Genetics are responsible for about 20% of how we age. The rest is down to us. Photo / Getty Images
Don’t let age hold you back: it’s never too late to build a more resilient brain and body.
We used to think that the only thing that could happen when you get older is that things go downhill. Thankfully we’ve moved past that phase. We now recognise for example that dementia is an abnormal trajectory of ageing.
While some change in our cognition is expected, it does not need to interfere with our daily lives.
In 2008, Prof Emily Rogalski at Northwestern University in Illinois, United States, coined the term SuperAger, someone over the age of 80 that has memory performance at least as good as people in their 50s and 60s.
At the time she hadn’t found any SuperAgers.
“We knew we were setting the bar really high,” says Rogalski, now professor of neurology at the University of Chicago. One thing her team realised early on is that the outer cortex of a SuperAger’s brain looks more like that of a 50 or 60-year-old.
“What usually happens with ageing is that the outer layer shrinks a bit. And that’s associated with changes in our memory and thinking abilities. In SuperAgers we don’t see that biological thinning,” explains Rogalski.
Scientists haven’t yet unlocked the secret recipe for keeping your brain young, but they have identified ways in which SuperAgers differ from the rest of the ageing population. And lifestyle is key.
In recent years the term has become a little bit muddier. In common parlance it has been applied to those with physical health that is well preserved as their cognition.
Prof Jugdeep Dhesi, a consultant geriatrician and president of the British Geriatrics Society, says: “It’s very difficult to disentangle cognition and physical health. There’s an overlap between them.”
We know that genetics are responsible for about 20% of how we age. The rest is down to us.
“We can make positive changes at any time,” says Dhesi.
So what habits do experts on ageing think we should learn from SuperAgers?
Rogalski considers herself to have the best job in the world: “I have the opportunity to meet and learn from these inspiring individuals. They teach me about adaptability”.
The SuperAgers she meets haven’t always had the easiest of lives, but they’ve been able to let things go and persevere through challenges.
“We’ve had holocaust survivors, individuals who’ve lost their entire families and they were the only ones to survive, people who’ve lost kids at a young age or been in poverty; really terrible life experiences where it would have been easy to say ‘Man, this is too much’, but they chose a different path.”
She has learnt a lot from their inspiring stories about how to live her own life: “We do have some control over recognising when we have mentions and learning to reframe there can be looking for the good. That might not be easy, but I think there are those opportunities.”
Attitude towards adversity is something that Dr Dawn Harper, GP and health and wellbeing ambassador at retirement villages operator Rangeford Villages, kept encountering when she wrote her book Live Well to 101.
“I have met many people who have held onto anger, which I believe has contributed to both mental and physical ill health,” she says.
Letting go can be a real challenge for some. Her advice is to buy a notebook and write down something that made you smile today. “It could be something as simple as the first snowdrop coming to life. It will help you see life through a positive lens.”
Images of frail, older people sitting in wheelchairs looking sad does us all a disservice. That’s a scientific fact.
Prof Becca Levy, of Yale School of Public Health in the US, has spent her academic career researching the impact of negative and positive beliefs about age.
She has found that individuals who have a positive attitude to ageing tend to have better physical, cognitive and mental health.
One study showed that among those who have an injury in later life, if they have positive age beliefs they will recover much faster.
In another study of the population of the town of Oxford, Ohio, everybody was asked about their age beliefs. Levy matched those findings to longevity information and found those individuals who had more positive age beliefs had on average a 7.5-year survival advantage over those who had adopted a more negative view of ageing.
“We know what children as young as age three have taken in the age beliefs of their culture,” says Levy.
However it’s never too late to start thinking differently about ageing.
In her book Breaking the Age Code, Prof Levy came up with a method for combating negative perceptions of ageing called the ABC Method.
“A” stands for awareness. “Be more perceptive in noticing the ways you’re being given messages about ageing. Both negative and positive,” Levy says.
“B” stands for “Blame ageism, not ageing”. When something goes wrong, Levy says we should not immediately blame ageing itself. “Is there something else contributing to it going wrong? Could it be ageism contributing to a health problem?”
“C” is for challenge. Find ways to challenge negative age beliefs that one encounters. “This can happen on an individual level and also by creating a social movement towards age positivity.”
A source of inspiration to Levy has been Japan, where she spent time earlier in her career.
“At the time they had the longest life span in the world – it’s still one of the longest – and I was interested in what the culture contributed to that longer life span. One of the things I noticed was how positively the older members of the culture were treated. They were celebrated and featured in pop culture in a way that showed admiration. Comic books had older characters with rich social lives.”
The SuperAgers that Rogalski researches all report higher levels of social connection than their peers.
While we know that loneliness is a killer (social isolation puts people at a 50% increased risk of developing dementia) there is more to spending time with others than it making us feel good.
Talking is good for our brain.
“It’s hard to have a conversation,” says Rogalski. “It’s good for your brain to have to think how to respond to a question.”
So it’s not just the community, social and emotional side of socialising that benefits us: “It’s also keeping your brain thinking about whatever your topics are.”
