San Diego Union-Tribune

LUCK, CARE KEEP SUPER AGERS SHARP

- BY AMY NORTON Norton writes for HealthDay News.

Researcher­s may have uncovered a key reason why some people remain sharp as a tack into their 80s and 90s: Their brains resist the buildup of certain proteins that mark Alzheimer’s disease.

The study focused on what scientists have dubbed “super agers” — a select group of older folks who have the memory performanc­e of people decades younger.

Compared with older people who had average brain power, super agers showed far less evidence of “tau tangles” in their brains, the researcher­s found.

Tau is a protein that, in healthy brain cells, helps stabilize the internal structure. But abnormal versions of tau — ones that cling to other tau proteins — can develop as well.

In people with Alzheimer’s, the brain is marked by a large accumulati­on of those tau tangles, as well as “plaques,” which are clumps of another protein called amyloid.

For years, amyloid plaques have gotten most of the attention as a potential target for Alzheimer’s treatment, said researcher Tamar Gefen, who led the new study.

But a body of evidence tells a different story: It’s the buildup of tau — not amyloid — that correlates with a decline in memory and thinking skills, said Gefen, an assistant professor at Northweste­rn University Feinberg School of Medicine, in Chicago.

These latest findings on super agers, she said, are in line with that research.

It’s not clear how many super agers are out there. One reason is that there’s no single definition of the term, said Claire Sexton, director of scientific programs and initiative­s at the Alzheimer’s Associatio­n.

This study involved people age 80 or older. But other research, Sexton said, has narrowed the focus to unusually sharp 90-somethings, or even centenaria­ns.

The million-dollar question is: What does it take to be a member of this elite group?

It’s likely super agers have genetics to thank, in part, according to Sexton. But in all probabilit­y, she said, it’s a mix of good genes, lifestyle factors and exposures over a lifetime, from physical activity, to social engagement, to mentally stimulatin­g experience­s.

In fact, previous research at Northweste­rn has shown those are common habits of super agers.

Gefen and her colleagues have also found brain difference­s between super agers and their peers with typical brain power: For example, super agers have more tissue volume in a brain region involved in processes like motivation and decision-making. Super agers also show a greater density of cells called Von Economo neurons, which are linked to social intelligen­ce.

For the current study, Gefen’s team analyzed brain tissue from seven super agers — all women — who had died in their 80s or 90s. The results were compared with brain studies from six elderly adults who’d had normal thinking skills before their deaths.

The super agers had all taken standard memory tests, and scored at or above the norm for people 20 to 30 years younger.

The researcher­s found that both super agers and their peers harbored similar amounts of amyloid plaque in the brain.

They differed, however, when it came to tangles: People with average memory and thinking skills had three times the amount of tau tangles in a memoryrela­ted brain region called the entorhinal cortex.

That does not mean plaques are unimportan­t, however. Abnormal amyloid and tau may interact with each other, and with other factors, to fuel Alzheimer’s brain changes, Sexton said.

According to the Alzheimer’s Associatio­n, it’s thought that as amyloid increases in the brain, it hits a tipping point that triggers abnormal tau to spread throughout the brain. And that’s when memory and thinking skills head downhill.

Gefen agreed that it’s probably a complex mix of factors — nature and nurture — that allows super agers to resist typical agerelated declines in brain power.

It’s unlikely to be a magic something that can be turned into a pill, she said.

More broadly, Gefen said far more work is needed to understand tau tangles, including why they zero in on memory cells.

That’s not to say tau has been completely ignored: Tau-targeting therapies for Alzheimer’s are under developmen­t, Sexton said.

For now, it seems clear that few people will become super agers. But, Sexton said, there are ways for everyone to support their brain health, including controllin­g heart disease risk factors like high blood pressure and diabetes, getting regular exercise, eating healthfull­y and staying mentally and socially engaged.

The findings were published Feb. 17 in the journal Cerebral Cortex.

The U.S. National Institute on Aging has more informatio­n on super agers at www.nia.nih.gov.

It’s likely super agers have genetics to thank, in part, says an expert from the Alzheimer’s Associatio­n. But in all probabilit­y, it’s a mix of good genes, lifestyle factors and mentally stimulatin­g experience­s.

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