SuperAgers with Emily Rogalski, Director, SuperAgers Research Initiative

Speaker 1: 0:06

Do you feel overlooked and invisible because you're an older woman? Have you had those age jump days when you look in the mirror and swear that you're looking at your mother? Do you feel the clock ticking and wonder whether you have enough time to check off all the items on your bucket list? Hello, I'm Jane Leder and I'm the host of Older Women and Friends, a podcast about and four older women that kick stereotypes to the curb. We older women are the keepers of stories, and guests on Older Women and Friends share their stories about love, loss, dreams, friendships. But let's not kid ourselves Aging can be a messy, complex affair. But older women have been around the block a few times and learned a thing or two, and this podcast celebrates their lessons. So put in your earbuds and join me on Older Women and Friends.

Speaker 1: 1:12

I'm a big fan of the AARP Bulletin and I was particularly taken by a cover article titled Super Agers. I've never heard that term. I've heard of Superman and Super Woman, but not Super Agers but it sounded like an interesting topic that was worth exploring. Is a Super Ager someone whose appearance belies their age, or is it someone who can do the Sunday New York Times puzzle and pencil? Or are we talking about something much bigger.

Speaker 1: 1:47

Like a good researcher, I got in touch with cognitive neuroscientist Emily Rogulski, who leads the Super Aging Research Institute. I knew she'd have a busy schedule, very busy, but maybe she'd be willing to answer a few questions or, better yet, be a guest on Older Women and Friends. The stars must have been aligned in my favor that day, because Emily is here to explain Super Agers and to share the secrets, or some of the secrets as to how we can live longer and enjoy life more. Emily, welcome to Older Women and Friends. Thank you so much for having me. I am excited and I'm just going to start right out, because I have a lot of questions and I actually posted this on one of my Facebook pages and I got some questions from some of my friends as well. So just quickly, what is a cognitive neuroscientist?

Speaker 2: 2:53

I have a degree in neuroscience, which means that I'm interested in the brain. So I'm interested in particularly in brain health. What can go wrong with the brain in aging, and I studied this in humans. So some neuroscientists study rats or mice, or might even look at fruit flies from the perspective of the brain, but I'm on the human side of things.

Speaker 1: 3:17

And, interestingly, you study both ends of that spectrum then, as I am understanding it, so we're going to talk about super-agers and then I'm assuming that at the other end we would be talking about people with dementia.

Speaker 2: 3:33

When we think about the aging continuum. There's a wide variety of ways in which we age, and so some individuals, like the super-agers, are doing quite well, and other individuals are having more difficulty with their memory and thinking abilities.

Speaker 1: 3:47

Yeah, I get that. So let's talk about super-agers and what makes a super-ager?

Speaker 2: 3:57

Yeah, so super-agers. This is a term that I operationalized about more than 15 years ago, and we use it to describe people who are over age 80 that have memory performance at least as good as individuals in their 50s and 60s. So you can quickly think of this as people like the Betty Whites of the world or, if you're a Chicago native, the Jesse Whites of the world, jesse White tumblers, or it's your friend, neighbor, grandma, grandpa, someone in your life that you can think of, that you'd say, oh gosh, you'd never believe so-and-so was over 80. They act and have a memory that's so much younger.

Speaker 1: 4:35

And so how many of us are lucky enough to fall into the category?

Speaker 2: 4:41

This is a great question.

Speaker 2: 4:43

The types of studies that we do are not what we call epidemiologic in nature.

Speaker 2: 4:47

So if we were to really answer that question precisely, we would have to do a study that looked at all 80-plus year olds in North America or in the United States and then say what percentage of 80-plus year olds fit these criteria.

