WHAT IS COGNITIVE DECLINE?

Much more common among aging individuals is what is called cognitive decline. They experience some brain changes and cognitive deficits that occur as part of the aging process, but their ability to function in everyday life is not impaired.

Chiefly, researchers have found that brain aging impacts some cognitive abilities, such as processing speed and some memory functions, visuospatial, language, and executive function abilities.

Medical research has identified the following features as characteristic of normal cognitive aging:

• Having Memory Lapses—For example, you might occasionally misplace things but can find them after retracing your steps.
• Being Forgetful—For instance, you might forget an appointment or name, but you can recall them at a later time.
• Ability to Maintain Daily Functions—As mentioned, these cognitive changes do not significantly impact your ability to do your day-to-day activities.

Many health professionals refer to this as “normal cognitive decline.”

However, Dr. Daniel Amen and the brain health specialists at Amen Clinics have found that cognitive decline may be common, but it is not normal. In fact, the brain-imaging work at Amen Clinics shows that age-related deficits can be reduced with lifestyle interventions, according to research.

Related: How Old Is Your Brain (And How to Make It Younger)

Unfortunately, there are millions of individuals who have cognitive decline and structural changes in the brain that are more dramatic. These people may suffer from either mild cognitive impairment (MCI) or some type of dementia, such as Alzheimer’s disease.

WHAT IS MILD COGNITIVE IMPAIRMENT?

When concerns with memory go beyond what’s considered normal cognitive changes, the symptoms may be due to mild cognitive impairment. Symptoms of MCI include trouble with memory, language, and judgment.

Yet, while the symptoms are more serious than normal cognitive aging, they still don’t impair daily functioning. 

Related: What Is Mild Cognitive Impairment?

It’s estimated that roughly 8 million U.S. adults suffer from MCI—and about 90 percent of them are unaware they have it.

Some of the most common symptoms of mild cognitive impairment may include:

• Forgetting things more frequently
• Missing appointments or social engagements
• Difficulty with language or finding the right word
• Trouble making decisions, finishing tasks or following instructions
• Getting lost in places one knows well
• Poor judgment
• Losing one’s train of thought or failing to follow the plot of a movie or book
• Trouble tracking a conversation
• Family and friends notice these changes

It’s not uncommon for people with MCI to also experience depression, anxiety, short temper/aggression, or a lack of interest in life. More people with MCI than without it will eventually develop dementia.

WHAT IS DEMENTIA AND ALZHEIMER’S DISEASE?

Dementia is an umbrella term for certain neurodegenerative diseases. There are four common types of dementia that damage important brain functions and lead to:

• Cognitive impairment
• Memory loss
• Language difficulties
• Changes in behavior and personality

Dementia significantly interferes with a person’s ability to perform everyday activities like bathing, dressing, cooking, managing finances, driving, and social engagement. As dementia advances, the level of support needed for care and increases as well. 

An estimated 55 million people around the world live with some form dementia. More than 6.5 million U.S. adults currently have Alzheimer’s disease, the most common form of dementia, and that number is expected to double by 2050.

Common signs and symptoms of dementia may include the following:

• Problems with short-term memory
• Difficulty paying bills
• Trouble preparing meals
• Forgetting appointments
• Getting lost in familiar areas
• Difficulty interpreting what is seen
• Struggling with vocabulary, verbal expression, and following conversations
• Impaired judgment
• Loss of restraint/increased impulsivity
• Changes in mood or personality
• Apathy
• Compulsive and repetitive behavior

WHAT CAUSES MCI AND DEMENTIA?

There’s no single cause of MCI and dementia, but rather a host of risk factors that contribute to its development, including:

• Family history of Alzheimer’s disease or other dementia types
• Traumatic brain injury (TBI), including concussions
• Obesity and eating a poor diet
• Diabetes or prediabetes
• Untreated sleep apnea
• Underactive thyroid
• Hypertension or prehypertension
• Lyme disease and other infections that can affect the brain
• Some medications
• Coronary artery disease, including heart problems
• Exposure to toxins
• Alcoholism and substance abuse
• Depression, ADD/ADHD, and posttraumatic stress disorder (PTSD)
• Periodontal (gum) disease
• Chronic inflammation
• Cancer/chemotherapy

WHAT RESEARCH SAYS ABOUT SUPERAGERS

Over two decades ago, researchers at the Cognitive Neurology and Alzheimer’s Disease Center at Northwestern University decided to study what is going right in the aging brain as opposed to studying pathology.

