope better with pathological brain changes.

Many studies have revealed that a variety of lifestyle factors may contribute to resilience, Dr. Stern said. Among them are obtaining a higher level and better quality education; choosing occupations that deal with complex facts and data; consuming a Mediterranean-style diet; engaging in leisure activities; socializing with other people; and exercising regularly.

“Controlled trials of exercise have shown that it improves cognition,” he said. “It’s not just a result of better blood flow to the brain. Exercise thickens the cerebral cortex and the volume of the brain, including the frontal lobes that are associated with cognition.”

Dr. Perls said, “Alzheimer’s disease is not an inevitable result of aging. Those genetically predisposed can markedly delay it or show no evidence of it before they die by doing the things we know are healthful: exercising regularly, maintaining a healthy weight, not smoking, minimizing red meat in the diet, and doing things that are cognitively new and challenging to the brain, like learning a new language or a musical instrument.”

Also important is to maintain good hearing, said Dr. Perls, a 60-year-old who wears a hearing aid. “I can’t emphasize enough how important it is for people to optimize their ability to hear,” he said. “There’s a direct connection between hearing and preserving cognitive function. Being stubborn about wearing hearing aids is just silly. Hearing loss results in cognitive loss because you miss so much. You lose touch with your environment.”

Vision, too, is important, especially for people who already are cognitively challenged. “Poor vision makes cognitive impairment worse,” Dr. Perls said. As his brain-challenging activity, he’s taken up birding, which requires both good hearing and good vision.

For her part, my friend Margaret reads, writes and recites poetry and occasionally acts in a relative’s films.

**
Jane Brody is the Personal Health columnist, a position she has held since 1976. She has written more than a dozen books including the best sellers “Jane Brody’s Nutrition Book” and “Jane Brody’s Good Food Book.”

Interesting, but I do wonder about the genetic aspects, and how much these behavioral/environmental things can really overcome genetic predisposition.

They mention vision at the end. I'd be curious about hearing loss as well. My dad had fairly significant hearing loss toward the end of his life, and it is such an isolating thing. People tend to get very frustrated with someone with hearing loss (as opposed to total deafness), almost as if the person with hearing loss just isn't trying hard enough to listen.

quote:

Originally posted by Nina:
Interesting, but I do wonder about the genetic aspects, and how much these behavioral/environmental things can really overcome genetic predisposition.

They mention vision at the end. I'd be curious about hearing loss as well. My dad had fairly significant hearing loss toward the end of his life, and it is such an isolating thing. People tend to get very frustrated with someone with hearing loss (as opposed to total deafness), almost as if the person with hearing loss just isn't trying hard enough to listen.

Well, it IS very frustrating. I've lived with my nearly-deaf husband for 25 years now, and living with someone with hearing loss is a serious challenge. We've had many fights that erupted because he misheard me completely, and insists I said something I did not say. And his inability to enjoy himself at movies, plays, or social gatherings because he can't hear is something that took me a long time to come to terms with. Not to mention having to always be in the same room and facing him to have a conversation, or even just to make an offhand remark. And I've always hated repeating myself. I have to do it endlessly it seems at times.

He's a lovely man and I'm lucky and he's worth it. But dealing with another person's hearing loss is not easy. Though I'm sure it's easier than being the person who has hearing loss. It *is* indeed very isolating.

piqué, pardon me if you explained this before, because I do remember that you've talked about this in the past, but does Mr. piqué wear any kind of hearing aids? And if not, why not?

I wear two hearing aids. They help, but are little help with some voices or people facing the other way. Too many start speaking with projection and then their voices fade away about mid-sentence.
Bob is taking speech therapy. His Parkinson's causes his voice to be very faint. If he does not do his therapy exercises we have trouble.
It is a double predicament.

A neurologist that teaches banjo - "continuing to develop your ear at this point is immensely good for your brain!"

Mr. Sphinx is also dealing with hearing loss, and it is maddening for everyone in the family. Everything I say received the same response: what? Then I have to yell the sentence again. At some point, it is just not worth it so I find myself not talking to him.

Is this his fault? To some extent, yes. He still does not have hearing aids, so to me it feels like he expects everyone else to do the work to communicate while he does nothing.

There is a genetic component to his hearing loss, as it seems to run in his side of the family. But I also think it is connected to simply failing to take care of himself with diet, exercise, and adequate rest. So I do question when the author of the article says that hearing loss causes dementia. I think it is equally likely that dementia causes hearing loss. It seems it would be easy to study this by looking at whether people with deafness are more likely to have dementia.

quote:

Originally posted by Cindysphinx:
Mr. spanks ...

Is that your pet name for him?

Darn auto correct!!

quote:

Originally posted by ShiroKuro:
piqué, pardon me if you explained this before, because I do remember that you've talked about this in the past, but does Mr. piqué wear any kind of hearing aids? And if not, why not?

Yes. He wears very fancy exceedingly expensive hearing aids with fancy accoutrements, including what his audiologist calls "the marriage saver": a clip on bluetooth gadget I put on my lapel so that my voice goes directly into his hearing aids, even when I'm in another room. I never use it. Imagine having the sound of your partner's breathing, sniffing, throat-clearing, and masticating right inside your ear canal.

The hearing aids work for awhile, then his hearing further deteriorates and the audiologist can no longer sufficiently adjust them. And he has to go up a level in equipment. Fortunately his insurance buys him a new pair every three years. One of many reasons he has not yet retired at age 73.

I'll never forget when he got his first pair of these high end hearing aids and they were perfectly calibrated. He loves birds. He was able to hear a meadowlark for the first time. He loves music. We went to go see "Tales of Hoffman" and he was in awe. Makes me tear up just thinking about it.

When we first met he did not have hearing aids. They were worse than useless back then. He got by by faking it and reading lips. I thought he was a real dud at parties,just standing there grinning, never joining in on a conversation. He never told me. Then we nearly slammed into a speeding police car as we went through an intersection. He never heard the siren. He was driving. I was screaming "stop! Stop!"at the top of my lungs.

The mother of the boy I helped raise was an audiologist. I dragged him to her. The test results were a shocker.

piqué, wow, I didn't realize that. I also thought it was much more recent. Thank goodness he has hearing aids then!

My 92 year old Mom only got her hearing aids about 6 months ago.

She had been living with my sister during the pandemic and it was apparent she was misunderstanding many things. That and that fact that she has the TV on full blast!

Now that she has them, she loves them!

Her Dad was hard of hearing in his 70's...I so remember Pop saying "HEH?" every time you spoke to him.

I hear you. (See what I did there?)

It IS incredibly frustrating for everyone. It's frustrating to those of us who have to walk over and speak in front of the person, or repeat ourselves a million times, or yell. It's frustrating for the person with the hearing loss because it's not like they wanted it. It's also embarrassing for them. As CHAS mentions, even the best hearing aids struggle with separating signal from noise in even a moderately noisy room.

The physics and physiology of hearing loss has fascinated me since I first learned about it in college. I think knowing some of the facts helped me, because I could understand what was going on with my dad a bit from that perspective, which helped me think of workarounds.

But there's no getting away from the fact that it's frustrating for everyone.