Speaker 2: 5:03

We haven't done that type of study, but what we can say is we invite individuals who are over age 80, who think they have good memory, and we find that it's still pretty rare that individuals meet the high bar that we set. We think this is a good thing because then, when those individuals have something in common, it's more likely to be biologically and scientifically meaningful and actionable. And that's our goal here is to understand what are those factors that are so important to maintaining health span. How can that help others maintain health span? How can it really help us dig into better understanding negative trajectories of aging where things go wrong? So one way to study Alzheimer's disease, for example, is to look at what's going wrong and try to reverse it another way, as to understand people who have avoided this trajectory and see what protective factors may have contributed to allowing them to avoid that trajectory and how can we implement that so it's helpful to others?

Speaker 1: 6:03

Well, I'm going to keep my fingers crossed because I'm not that far from 80. So at some point I may volunteer for some of those studies, but in the meantime I have to say that some of the statistics and information in this article were absolutely mind-blowing. There was a study not a study, but a story about a man in that AARP bulletin that I was referring to earlier. He had extraordinarily mental and physical capabilities. Do you remember that story and, if not, do you have one to share?

Speaker 2: 6:47

Oh, I have so many stories to share. So the oldest living superager we have is 109. Now, when you think of 109-year-old, I think we all tend to think of somebody who's probably not that mobile or active or sharp. This woman is incredibly sharp and in fact, when we went to visit her just before her birthday this year, she gave us a jar of ruba strawberry jam that she had just made the day before. Now she had never tried this recipe before and she's still learning new things at age 108, almost 109. We have stories of individuals who have taken their 92nd birthday trip to Patagonia. We have individuals who are avid exercisers. On the flip side, we also have individuals who say Dr Rogalski, I've never exercised and I don't plan to start exercising, and the only time that you'll see me run is when someone's chasing me. So there's a little bit of everything in between, but I think that's one of the most rewarding and valuable personally valuable parts of the study is getting the opportunity to meet these individuals and hear their stories.

Speaker 1: 8:01

Sounds fascinating, as do lots of the statistics that I came across in that one article, which was fabulous. So what have you discovered about memory with these superagers?

Speaker 2: 8:18

Yes, so the type of study that we do sometimes in research, you focus on one topic. So you say, I'm doing a research study and I want to look at exercise, and then that's the only thing you evaluate. We didn't want to take that approach with this study. Instead, we wanted to look across both biologic factors and lifestyle factors. So the study was what we call multidisciplinary or multi component from the beginning. So when the superagers come in, we ask them to do memory and thinking tests, but we also ask about their family history. We ask about their lifestyle factors. We ask them to get into an MRI scanner so we can take a fancy picture of their brain and look at brain health from that lens. We ask them to donate blood so that we can ask genetic questions and other questions about the health of their biologic markers. And then we ask them to come back over time so that we can see how things change or don't change. And then, finally, we ask that individuals consider donating their brain at the time of death. Now, this is a huge ask but is incredibly meaningful and important, because there's only a certain resolution with which we can see things during life, and by donating your brain at the time of death, we can look at cellular and molecular factors that just otherwise wouldn't be visible. I like to use an analogy and say it's kind of like when we very first got our digital cameras. People were extraordinarily excited because we didn't need film anymore. We could take lots of pictures and you could see them immediately to see if people's eyes were closed or if they were smiling or not, and it was great. But then we printed those pictures at home on a piece of white paper and what we found is the pictures were really blotchy or, had you know, pixelated. This is kind of the same analogy with what we can see during life, sometimes when we're looking through the in vivo or during life measurements that we have, and it's only when we look under the microscope or at the time of death that we can see some of these features that are just really hard to see during life. So that's a little bit of the rationale and what we cover at the study and so what we've seen.

Speaker 2: 10:32

Initially the goal was can we find these people? Is it even possible to find people who do this? Well, and of course the answer is yes, otherwise I wouldn't be here today. But then we asked OK, well, if we look at the health of the brain structure, do superagers look more like 80 year olds that they are chronologically similar to, or do they look more like average 50 to 60 year olds who they share similar memory performance to? And one of our early findings was that superagers' brains look just as good as the 50 to 60 year olds and in fact, in one part of the brain it even looks better, and that's called the anterior cingulate, which is very deep in our brain, right in the middle, and this region of the brain is really important for attention, and attention supports memory. So this is one potential mechanism of how superagers are maintaining their great memory performance.

