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Pezzoli S, Giorgio J, Martersteck A, Dobyns L, Harrison TM, Jagust WJ. Successful cognitive aging is associated with thicker anterior cingulate cortex and lower tau deposition compared to typical aging. Alzheimers Dement 2024; 20:341-355. [PMID: 37614157 PMCID: PMC10916939 DOI: 10.1002/alz.13438] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/30/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION There is no consensus on either the definition of successful cognitive aging (SA) or the underlying neural mechanisms. METHODS We examined the agreement between new and existing definitions using: (1) a novel measure, the cognitive age gap (SA-CAG, cognitive-predicted age minus chronological age), (2) composite scores for episodic memory (SA-EM), (3) non-memory cognition (SA-NM), and (4) the California Verbal Learning Test (SA-CVLT). RESULTS Fair to moderate strength of agreement was found between the four definitions. Most SA groups showed greater cortical thickness compared to typical aging (TA), especially in the anterior cingulate and midcingulate cortices and medial temporal lobes. Greater hippocampal volume was found in all SA groups except SA-NM. Lower entorhinal 18 F-Flortaucipir (FTP) uptake was found in all SA groups. DISCUSSION These findings suggest that a feature of SA, regardless of its exact definition, is resistance to tau pathology and preserved cortical integrity, especially in the anterior cingulate and midcingulate cortices. HIGHLIGHTS Different approaches have been used to define successful cognitive aging (SA). Regardless of definition, different SA groups have similar brain features. SA individuals have greater anterior cingulate thickness and hippocampal volume. Lower entorhinal tau deposition, but not amyloid beta is related to SA. A combination of cortical integrity and resistance to tau may be features of SA.
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Affiliation(s)
- Stefania Pezzoli
- Helen Wills Neuroscience InstituteUniversity of CaliforniaBerkeleyCaliforniaUSA
- Lawrence Berkeley National LaboratoryBerkeleyCaliforniaUSA
| | - Joseph Giorgio
- Helen Wills Neuroscience InstituteUniversity of CaliforniaBerkeleyCaliforniaUSA
- University of NewcastleNewcastleNSWAustralia
| | - Adam Martersteck
- Helen Wills Neuroscience InstituteUniversity of CaliforniaBerkeleyCaliforniaUSA
| | - Lindsey Dobyns
- Helen Wills Neuroscience InstituteUniversity of CaliforniaBerkeleyCaliforniaUSA
| | - Theresa M. Harrison
- Helen Wills Neuroscience InstituteUniversity of CaliforniaBerkeleyCaliforniaUSA
| | - William J. Jagust
- Helen Wills Neuroscience InstituteUniversity of CaliforniaBerkeleyCaliforniaUSA
- Lawrence Berkeley National LaboratoryBerkeleyCaliforniaUSA
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Powell A, Page ZA, Close JCT, Sachdev PS, Brodaty H. Defining exceptional cognition in older adults: A systematic review of cognitive super-ageing. Int J Geriatr Psychiatry 2023; 38:e6034. [PMID: 38078669 PMCID: PMC10947516 DOI: 10.1002/gps.6034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/18/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVE A consistent approach to defining cognitive super-ageing is needed to increase the value of research insights that may be gained from studying this population including ageing well and preventing and treating neurodegenerative conditions. This review aims to evaluate the existing definitions of 'super-ageing' with a focus on cognition. METHODS A systematic literature search was conducted across PubMed, Embase, Web of Science, Scopus, PsycINFO and Google Scholar from inception to 24 July 2023. RESULTS Of 44 English language studies that defined super-ageing from a cognitive perspective in older adults (60-97 years), most (n = 33) were based on preserved verbal episodic memory performance comparable to that of younger adult in age range 16-65 years. Eleven studies defined super-agers as the top cognitive performers for their age group based upon standard deviations or percentiles above the population mean. Only nine studies included longitudinal cognitive performance in their definitions. CONCLUSIONS Equivalent cognitive abilities to younger adults, exceptional cognition for age and a lack of cognitive deterioration over time are all meaningful constructs and may provide different insights into cognitive ageing. Using these criteria in combination or individually to define super-agers, with a clear rationale for which elements have been selected, could be fit for purpose depending on the research question. However, major discrepancies including the age range of super-agers and comparator groups and the choice of cognitive domains assessed should be addressed to reach some consensus in the field.
