A superager is someone aged 80 or older whose memory performs as well as a typical person in their 50s or 60s. Less than 5 percent of the population qualifies. While most people experience a gradual decline in memory as they age, superagers seem to resist that trajectory, maintaining sharp recall well into their eighth and ninth decades of life.
How Superagers Are Identified
The term was developed by researchers at Northwestern University’s Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, where the SuperAging Program has been running for 25 years. Their classification uses a specific memory test: participants hear a list of 15 words and, after a delay, must recall as many as possible. The average 80-year-old remembers about 5. To qualify as a superager, a person must recall at least 9, which is the average score for someone aged 56 to 66. That’s a high bar, requiring memory performance two to three decades ahead of what’s expected.
Beyond memory, superagers must also score at or above average for their age on tests covering other cognitive areas, including attention, language, and visual-spatial skills. The classification isn’t just about having one strong ability. It reflects broad cognitive health with especially preserved memory.
A separate research group at Massachusetts General Hospital studies a younger version of the phenomenon: people between 60 and 80 whose memory recall matches that of 18- to 32-year-olds.
What’s Different About Their Brains
Superager brains physically look younger. The most consistent finding is that certain brain regions shrink more slowly. In one study, cognitively normal older adults lost an average of 2.24 percent of brain volume per year, while superagers lost only 1.06 percent. That difference compounds dramatically over a decade.
The areas with the greatest preservation tell an interesting story. Superagers have more grey matter in the hippocampus (the brain’s primary memory hub), the amygdala (involved in emotion and motivation), and surrounding structures in the medial temporal lobe that support memory formation. They also show greater volume in the thalamus, though notably in regions tied to motor function and emotional processing rather than the part most directly linked to memory. A longitudinal study published in The Lancet confirmed that superagers maintained more grey matter over time, with the slowest shrinkage occurring in memory-related areas.
The cingulate cortex, a region important for integrating memory, attention, and motivation, stands out in particular. In superagers, this region is thicker than in same-age peers and shows no thinning compared to middle-aged adults. It’s one of the clearest structural markers of the superaging brain.
A Rare Type of Brain Cell
One of the more striking discoveries involves a rare, spindle-shaped brain cell found primarily in the cingulate cortex. These cells, called von Economo neurons, are thought to play a role in social awareness, intuition, and rapid decision-making. Superagers have significantly more of them than any other group studied, including not just same-age peers but also younger, cognitively healthy adults. People with mild cognitive impairment or Alzheimer’s disease have far fewer.
What makes this finding unusual is that in people with average cognition, the density of these cells doesn’t change much throughout life. Superagers aren’t preserving a normal amount. They appear to have started with, or developed, an unusually high concentration. Whether this is a cause of their cognitive resilience or simply a marker of it remains an open question.
Resilience, Not Resistance, to Alzheimer’s Pathology
One of the most surprising findings about superagers is what their brains have in common with everyone else. Brain imaging studies have measured the buildup of amyloid plaques and tau tangles, the two hallmark proteins of Alzheimer’s disease, in superagers and found no difference compared to typical older adults. Superagers accumulate these proteins at the same rate. This held true even in people over 90.
This distinction matters. Superagers don’t appear to be resistant to Alzheimer’s-related pathology. They’re resilient to it. Their brains accumulate the same damage but continue to function at a high level regardless. Something about their brain structure, cellular makeup, or neural connectivity seems to buffer against the cognitive effects that these proteins normally cause. Researchers describe this as a different relationship between pathology and performance, not the absence of disease but the ability to withstand it.
The Genetic Profile
Genetics play a measurable role. The APOE gene, which comes in several variants, is the strongest known genetic risk factor for Alzheimer’s disease. The e4 variant increases risk, while the e2 variant is considered protective. Superagers are significantly less likely to carry the e4 variant and more likely to carry e2.
In a large study comparing superagers to same-age controls, superagers had roughly 20 percent lower odds of carrying an e4 allele and about 30 percent higher odds of carrying an e2 allele. These patterns were strongest in non-Hispanic white participants but followed a similar trend in non-Hispanic Black superagers, though with smaller sample sizes. Compared to people who had developed Alzheimer’s disease, the genetic differences were even more dramatic, with superagers being four to five times more likely to carry the protective e2 variant.
Genetics aren’t destiny here, though. Many superagers carry the e4 variant, and many people with e2 still experience cognitive decline. The APOE gene is one factor among many.
Social Connections and Lifestyle
When researchers at Northwestern surveyed superagers about their daily lives, one factor stood out above exercise habits or diet: the quality of their social relationships. Superagers scored significantly higher on measures of positive social relationships, reporting more satisfying, high-quality connections with the people in their lives. This aligns with a broader body of research linking social engagement to better cognitive function in aging and lower dementia risk.
The emphasis is on quality, not quantity. Having a large social network didn’t distinguish superagers from their peers. What mattered was whether those relationships felt meaningful and fulfilling. Visiting friends, volunteering, attending events, and staying socially active were all associated with better outcomes, but the subjective experience of the relationships appeared to be the key ingredient.
Research from the UK Biobank has identified cognitive reserve as another relevant factor. This concept refers to the brain’s ability to improvise and find alternative ways to complete tasks when its usual pathways are compromised. People who build cognitive reserve through education, intellectually stimulating work, or complex hobbies may have more neural flexibility to draw on as they age. In one analysis, a cluster representing about 17 percent of the study population maintained high fluid intelligence despite older age, suggesting that reserve can buffer against age-related decline even when some loss is occurring.
Why Superaging Research Matters
Studying superagers flips the usual approach to brain aging. Rather than focusing on what goes wrong in Alzheimer’s disease and cognitive decline, this research examines what goes right in people who defy the expected trajectory. The hope is that understanding the combination of brain structure, cellular biology, genetics, and lifestyle that protects superagers could reveal new strategies for helping everyone age with sharper minds. The fact that superagers carry normal levels of Alzheimer’s pathology yet remain cognitively intact suggests that the brain has more capacity for resilience than previously appreciated, and that resilience may be something that can be supported or strengthened rather than simply inherited.