Speaker 1: 11:28

It's just so amazing, the entire idea. I have a question about physical health, which is to say, does a superager not only have a super memory, but also a physical body that's particularly strong and flexible?

Speaker 2: 11:50

Excellent question and a really important criteria. So some studies of what we call successful aging require that individuals have both good mental health, but also and also good physical health. We didn't make that a criteria as entry to the study because we didn't want to penalize people who maybe needed a wheelchair or walker, but instead then we can look at that scientifically to say, of the superagers we enroll, how many of them have good physical health and how do those things interplay or work hand in hand? And what we see is some variability, where some superagers are leading their exercise classes or they're doing water aerobics with weightlifting, yet others are using a wheelchair or walker and maybe they're leading a stretching class or maybe they're not exercising at all. So we do see some variability in the physical health of the superagers.

Speaker 2: 12:44

What we're doing right now as an expansion to the study so in 2021, we had an opportunity to expand the study across five cities in the US and Canada, so that we're not just enrolling superagers locally in Chicago or you didn't have to come to Chicago for your study visit. We now have multiple cities where people can enroll and in the expansion of the study, we also asked that superagers wear these special sensors. They're like more sophisticated than our Apple watches or Fitbits and things like that, but conceptually you can kind of think of them like that. And these biologic sensors now give us quantitative information about physical health and activity in a way that we only had individual reports on before, so kind of subjective reporting on how often do you do XY&Z, and so we're excited about this expansion of the study.

Speaker 1: 13:37

And I'm assuming then it's going to measure blood pressure or things going on with your heart, the amount of exercise you do, what level it is, whether it's very gentle or much more challenging. Is that the kind?

Speaker 2: 13:54

of thing. Yes, exactly, we're measuring those aspects. We also can measure quality of sleep and interactions with others to get a sense of social engagement, so that another factor that we see is pretty common among the superagers, or seems to be common among the superagers, is this idea of social engagement, which is so important because, on the flip side, we've seen reported from a research standpoint as well as lived experience, the negative consequences of social isolation and loneliness and how maintaining social activity and cognitive engagement is so very important for our brain health.

Speaker 1: 14:36

Now I mentioned that I have come across a lot of statistics, but I just have to quote one, and that is those who had cataract surgery had a 29% lower risk of dementia compared with those who did not have the procedure. And I just had the procedure two months ago, so I'm feeling smarter already. I was like are you kidding? So let me take a step back and can you tell us? You've already mentioned loneliness versus connection with people and having a community and being able to spend time with other people. You've also mentioned the structure of the brain and some of the changes or the advantages that super-agers' brains show. So can you talk about some of these others in the article that referred to them as the seven secrets of super-agers? I'm ready to say super-adventures, super-agers. So can you talk about some of those secrets or some of those things that we might consider doing to minimally improve the quality of our lives and, who knows, maybe ending up being a super-ager?

Speaker 2: 15:57

Well, one thing that we really see, that we know that our brains like and what's good for our brains is being challenged. So when we talk about exercise for our body, we also talk about exercise for our brain. And what do we mean by exercise for our brain? Our brain likes novel things and it likes to be challenged, and so this fits well with this idea of staying socially connected. Because it turns out to stay socially connected and to have a conversation is actually very difficult, so I don't know exactly what you're going to ask me next. So my brain has to stay on its toes to really be ready for whatever comes next at me, and that's good exercise for our brain.