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Affiliation(s)
- Alice Powell
- Centre for Healthy Brain AgeingDiscipline of Psychiatry and Mental HealthSchool of Clinical MedicineUniversity of New South WalesRandwickNew South WalesAustralia
| | - Zara A. Page
- Centre for Healthy Brain AgeingDiscipline of Psychiatry and Mental HealthSchool of Clinical MedicineUniversity of New South WalesRandwickNew South WalesAustralia
| | - Jacqueline C. T. Close
- Neuroscience Research AustraliaUniversity of New South WalesSydneyNew South WalesAustralia
- The Prince of Wales Hospital Clinical SchoolUniversity of New South WalesSydneyNew South WalesAustralia
| | - Perminder S. Sachdev
- Centre for Healthy Brain AgeingDiscipline of Psychiatry and Mental HealthSchool of Clinical MedicineUniversity of New South WalesRandwickNew South WalesAustralia
- Neuropsychiatric InstituteThe Prince of Wales Hospital Clinical SchoolUniversity of New South WalesSydneyNew South WalesAustralia
| | - Henry Brodaty
- Centre for Healthy Brain AgeingDiscipline of Psychiatry and Mental HealthSchool of Clinical MedicineUniversity of New South WalesRandwickNew South WalesAustralia
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Powell A, Lam BCP, Foxe D, Close JCT, Sachdev PS, Brodaty H. Frequency of cognitive "super-aging" in three Australian samples using different diagnostic criteria. Int Psychogeriatr 2023:1-17. [PMID: 37997622 DOI: 10.1017/s1041610223000935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
OBJECTIVES To investigate the frequency of exceptional cognition (cognitive super-aging) in Australian older adults using different published definitions, agreement between definitions, and the relationship of super-aging status with function, brain imaging markers, and incident dementia. DESIGN Three longitudinal cohort studies. SETTING Participants recruited from the electoral roll, Australian Twins Registry, and community advertisements. PARTICIPANTS Older adults (aged 65-106) without dementia from the Sydney Memory and Ageing Study (n = 1037; median age 78), Older Australian Twins Study (n = 361; median age 68), and Sydney Centenarian Study (n = 217; median age 97). MEASUREMENTS Frequency of super-aging was assessed using nine super-aging definitions based on performance on neuropsychological testing. Levels of agreement between definitions were calculated, and associations between super-aging status for each definition and functioning (Bayer ADL score), structural brain imaging measures, and incident dementia were explored. RESULTS Frequency of super-aging varied between 2.9 and 43.4 percent with more stringent definitions associated with lower frequency. Agreement between different criteria varied from poor (K = 0.04, AC1 = .24) to very good (K = 0.83, AC1 = .91) with better agreement between definitions using similar tests and cutoffs. Super-aging was associated with better functional performance (4.7-11%) and lower rates of incident dementia (hazard ratios 0.08-0.48) for most definitions. Super-aging status was associated with a lower burden of white matter hyperintensities (3.8-33.2%) for all definitions. CONCLUSIONS The frequency of super-aging is strongly affected by the demographic and neuropsychological testing parameters used. Greater consistency in defining super-aging would enable better characterization of this exceptional minority.
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Affiliation(s)
- Alice Powell
- Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Ben C P Lam
- Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - David Foxe
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Jacqueline C T Close
- Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
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Touroutoglou A, Wong B, Andreano JM. What is so super about ageing? THE LANCET. HEALTHY LONGEVITY 2023; 4:e358-e359. [PMID: 37454674 DOI: 10.1016/s2666-7568(23)00103-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023] Open
Affiliation(s)
- Alexandra Touroutoglou
- Harvard Medical School, Boston 02115, MA, USA; Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Boston, MA, USA.
| | - Bonnie Wong
- Harvard Medical School, Boston 02115, MA, USA; Frontotemporal Disorders Unit, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Joseph M Andreano
- Harvard Medical School, Boston 02115, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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Garo-Pascual M, Gaser C, Zhang L, Tohka J, Medina M, Strange BA. Brain structure and phenotypic profile of superagers compared with age-matched older adults: a longitudinal analysis from the Vallecas Project. THE LANCET. HEALTHY LONGEVITY 2023; 4:e374-e385. [PMID: 37454673 PMCID: PMC10397152 DOI: 10.1016/s2666-7568(23)00079-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Cognitive abilities, particularly memory, normally decline with age. However, some individuals, often designated as superagers, can reach late life with the memory function of individuals 30 years younger. We aimed to characterise the brain structure of superagers and identify demographic, lifestyle, and clinical factors associated with this phenotype. METHODS We selected cognitively healthy participants from the Vallecas Project longitudinal cohort recruited between Oct 10, 2011, and Jan 14, 2014, aged 79·5 years or older, on the basis of their delayed verbal episodic memory score. Participants were assessed with the Free and Cued Selective Reminding Test and with three non-memory tests (the 15-item version of the Boston Naming Test, the Digit Symbol Substitution Test, and the Animal Fluency Test). Participants were classified as superagers if they scored at or above the mean values for a 50-56-year-old in the Free and Cued Selective Reminding Test and within one standard deviation of the mean or above for their age and education level in the three