August 2025

PSYCHIATRY

INSIGHTS ON ‘SUPERAGING:’ WHAT HELPS OLDER ADULTS AVOID COGNITIVE DECLINE

Featuring: Tamar Gefen, PhD, ​M. Marsel Mesulam, MD, Sandra Weintraub, PhD, Changiz Geula, PhD,
For the past 25 years, Northwestern Medicine scientists have studied "SuperAgers," people over 80 with cognitive abilities comparable to those of individuals at least 30 years younger. This research challenges the long-standing belief that cognitive decline is an unavoidable consequence of aging, opening up new avenues for clinical intervention.
Sandra Weintraub, PhD, Professor of Psychiatry and Behavioral Sciences, Tamar Gefen, PhD, Associate Professor of Psychiatry and Behavioral Sciences, Changiz Geula, PhD, Research Professor of Cell and Developmental Biology and Neuroscience, co-authored a recent retrospective  in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association along with M. Marsel Mesulam, MD, the Founder of Mesulam Institute for Cognitive Neurology and Alzheimer’s Disease and Chief of Behavioral Neurology, who coined introduced the term SuperAger in the late 1990s.

The Neurobiological Underpinnings of SuperAging
Northwestern Medicine’s research has revealed significant differences between SuperAgers and those undergoing typical aging processes. Dr. Weintraub shares that they’ve identified two mechanisms linked with someone becoming a SuperAger:
  • Resistance, where individuals develop fewer plaques and tangles associated with Alzheimer’s
  • Resilience, where they develop these substances without cognitive impairment

One of the critical contributions of the SuperAger study is the opportunity for post-mortem brain examination. Many participants consent to brain donation, which allows for in-depth analysis of their unique neural substrates. These exams support resilience and resistance to neuropathologic changes of aging.  

Findings From Almost 3 Decades of Analysis
Research findings indicate that SuperAgers:
  • Can score at least 9 out of 15 on delayed word recall tests, a benchmark typically associated with much younger cohorts.
  • Preserve their cortical thickness compared to age-matched peers, characterized by a notably thicker anterior cingulate cortex, suggesting a complex interplay between brain health and cognitive performance.
  • Possess unique cellular traits, including a higher density of von Economo neurons and larger entorhinal neurons, which have been linked to better social behavior and memory functionality, respectively.
  • Overwhelmingly report rich interpersonal relationships, a sociability trait that appears to correlate with cognitive resilience.

Looking Forward
To further explore the potential for SuperAging research in clinical applications and to join the growing interest in enhancing cognitive longevity, engage with ongoing studies at Mesulam Center and contribute to a growing body of literature.
​
Tamar Gefen, PhD, Associate Professor of Psychiatry and Behavioral Sciences at Northwestern Medicine

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