Speaker 2: 16:38

Oftentimes people will ask gosh, is it the New York Times crossword puzzle or is there some magic thing that I can do to help support my brain exercise or brain health? And my response is usually well, do you like crossword puzzles and do you find them challenging? And both elements are important, because if you don't like crossword puzzles and they give you a lot of angst, any potential brain benefit that you're going to get is going to get washed out by the anxiety and dislike of those crossword puzzles. And then the second point is important too, because if crossword puzzles are really easy for you and you can do them in your sleep, don't stop doing them, because if you enjoy them, then you should still do things you enjoy. But the amount of brain benefit that you're going to get from something that is so easy is likely to not be as great. And I think there's a really great example of a study that was done by Denise Park years ago, where she took a group of individuals who didn't know how to knit and she taught them to knit, and a group of individuals who had never taken photography class and taught them photography. And then there was a control group that I don't like sat on the couch and watched TV or something. And then the question was who benefited? Who had the most brain benefit, the knitting group, the photography group or the control group? And, interestingly, what she found was that knitting and photography groups were similar and that's because both of them were doing something new and novel and both were superior to doing nothing or, you know, pathively watching TV, because in part, potentially, because of this idea of challenging your brain. So if I had practical advice, I would say do something that is engaging and exciting to you but that challenges your brain. Stay socially connected, because there's benefits beyond challenging your brain, that social and emotional health is also important, and that staying socially connected may look different for one individual than another. If someone's really extroverted social connection might mean being connected to lots of people, if you're more introverted, then it may be having that one trusted friend that is really important.

Speaker 2: 18:46

One last theme that really runs throughout our superagers that we often see is that they adaptability. So I can think of a superager who and recognizing that these individuals are in their 80s, 90s and 100s and so sometimes they've lost some of their peers, so they've had to be adaptable and really find connection with younger generations. And so I think of one of the superagers who says you know, I decided to move in with my family, not because I had to Physically he was perfectly capable of living on his own and mentally but because he wanted to. And he said when I talked to my grandkids, I have to talk. They don't know much about Frank Sinatra or Franklin Delano Roosevelt, so I have to ask them is Taylor Swift or Chance the Rapper coming into town? Ah, and I think it's such an elegant example of how to be adaptable and find connection and joy in connecting with younger generations.

Speaker 1: 19:47

And kudos to him for even knowing who the heck she is. But in this day and time, it seems to me that Taylor Swift is maybe one of the most visible, well-known people in the world, which is a whole other issue that we're not going to go into. Well, you know, we always hear about the benefits for health, the diets and, you know, staying away from a lot of meat and, of course, sugar, et cetera, and also the importance of sleep and you have mentioned sleep before and I wonder if those two categories come into play and how important they might be for super-anches.

Speaker 2: 20:29

Absolutely so. When we think about diet, I think it's very true that a brain-healthy diet is a, or a heart-healthy diet is a brain-healthy diet, and so diet is certainly important. But I will mention that our super-agers are really variable in their diet. So there are some individuals who are vegetarians. There's another individual who says, gosh, my family would say I can't be your diet.

Speaker 2: 20:52

I eat way too many TV dinners growing up, or way too many hamburgers and french fries. So I think this is important, not to say that everybody should run out and get hamburgers and french fries, but to know that there might be some individuals, may have the genetic background that can tolerate hamburgers and french fries a little bit more than others, but certainly there's a wealth of literature talking about the importance of diet. Sleep Sleep is essential and definitely incredibly important for brain health, and one of the benefits of sleep is it actually gets rid of, it's a time to kind of wash out bad things in our brain. We're really excited about these wearable sensors because for the first time, we'll have more than self-report on how someone sleeps. We'll actually have quantitative information. So I'm gonna hold my comment on exactly how long super-agers sleep until we have that quantitative data, and so that should be coming in the near future.

Speaker 1: 21:43

And then I read about again in the AARP bulletin. That's a mouthful to get out. It was a Canadian study that found trouble falling or staying asleep Three or more nights per week for three months boosted the risk of worsening memory.

Speaker 2: 22:03

Yeah, that certainly makes sense because when we sleep it's not just one uniform thing that is happening, so we go through cycles of sleep and being able to have both quantity and the quality to be able to get through those sleep cycles is really important for kind of getting that waste out of our brain, helping us feel rested and be able to navigate the day.

