Dementia and Alzheimer’s disease may not be an inevitable part of aging, according to a recent Dutch study, which identified 100-year-olds with high cognitive performance, despite risk factors for decline.
This six-year study of centenarians – people over 100 – found that despite the high levels of a brain marker associated with cognitive decline, called beta amyloid, these centenarians were still sharp and performed well on cognitive tests. The researchers concluded that these elderly people may have resilience mechanisms protecting them from memory loss.
In fact, they said that the risk of dementia may not necessarily increase when you pass your hundredth birthday.
“A person between 70 and 95 years old is exposed to the same risk of dementia as a person who lives between 100 and 102 years old,” said Henne Holstege, Ph.D., from Amsterdam University Medical College in the Netherlands, who was involved in the study.
These results provide a glimpse of hope for some that, although dementia and Alzheimer’s are more likely to occur with increasing age, it will not be everyone’s fate.
“Age is the number 1 risk factor for Alzheimer’s, but these findings show us that it is possible for centenarians to thrive despite their advanced age,” said Dr. Richard Isaacson, director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine and New York- Hospital Presbiteriano, who led the study.
Although these findings illuminate aging and cognitive function, it is still a complex phenomenon that needs to be further explored, according to some experts.
“Dementia and Alzheimer’s tend to be multifactorial conditions, which means that a mix of genetics, age, environment, lifestyle and medical conditions that coexist and can take a person close to or away from cognitive decline,” said Isaacson.
Researchers still don’t know exactly why some people are protected from cognitive decline, while others are spared. The researchers in the study proposed that some of these protective factors associated with cognitive performance could be education, frequent cognitive activity and even IQ. But there may be more at stake.
“There may be protective immune and cardiovascular risk factors that help keep your brains resilient and cognitively functional even in old age,” said Dr. Gayatri Devi, a neurologist and psychiatrist at Lenox Hill Hospital in New York City.
The role that the brain markers analyzed in the study play in memory, including a sticky plaque called beta amyloid, typically found in the brains of people with Alzheimer’s, is now a heated debate among experts. The variable presence of these markers in this study further contributes to this complicated process.
“It is important to understand that the presence of amyloid in the brain does not definitely mean that a person will develop dementia,” said Isaacson. “There are other lifestyle factors and behaviors that can make us resilient and resistant to cognitive decline.”
It is important to note that there are some caveats in this study. For example, brain markers were analyzed only in 44 of the participants, so the findings may not apply to everyone, and more research needs to be done to learn about the complexity of aging.
Other studies have investigated the prevention of cognitive decline. According to the 2020 Lancet Commission Report, 40% of dementia cases can be prevented based on modifiable risk factors. Some of these previous studies have been successful in improving cognitive function and reducing risk.
A study by Isaacson’s team at the Alzheimer’s Prevention Clinic found that it was possible to improve cognitive function and reduce risk, especially in those who followed suggestions for lifestyle modifications, such as exercise, nutrition, vascular risk and medications.
Even though more is being discovered and debated, experts still recommend maintaining a healthy lifestyle, including balanced nutrition, exercise and medical appointments, to maintain cognition during aging.
“It is essential for people at risk to see their doctors regularly and consider cognitive screening tests,” said Isaacson.
Alexis E. Carrington, MD, is a dermatology researcher at the University of California, Davis and a contributor to the ABC News Medical Unit.