A SuperAger is someone aged 80 or older whose memory performs as well as a typical person in their 50s or 60s. The term was coined by researchers at Northwestern University, who have spent 25 years studying these individuals to understand why their brains resist the cognitive decline most people experience with age. To qualify, a person must score at least 9 out of 15 on a standardized delayed word recall test, a threshold that places them decades ahead of their peers in memory ability.
What makes SuperAgers remarkable isn’t just that they remember things well. Their brains are physically different, they lose brain tissue at a slower rate, and they appear to resist the biological hallmarks of Alzheimer’s disease, all while sharing certain lifestyle patterns worth paying attention to.
How SuperAger Brains Look Different
Brain scans reveal that SuperAgers have a thicker cortex, the outer layer of the brain responsible for thinking and memory, than other people their age. One region stands out in particular: the anterior cingulate cortex, a structure involved in attention, decision-making, and emotional processing. In SuperAgers, this area is not only thicker than in typical 80-year-olds but actually measures about 0.8 millimeters thicker than in middle-aged adults. That’s an unusual finding, since this region normally thins steadily with age.
At the cellular level, SuperAger brains contain a higher density of a rare type of brain cell called a Von Economo neuron. These are large, spindle-shaped cells found mainly in the anterior cingulate cortex and parts of the brain involved in social awareness and gut-feeling decisions. SuperAgers have significantly more of these cells than elderly adults with average cognition, more than people in the early stages of Alzheimer’s, and even more than younger, cognitively healthy adults. That last detail is especially striking: it suggests this isn’t simply a matter of losing fewer cells over time, but that SuperAgers may have started with an unusually high number to begin with.
Their Brains Shrink More Slowly
Everyone’s brain loses volume with age. But the rate at which this happens varies enormously, and SuperAgers sit at the slow end of the spectrum. Research tracking brain volume over time found that SuperAgers lose about 1.06% of their cortical volume per year, compared to 2.24% per year in cognitively average adults of the same age. That means a typical 80-year-old’s brain is shrinking at roughly twice the rate of a SuperAger’s. Over a decade, that difference compounds into a meaningful gap in the amount of healthy brain tissue remaining.
Resilience Against Alzheimer’s Pathology
One of the more surprising discoveries is that SuperAgers don’t necessarily have cleaner brains in terms of Alzheimer’s-related proteins. Brain imaging studies comparing SuperAgers to younger healthy adults found no significant differences in the levels of amyloid plaques or tau tangles, two toxic proteins that accumulate in Alzheimer’s disease. However, when SuperAgers were compared directly to typical older adults, the typical group had significantly higher levels of tau tangles in brain regions critical for memory, including the inferior temporal lobe and precuneus.
This suggests that SuperAgers may benefit from a combination of having somewhat less Alzheimer’s pathology in key areas and being more resilient to whatever pathology they do have. Their brains seem to function well even in the presence of some age-related damage.
Genetics Play a Role
Genetic studies have identified several genes strongly associated with SuperAging, and the most prominent is APOE, the same gene linked to Alzheimer’s risk. Variants of APOE that increase Alzheimer’s susceptibility appear far less often in SuperAgers, while protective variants are more common. A second well-known Alzheimer’s risk gene, BIN1, also showed a strong association. Beyond these established genes, researchers identified a novel genetic marker on chromosome 4 near a gene called RNF150, though its exact role in cognitive preservation is still being investigated.
Genetics clearly matter, but they aren’t the whole story. Many SuperAgers, like one participant who noted her mother lived to 99, point to family longevity. Still, genes set the stage rather than determine the outcome.
Lifestyle Patterns of SuperAgers
When researchers look beyond biology, a consistent set of habits emerges. SuperAgers tend to be more physically active and less sedentary during the day than their peers. The activities aren’t extreme: daily three-mile walks, regular tennis, yard work, gardening. What’s notable is the consistency and the fact that they stay physically engaged well into their 80s and 90s rather than gradually withdrawing from activity.
Social connection appears to be equally important, though quality matters more than quantity. SuperAgers don’t necessarily have larger social networks, but they report warmer, more trusting, and higher-quality relationships. Some maintain friendships spanning 50 years or more. Research on male SuperAgers specifically found that participating in social activities and having fewer depressive symptoms were particularly influential factors. For women, intellectually stimulating activities were more significant.
Mental challenge is another common thread. Northwestern Medicine highlights that SuperAgers tend to push themselves into unfamiliar territory, whether that’s reading about subjects outside their expertise, taking classes in new areas, or engaging with problems that force them to think differently. The key seems to be choosing activities that are genuinely difficult rather than comfortably routine. Doing the same crossword puzzle format every day is less beneficial than tackling something that creates a real sense of mental effort.
How Stable Is SuperAging Over Time?
An important question is whether SuperAgers simply have one good testing day or whether their abilities hold up over time. Longitudinal tracking of 18 SuperAgers over 18 months found no significant decline on any neuropsychological measure, including tests of memory, attention, language, and executive function. As a group, their cognitive performance remained stable across every domain tested. This wasn’t a case of averaging out individual ups and downs: the stability held at the individual level as well.
Longer-term data is still being collected to determine whether SuperAgers maintain this advantage over periods of five or ten years, and whether their rate of eventual cognitive change is meaningfully slower than that of average older adults. Early indications suggest it is, but confirming that requires following the same individuals over many years.
What SuperAging Research Means for Everyone
SuperAgers represent an extreme end of the aging spectrum, and not everyone can become one. The combination of favorable genetics, brain structure, and cellular architecture isn’t something you can manufacture. But the lifestyle factors associated with SuperAging, staying physically active, maintaining deep social bonds, and regularly challenging yourself mentally, are available to anyone and consistently linked to better cognitive outcomes in the general population as well.
The fact that SuperAgers’ brains resist shrinkage and show resilience against Alzheimer’s pathology suggests that cognitive decline in old age, while common, is not inevitable. Some brains are built to last longer, and some habits appear to help them do so.