Strongly linked to this idea of socialising is the evidence that many SuperAgers have a strong sense of service.
“Many of them volunteer, and find ways for intergenerational connection,” says Rogalski.
As well as helping them to be adaptable cognitively, there are the social benefits associated with spending time with others.
Dhesi agrees: “In the community where I live, there are lots of older people who volunteer. And we know that volunteering brings loads of mental health and social benefits.”
She adds: “We often think communities don’t exist any more. But people do want to belong in communities and they are looking out for opportunities to do that. Often there’s a lot more going on locally than you would think.”
The word Super might make you think that you have to be invincible to qualify as a SuperAger. Not true.
Rogalski looked at medication use, as types of medications compared with controls are one way to measure health. “We see that with SuperAgers medication use is similar compared to a group of cognitively average 80-year-olds. It’s not that they [have got away] scot-free [in not] needing medications.”
However, SuperAgers are more likely to follow a healthy lifestyle, which gives them good chances of recovery. Not least their attitude.
“This is apparent in my day-to-day practice,” says Dhesi. “We see people in hospitals who don’t get out of bed. We know if they’re sitting in their chair they are less likely to lose muscle compared to being in bed.”
Her own parents are 87 and her husband’s parents are aged 90 and 87. “They’ve all had their physical health problems as well but they are continuing to make the most of life, despite those limitations.”
A common negative age belief is that we only associate creativity with youth. However there is no evidence that older people are not as creative as younger people.
“There’s actually a lot of evidence of people really flourishing in later life in terms of creativity,” says Levy. “People like Matisse and Michelangelo.”
Dhesi agrees: “My mother-in-law is really into arts and crafts. She makes all her own birthday cards for her family.”
The benefits of creativity are that you are using your hands, brain and giving yourself purpose. “It’s those kinds of things alongside the usual medical stuff that we so often talk about when thinking about links to positive ageing.”
A willingness to try to learn new things is another key difference that Rogalski has identified between SuperAgers and their peers.
“We do know from other studies the importance of keeping your brain elastic. We think of it like a muscle,” she says. “It turns out our brain is really responsive to learning new things, especially things that are challenging.”
Dhesi recently received a call from her mother, saying she had met someone who knew how to make a particular Indian dish that she’s never learnt how to make: “So she’s invited this younger woman over to her house to teach her how to make it.”
It is an added benefit that the woman is younger. “We know there are loads of benefits of intergenerational relationships,” Dhesi adds. “That shared wisdom between generations is important. Spending time with someone who is younger than you might be able to give you different perspectives.”
It is unsurprising that SuperAgers tend to keep active physically, as well as mentally.
Physical activity results in increased oxygen intake, which helps your body perform optimally.
However, we know that about half of people over 75 in the UK aren’t physically active, which means they’re not moving for longer than 30 minutes a week.
“That’s a tiny level of activity,” says Dhesi.
She is constantly encouraging patients to get moving. “We can see changes in muscle from sedentary behaviour within 24 hours , so if we can delay that change, or prevent it, then that’s really important,” she says.
We’re not talking about signing up for an exercise class, but simply reminding people to move about in their living room and go up and down the stairs. “When people start to limit what they’re doing, they find they are able to do even less,” Dhesi adds.
Neither her parents nor her in-laws have a cleaner. “They all do their own dusting and hoovering. They just pace it better now. They might dust one area or one room [so] that’s something they’ve achieved that day and then the next day there’s something else they might do.”
She adds: “There’s a lot that people can do for themselves if they pace themselves and get value from, recognising that you’ve achieved something.”
Dhesi’s tips include making sure that you are moving from sitting to standing 20 times every couple of hours. “That will help build up those leg muscles.” She adds: “Things like step counts really do help. It makes you competitive with yourself and your friends.”
Multiple studies have shown that the diets of SuperAgers tend to be high in fruits, vegetables, whole grains and fish, and low in red meat, butter and sweets. These diets may help slow cognitive decline and reduce the risk of dementia.
Harper says: “Try changing your thinking about ‘meat and two veg’. At home we think of the vegetables as the main affair and the protein as a side dish. I am convinced of the benefits of a plant-based diet.”
At the very least try to avoid beige-coloured foods and opt for colour on your plate.
“Even if that is a kiwi, an orange, some greens with your meat and fish in the evening,” says Dhesi. “It’s not that hard to build in some of those changes into your day. It’s having them in mind.”
Living a long and healthy life doesn’t mean it has to be a boring one. Although if you’re socialising as much as a SuperAger does, it could hardly fail to be fun.
That certainly doesn’t mean you can’t have a drink while you’re doing it. Studies have shown that people who drink moderately were 23% less likely to develop Alzheimer’s disease or signs of memory problems than those who don’t drink alcohol.
The key though is moderation. It is the catchword of Dhesi. Of the SuperAgers she knows, she says: “They have not all been born into the groups you would expect to live longer. They come from difficult backgrounds, but they’ve all made important life choices about not smoking, drinking in moderation, cooking and eating well and being physically active”.
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