non-memory tests, or as typical older adults if they scored within one standard deviation of the mean for their age and education level in the Free and Cued Selective Reminding Test. Data acquired as per protocol from up to six yearly follow-ups were used for longitudinal analyses. FINDINGS We included 64 superagers (mean age 81·9 years; 38 [59%] women and 26 [41%] men) and 55 typical older adults (82·4 years; 35 [64%] women and 20 [36%] men). The median number of follow-up visits was 5·0 (IQR 5·0-6·0) for superagers and 5·0 (4·5-6·0) for typical older adults. Superagers exhibited higher grey matter volume cross-sectionally in the medial temporal lobe, cholinergic forebrain, and motor thalamus. Longitudinally, superagers also showed slower total grey matter atrophy, particularly within the medial temporal lobe, than did typical older adults. A machine learning classification including 89 demographic, lifestyle, and clinical predictors showed that faster movement speed (despite no group differences in exercise frequency) and better mental health were the most differentiating factors for superagers. Similar concentrations of dementia blood biomarkers in superager and typical older adult groups suggest that group differences reflect inherent superager resistance to typical age-related memory loss. INTERPRETATION Factors associated with dementia prevention are also relevant for resistance to age-related memory decline and brain atrophy, and the association between superageing and movement speed could provide potential novel insights into how to preserve memory function into the ninth decade. FUNDING Queen Sofia Foundation, CIEN Foundation, Spanish Ministry of Science and Innovation, Alzheimer's Association, European Research Council, MAPFRE Foundation, Carl Zeiss Foundation, and the EU Comission for Horizon 2020. TRANSLATION For the Spanish translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Marta Garo-Pascual
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, IdISSC, Madrid, Spain; Alzheimer Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Centre, Madrid, Spain; PhD Program in Neuroscience, Autonomous University of Madrid-Cajal Institute, Madrid, Spain.
| | - Christian Gaser
- Structural Brain Mapping Group, Department of Neurology, Jena University Hospital, Jena, Germany; Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; German Centre for Mental Health, Jena, Germany
| | - Linda Zhang
- Alzheimer Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Centre, Madrid, Spain
| | - Jussi Tohka
- A. I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Miguel Medina
- Alzheimer Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Centre, Madrid, Spain; Network Centre for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | - Bryan A Strange
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, IdISSC, Madrid, Spain; Alzheimer Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Centre, Madrid, Spain
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Ticha Z, Georgi H, Schmand B, Heissler R, Kopecek M. Processing speed predicts SuperAging years later. BMC Psychol 2023; 11:34. [PMID: 36732871 PMCID: PMC9896833 DOI: 10.1186/s40359-023-01069-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND SuperAging is one of the current concepts related to elite, resilient or high-functioning cognitive aging. The main aim of our study was to find possible predictors of SuperAgers (SA). METHODS Community-dwelling older persons (N = 96) aged 80-101 years in 2018 were repeatedly tested (year 2012 and 2018). SA were defined based on their performance in 2018 as persons of 80+ years of age who recalled ≥ 9 words in the delayed recall of the Philadelphia Verbal Learning Test, and had a normal performance in non-memory tasks [the Boston Naming Test, the Trail Making Test Part B, and Category Fluency ("Animals")], which was defined as a score within or above one standard deviation from the age and education appropriate average. Three composite scores (CS; immediate memory, processing speed, and executive functions) were created from the performance in 2012, and analysed as possible predictors of SA status in 2018. RESULTS We identified 19 SA (15 females) and 77 nonSA (42 females), groups did not significantly differ in age, years of education, and sex. The logistic regression model (p = 0.028) revealed three predictors of SA from the baseline (year 2012), including processing speed (p = 0.006; CS-speed: the Prague Stroop Test-Dots and the Digit Symbol Substitution Test), sex (p = 0.015), and age (p = 0.045). CONCLUSIONS Thus, SA may be predicted based on the level of processing speed, which supports the hypothesis of the processing speed theory of healthy aging.
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Affiliation(s)
- Zuzana Ticha
- grid.445531.20000 0004 0485 9760Prague College of Psychosocial Studies, Hekrova 805, 149 00 Prague 11, Háje, Czech Republic
| | - Hana Georgi
- grid.445531.20000 0004 0485 9760Prague College of Psychosocial Studies, Hekrova 805, 149 00 Prague 11, Háje, Czech Republic
| | - Ben Schmand
- grid.7177.60000000084992262Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Radek Heissler
- grid.447902.cNational Institute of Mental Health, Klecany, Czech Republic
| | - Miloslav Kopecek
- grid.447902.cNational Institute of Mental Health, Klecany, Czech Republic ,grid.4491.80000 0004 1937 116XDepartment of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
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Spires-Jones TL. Your brain is amazing: Let’s keep it that way. Brain Commun 2022; 4:fcac160. [PMID: 35873919 PMCID: PMC9305202 DOI: 10.1093/braincomms/fcac160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Tara L Spires-Jones
- Centre for Discovery Brain Sciences, UK Dementia Research Institute, University of Edinburgh , EH8 9JZ Edinburgh , UK
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