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Cognitive decline is not inevitable with age.

"Super-agers" show resistance and resilience to age-related dementia.

You can make lifestyle changes to adopt some common practices of super-agers.

Many people assume that memory systems will fail as we age and that memory loss in the elderly is inevitable. However, the research shows that this is not actually the case. In fact, only approximately 11 percent of individuals 65 years of age or older have been diagnosed with Alzheimer’s Disease (AD), the most commonly diagnosed form of dementia (Alzheimer’s Association Report, 2025).

The research also shows that some elderly individuals do not seem to lose their cognitive faculties at all, actually performing as well on tests of memory as do people 30 years younger. These individuals are known as “super-agers,” and they have been a focus of study for quite a while.

The term “super-ager” was first coined by neurologist Dr. M. Marsel Mesulam in the late 1990s. Mesulam defined super-agers as “individuals over age 80 with episodic memory performance at least as good as normative values for 50- to 65-year-olds” (Harrison, Weintraub, Mesulam, and Rogalski, 2012).

Episodic memory is memory for our own personal history, as well as the context, the who, what, where, when, and why, associated with that particular event. We use episodic memory not just to recall the past, but also to support our daily lives. Have you ever stood by the door trying to remember where you put your keys? Coming up with the location of that lost object is an episodic memory. Episodic memory is also the first type of memory to show decline in AD, even before other symptoms are noticeable (Gallagher and Koh, 2011; Ghetti and Bunge, 2012).

By definition, super-agers have extraordinarily good episodic memory. The question is why they seem to avoid the decline seen in others. How are the brains of super-agers different from those of non-super-agers?

Research has revealed a number of neurological differences in this unique group of people. First, some super-agers show amyloid plaques and tau tangles in the brain, which are characteristic of AD, yet they do not show the memory problems seen in AD—their brains are resilient to these neurological effects. Others do not show any of the plaques and tangles. Their brains seem to resist developing these problems. Understanding resistance and resilience to AD in the brain is important to developing treatments for diseases like AD (Samuelson, 2025).

Recent research has found that the brains of super-agers do something else remarkable—they grow new neurons in greater numbers than do the brains of non-super-agers. Growth of new neurons in rodent brains has been known for many years, but the growth of new neurons in an adult human brain has been the source of debate in neuroscience. Proof that new neurons are being produced throughout our lifespan, although usually slowing as we age, is a relatively recent discovery (Owji and Shoja, 2020). The question has now shifted to what these new neurons do for us cognitively.

Most studies agree that neurogenesis (the birth of new neurons) is happening in a structure in the medial temporal lobe called the hippocampus. The hippocampus is particularly of interest because of its role in memory.

Disouky, Sanborn, Sabitha, et al. (2026) studied hippocampal tissue (obtained post-mortem from tissue donated to a brain bank) from several different age cohorts: young adults who, prior to their deaths, had no memory problems; older adults also with no cognitive impairments; a group of older adults that had been identified as super-agers; a group that had been diagnosed with preclinical, intermediate brain pathology; and adults diagnosed with AD. They found “a distinct profile of neurogenesis in super-agers that may reflect a “resilience signature.” Super-agers grew significantly more new neurons, nearly double the growth, than their peers. In contrast, individuals with AD showed negligible to no signs of new neuron growth.

How to live like a super-ager

So, of course, the question we all want answered is, can I become a super-ager? The answer is yes, you can. Or at least you can incorporate their healthy habits into your everyday life.

First, stay active, both physically and socially. Super-agers tend to be physically active, engaging in regular exercise and keeping their BMI below 30. The old saying, “A sound mind in a sound body,” tends to be true.

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They also tend to be socially connected, maintaining strong social relationships with others. This characteristic may be linked to another region in the brain called the anterior cingulate cortex, which contains what are known as von Economo neurons. These cells and this region are thought to be important in attention, social processing, and social awareness. Super-agers had a higher density of von Economo neurons compared to others of the same age who had an average memory or those with cognitive impairment.

Super-agers also tend to challenge themselves intellectually. They try new things, things that they were not already good at, take classes, and keep learning throughout their lives. There’s another old saying that applies here: “Use it or lose it.”

And lastly, super-agers occasionally indulge in a glass of wine or a cocktail. There is some evidence that alcohol consumption in moderation can reduce the risk of developing AD. Be aware that overindulgence has the opposite effect, increasing the risk of AD (Lindquist, 2023; Neafsey and Collins, 2011). So, a social drink with your friends may be doubly good for you.

Alzheimer’s Disease facts and figures (2025) Alzheimer’s and Dementia,29;21(4):e70235. doi: 10.1002/alz.70235. Accessed Mar. 18, 2026

Disouky, A., Sanborn, M.A., Sabitha, K.R., Mostafa, M.M., Ayala, I.A., Bennett, D.A., Lu, Y., Zhou, Y., Keene, C. D., Weintraub, S., Gefen, T., Mesulam, M.M., Geula, C., Maienschein-Cline, M., Rehman, J., and Lazarov. O. (2026). Human hippocampal neurogenesis in adulthood, ageing and Alzheimer’s disease. Nature, https://doi.org/10.1038/s41586-026-10169-4

Gallagher, M., and Koh, M.T. (2011). Episodic memory on the path to Alzheimer’s Disease, Current Opinion in Neurobiology, 21(6), 929–934. doi:10.1016/j.conb.2011.10.021

Ghetti, S., and Bunge, S.A. (2012). Neural changes underlying the development of episodic memory during middle childhood, Developmental Cognitive Neuroscience, 2, 381– 395.

Harrison, T.M., Weintraub, S., Mesulam, M.M., and Rogalski, E. (2012). Superior memory and higher cortical volumes in unusually successful cognitive aging. Journal of the International Neuropsychological Society, 18(6), 1081–1085. doi:10.1017/S1355617712000847

Lindquist, L. (2023). 4 habits of superagers, https://www.nm.org/healthbeat/healthy-tips/4-habits-super-agers.

Neafsey, E.J., and Collins, M.A. (2011). Moderate alcohol consumption and cognitive risk. Neuropsychiatric Disease and Treatment, 7, 465–484.

Samuelson, K. (2025). What makes a superager? Northwestern Now, August 7, https://news.northwestern.edu/stories/2025/08/what-makes-a-superager

Owji, S., and Shoja, M.M. (2020). The history of discovery of adult neurogenesis, Clinical Anatomy, 33, 41–55.

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