Mentally healthy centenarians should stay that way until death, study says

One of my greatest pleasures during the pandemic shutdowns was having time to talk on the phone for over an hour with friends and family that I couldn’t see in person. Especially encouraging were my biweekly conversations with Margaret Shryer, a 94-year-old Minneapolis resident who is twice widowed.

My conversations with Margaret are substantial and illuminating, covering topics that include politics, poetry, plays, and philosophy, as well as family pleasures and problems. I appreciate your wisdom and wise advice. I’m especially glad that she doesn’t seem to have lost an ounce of her youthful brain power. She’s as smart now as she was when we met decades ago.

Recent findings on the trajectory of human cognition suggest that if Margaret does not suffer any physical ailments in the next six years, as a stroke is destined to be a cognitively sharp centenarian.

Less than one percent of Americans reach the age of 100, and new data collected in the Netherlands indicates that those who reach this milestone with their mental faculties still intact are likely to remain so for the remaining years, even if their brains are strewn with neurofibrillary tangles and tangles. neuritic plaques, which are typical of Alzheimer’s disease.

The Dutch study’s findings could pave the way for many to become “cognitive super seniors,” as the researchers call people approaching the final part of human life with a brain that functions as if it were 30 years younger.

One day, everyone who reaches the age of 100 will also be able to remain mentally healthy.

By studying centenarians, researchers hope to identify reliable traits and develop treatments that result in healthy cognitive aging for the majority. In the meantime, we can do a lot now to keep our brains in top condition, even if reaching a hundred years is neither a goal nor a possibility.

These promising prospects stem from the study of 340 Dutch centenarians who live independently. They were tested and shown to be cognitively healthy at the time of enrollment. The 79 participants who did not die or drop out of the study returned for more cognitive tests, performed every 19 months on average.

The research team, led by Henne Holstege at the Free University of Amsterdam, reported in the “Jama Network Open” in 2021 that participants did not record a decline in key cognitive measures, except for a slight loss in memory function.

Basically, participants performed as well as people 30 years younger in general cognition, with the ability to make decisions, make plans and execute them; to draw a picture of a figure they had seen; to list animals or objects that begin with a certain letter; and not being easily distracted when carrying out a task or getting lost when leaving the house.

Even those with genes linked to a high risk of developing Alzheimer’s disease performed well in the tests.

Nearly a third of participants agreed to donate their brains after death. The brain autopsy of 44 of the original centenarians revealed that many had substantial neuropathology common to people with Alzheimer’s disease, even though they had remained cognitively healthy for up to four years beyond one hundred.

Thomas T. Perls, a geriatrician at Boston University who directs the New England Centenarian Study and wrote an editorial accompanying the study, said the Dutch participants represented “la crème de la crème” of centenarians who avoided the onset of Alzheimer’s disease by at least 20 to 30 years.

They appeared to be disease-resistant or cognitively resilient, somehow able to ward off manifestations of brain-damaging effects. Maybe both.

According to Perls, resistance may reflect a relative absence of brain damage conferred by a person’s genes or lifestyle. Or it could be that there are “protective biological mechanisms that slow the aging of the brain and prevent clinical disease.”

Resilience, on the other hand, characterizes people with normal cognitive abilities, although the brain can show damage typical of Alzheimer’s disease, the main cause of dementia. In addition to neurofibrillary tangles and neuritic plaques, these changes include loss of neurons, inflammation, and clogged blood vessels.

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

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

Stern pointed out that many studies have revealed that various lifestyle factors can contribute to resilience. These include completing quality higher education; choosing an occupation that deals with complex facts and data; consume a Mediterranean-style diet; engaging in leisure activities; socialize with others; and exercise regularly.

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

For Perls, “Alzheimer’s disease is not an inevitable result of aging. Those genetically predisposed can significantly delay it or show no evidence of its presence in life by doing things we know are healthy: exercising regularly, maintaining a healthy, not smoking, consuming a low level of red meat in the diet, and doing things that are cognitively new and challenging for the brain, like learning a new language or a musical instrument.”