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    A study of ‘super-agers’ who are mentally fit into their nineties shows the standard approach to the illness may be flawed
    They smoke, they drink and brain scans suggest that they should be getting dementia but a group of “super-agers” — aged 80 to 100 and found to be mentally sharper than most fiftysomethings — are confounding medical beliefs.

    Researchers who followed the group for years found that their brains seem resilient to age, keeping their powers of memory, cognition and language, despite lifestyles that often included the bad habits that doctors warn against. The super-agers retained these powers despite their brains having many symptoms associated with dementia — including neurofibrillary tangles, deposits of deformed proteins that are supposedly highly toxic for brain cells.

    Emily Rogalski, professor of cognitive neurology at Northwestern University in Chicago, said what the super-agers had in common was a positive attitude to life and an unusually high proportion of a rare type of brain cell called a von Economo neuron. Her team’s findings emerged from post-mortem examinations of the brains of 10 super-agers who agreed to undergo extensive testing of their personalities and mental powers while they were alive and have their brains dissected after death. They were part of a group of 74 super-agers followed by the researchers.

    “The findings suggest that super-agers have unique personality profiles,” Rogalski said, in a paper she is presenting today at the American Association for the Advancement of Science annual conference in Austin, Texas.

    “Excellent memory capacity is biologically possible in late life and can be maintained for years even when there is significant neuropathologic burden.”

    Her findings, that great age and changes in brain structure need not always mean mental decline, are a rare piece of good news in a field that has seen billions spent on research with little hint of a cure in sight. There are 850,000 people with dementia in the UK, with numbers expected to exceed 1m by 2025. Most research has focused on trying to reverse the spread of amyloid and tau, the deformed proteins that form clumps and tangles in the brains of many people with dementia. However, some scientists suspect that this approach is flawed and the real causes are more subtle.

    Rogalski’s approach is to try to find what those causes might be, by looking at people who stay well, rather than those who become ill. She found that 71% of super-agers smoked, above average, and 83% drank alcohol regularly, with one lady suggesting that her daily 5pm martini helped keep her well.

    Another was that super-agers are rare — Rogalski estimates that fewer than 5% of people fit the bill. However, perhaps the most fascinating finding was that all shared a highly positive attitude to life, even when hit by disaster and hardship.

    One super-ager described “growing up extremely poor” and being left divorced with two children but added that she still considered herself independent, giving and optimistic. Another “highly extrovert” woman who suffered emotional and physical abuse in childhood and severe health problems as an adult, had risen to a senior managerial position and held it till she was 78. Just before dying, aged 92, she still considered herself “fiercely independent and rebellious”. In a separate paper published this month Rogalski and her colleagues suggest that a particular type of brain cell, called von Economo neurons after the man who discovered them, seems to play a central role in maintaining brain health and positivity.

    The neurons are found only in the brains of higher mammals with large brains, such as elephants, gorillas and humans, and are thought to offer highspeed connections between different brain regions — a kind of mental motorway. In humans they are found mainly in a small region known as the anterior cingulate cortex.

    Why, though, should some people have brains better equipped to resist ageing? Such cells form in late pregnancy and early childhood so it could be largely down to luck.

    Rogalski said personality tests on super-agers suggested a “unique personality profile, highlighting optimism, resilience and perseverance as well as active lifestyles . . . reading and travel were constant themes”, as were “positive social relationships”.

    She and her colleagues had a direct taste of this when they invited the superagers to meet at their research centre. “They all demanded a cocktail-hour party then. Now they want another one.”

    Reported in The Sunday Times of London.

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