They became aware of certain individuals who appeared to defy normal brain aging, more serious memory deficits, and neurodegenerative issues. They sought to study these people in hopes that it might provide information helpful in treating Alzheimer’s disease and other forms of dementia and launched the SuperAging Program in the year 2000.

They coined the term superager and defined it as an individual 80 years or older with a demonstratable memory test score at or above the norm of 50- to 65-year-olds.

During initial recruitment, just 10 percent of the people screened who believed they had outstanding memories were included in the research. Since its inception, the program has studies 290 superagers. A total of 79 of these individuals donated their brains to the program for autopsy research after death.

In an initial study, published 12 years into the program, the researchers noted that superagers exhibit significantly greater cortical thickness and volume than their cognitively normal age-matched peers. In addition, they show no cortical atrophy.

Since this region is associated with attention, and attention supports memory, the finding reveals that keen attention may possibly be what supports the exceptional memory function in superagers.

SUPERAGERS AND SOCIAL CONNECTIONS

In the 2025 study published in Alzheimer’s and Dementia mentioned earlier, the SuperAging Program researchers compiled new and revelatory observations based on over 20 years of data.

Here are some of the characteristic findings about superagers:

• Diverse: The studied superagers were a diverse group of individuals. They did not share a particular healthy diet, exercise regimen, or take a particular medication.
• Extroverted: The superagers were somewhat extroverted and gregarious.
• Place High Value on Connecting Socially: They took time for and valued connecting socially with others.

The importance superagers place on building and maintaining social connections was one of the most significant commonalities noted about them.

Their high sociability makes sense and even aligns with previous studies on aging populations. Indeed, social connections and aging well are closely linked.

Highly social people are more resistant to cognitive decline as they grow older, research shows. Studies also suggest a link between larger brain size and greater social connectedness.

On the other hand, loneliness, defined as having a lack of meaningful social connections, appears to have a detrimental impact on aging brains as it is associated with cognitive decline, memory loss, and increased dementia risk.

A 2024 review study on loneliness and aging analyzed data from more than 600,000 participants. It found that feeling lonely increases the risk for dementia by 31 percent.

Related: 7 Ways to Be Less Lonely

While other factors are at play in superagers, this finding alone speaks volumes in terms of the potential protections an aging brain may enjoy from an individual developing strong social connections.

SUPERAGERS AND THE BRAIN

Scientists have discovered that superagers’ brains have special features that help explain why they stay sharp and socially connected well into later life.

Here’s what makes their brains different:

• Resist Alzheimer’s Changes: Superagers show fewer buildups of amyloid and tau proteins (the changes often seen in Alzheimer’s disease). And even when small amounts are present, they don’t seem to harm memory.
• More Memory Cells: They have higher numbers of neurons in the entorhinal cortex—a brain area that plays a big role in making memories, processing what you see and hear, and helping you navigate spaces.
• Special Social Neurons: Their brains contain more von Economo neurons—rare brain cells also found in highly social animals like dolphins, whales, and great apes. These cells are linked to empathy, self-awareness, and managing emotions. Having more of them may explain superagers’ strong social connections.
• Stronger Attention and Learning System: Superagers’ cholinergic system—which supports focus, learning, memory, and even blood flow—stays healthier compared to others their age.
• Lower Brain Inflammation: They have fewer overactive immune cells (called microglia) in their brain’s white matter. Too many of these cells are linked to Alzheimer’s and other memory problems.

HOW TO BECOME A SUPERAGER

Being more social may be one of the keys to achieving superager status. However, researchers believe what it’s probably a combination of behavior, as well as genetics and biology that makes superagers.

That said, building and maintaining meaningful social connections may help to protect your memory and brain function. Enjoying quality social connections, of course, will also add to your overall well-being.