Speaker 1: 22:24

And then I think I have one more secret in terms of being, or hoping to be, a super-ager, and that has to do with stress and mental health, because I have read, and I think it's probably generally understood, that if you have high stress levels or you're depressed, for example, and you're not tending to that, then in effect that is going to have an effect on your brain health.

Speaker 2: 22:54

Certainly Well. There have been multiple studies that have been done at the level of rats and mice all the way up to humans, showing that chronic stress has really negative consequences in the brain. It changes levels of cortisol and if those stay really high and other neurochemical imbalances, it actually can negatively impact the structure of your brain. So literally there's shrinkage in structure called the hippocampus and the hippocampus is critically important for memory formation and the ability to remember. And then the same thing with depression is that there are neurochemical changes that then impact our structural and physical health.

Speaker 1: 23:35

I have maybe one more question, and that has to do with the difference between Alzheimer's and dementia. I think my mother, for example, had dementia, but I'm not 100% sure and I find that a lot of people stumble over those two terms.

Speaker 2: 23:53

Unfortunately, in science sometimes the nomenclature or the names that we use to describe things become very jarbled and confused, and this is one place that causes lots of confusion, and part of the reason that we get this confusion is because our understanding has changed over time. So back in the 1900s we used to use the word senility and it was thought that everyone had. The only trajectory of aging was for people to be. As they got older, they became senile and it was expected and there was no other way to go. And then we got more sophisticated and said oh wait a second, there's trajectories of aging and dementia was recognized as an abnormal trajectory. Now we have an even more nuanced understanding and we say, okay, there's this big umbrella term, dementia, and it reflects the idea that there's been a change in thinking ability that's so severe that it's interrupting one's daily life. Sometimes that change can be because there's an imbalance in a vitamin deficiency. So we would say that's reversible, because if you restore the vitamin deficiency the memory bounces back Wow.

Speaker 2: 25:08

In other instances, where we think of Alzheimer's disease. That's one of the types of dementia that we call neurodegenerative, where there's a change that's been taking place in the brain and it's going to continue to get worse over time unless there's a treatment to ameliorate it, and at this point we don't have a definitive cure. But there's more than Alzheimer's. So Alzheimer's dementia is where there's memory loss and then it's caused by Alzheimer's disease, which are these bad proteins that are in the brain. But there's other types of dementia where the primary symptom might be language, so individuals have difficulty thinking of words, and that's another area that I have expertise in, these different types of dementia that we often don't hear about.

Speaker 1: 25:52

No, not at all. I mean, I think we either say dementia or Alzheimer's, that we don't go any further, and maybe at another time we can talk about that. And I would be remiss if I didn't ask you about someone who is 80 plus and thinks that she has a very sharp memory and would like to come to either the Institute in Chicago or other cities that you mentioned, and how would she go about that?

Speaker 2: 26:23

Absolutely we would let. We are actively recruiting and looking for super-agers, and so we would like to encourage them to come to our website, and then we can direct them to the right place. We have a registry that they can join, and perhaps I can share a flyer or some other research material so that they can get in contact with us. We'd really appreciate it.

Speaker 1: 26:44

I want to thank Emily for all of her input Very enjoyable or maybe that's not the word, but informational. And again, I will put up the email on the show notes. So when you listen to this and I assume you're listening right now you will get the convoluted but accurate website address, emily. Thank you so so much. I know you're busy. I'm very pleased that you were here. I'm sure everybody else is and thank you again.

Speaker 2: 27:18

It was so wonderful to be here. Thank you for having me.

Speaker 1: 27:23

Thank you so much for joining me on this episode of Older Women and Friends Speaking of friends. Please tell yours about this podcast and if you'd like to contact me with comments or suggestions, you can email me at olderwomenandfriendspodcasts at gmailcom. And while you're at it, please take a few minutes to write a review. It's really easy. Go to Apple Podcasts, type in Older Women and Friends, scroll down the page and click on Reviews. Until next time.