"Superages": 80+ and memory like 50-60 year olds - what was discovered over 25 years of observations

“Superagers” are people aged 80+ who score on a delayed verbal recall test comparable to the results of typical 50-60-year-olds. A review of the 25-year Northwestern University program in Alzheimer's & Dementia concludes: the brain of superagers ages differently - the cortex remains “younger”, especially the anterior cingulate cortex; at the cellular level, there are fewer signs of Alzheimer's disease, larger neurons in the entorhinal cortex, a higher density of von Economo neurons, and fewer activated microglia in the white matter. This confirms that pronounced memory loss in late life is not a “fatality”.

Background of the study

• What usually happens to memory with aging. Normally, by the age of 80, delayed word recall drops noticeably: the average "raw" score on the test is about 5 out of 15, that is, about half as much as that of 56-year-olds. Against this background, people 80+, whose memory is at the level of much younger people, seem "anomaly".
• What was already known at the beginning of the review.
  • Cortical structure. Super-agers have a cortex that is, on average, no thinner than younger adults, and the anterior cingulate cortex (ACC) is often thicker than even that of 50- to 65-year-olds.
  • Neurobiology/histology: Smaller volumes of AD-like lesions, larger neurons in the entorhinal cortex, less activated microglia, higher density of von Economo neurons, and better preservation of cholinergic innervation have been described, features that potentially support memory.
• Why a 25-year review is needed. Most research on brain aging has focused on pathology (amyloid/tau). The SuperAging program has systematically accumulated data on resistance and resilience — when either the pathology is small or its effects on memory networks are surprisingly small. The review in Alzheimer's & Dementia summarizes these 25 years: selection criteria, behavioral profile, MRI/pathology, and future directions.
• What a scientific gap it closes. Instead of the thesis that “memory decline in late life is inevitable,” the program proposes an alternative trajectory of cognitive aging and a set of biomarkers that can be tested in interventions — from the modulation of neuroinflammation and cholinergic transmission to the role of social connections and lifestyle.

Who are superagers and how are they defined?

The term was coined at Northwestern ADRC: these are participants 80+ whose “delayed recall” score on a word list is at least as good as that of people 20 to 30 years younger. At the group level, they constitute a distinct cognitive and biological phenotype, not just a “lucky statistical sample.”

What's special about their brain?

• Structure: Superagers maintain cortical volumes at the level of neurotypical adults 20–30 years younger; the anterior cingulate cortex (BA24) stands out as being thicker not only compared to peers but also compared to younger controls.
• Cell Biology. In Superages:
  • less AD-like changes (tau pathology) in vulnerable areas;
  • larger neurons of the entorhinal cortex;
  • fewer activated microglia in white matter;
  • cholinergic innervation is better preserved;
  • higher density of von Economo neurons (rare "social" neurons important for integrating complex signals).

Two trajectories of "irreducible memory"

According to the center, over 25 years, approximately 290 super-agers have passed through the program; to date, dozens of postmortem studies have been described (about 79 brains). The researchers' conclusion: there are at least two mechanisms of "super-aging" of memory - resistance (few plaques and tangles) and resilience (there is pathology, but it does not destroy the network).

Why the Key Node is the Anterior Cingulate Cortex

The anterior cingulate cortex (ACC) integrates motivation, emotion, and attentional control—processes closely linked to successful recall. Its “youthful” thickness in super-agers is the most consistent finding in the MRI studies: it may be an anatomical “buffer” against age-related memory decline.

What does this mean for science and practice?

• Shifting the lens. Not just “slowing down the losses,” but also studying the sources of resilience. Understanding why some people retain “young” markers (ACC, cholinergic pathways, low neuroinflammation) can help target prevention and therapy more precisely.
• Hypotheses for interventions. Candidate directions are support of cholinergic transmission, modulation of neuroinflammation, “training” of attention/motivation systems, and behavioral factors (social activity is common in superagers). These ideas have yet to be tested in RCTs.

Important Disclaimers

This is a review of a multi-year program with a rich but heterogeneous data set: not all conclusions are automatically extrapolated to the population. Superagers are a rare phenotype, and there is no “formula” for how to become one. Nevertheless, the very fact of an “unusually young” brain at 80+ has been confirmed neuropsychologically, neuroimaging, and histologically.

Conclusion

Superagers demonstrate that exceptional memory in their 80s is possible and is associated with a distinct neurobiological profile, from a thick anterior cingulate cortex to favorable cellular markers. This changes the conversation about aging: the goal is not just to combat pathologies, but to develop and maintain the brain’s resilience mechanisms.