Superagers: High-achieving older Australians reveal the secrets of defying old age
SUPERAGERS have the mental or physical capabilities of people who are decades younger. Now scientists believe they could hold the key to stopping ageing in its tracks.
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IT IS the next frontier in medical research; how to stop the brain deteriorating.
Research laboratories around the world have long been working on cracking the causes, contributors and early warning signs of dementia so we can live active and meaningful lives in our final decades. But we’re not there yet.
In the meantime, a group of people who appear to defy the ravages of time have caught the attention of scientists as they look for clues behind this different trajectory of ageing.
“Supernormals” or “Superagers” are people aged over 80 who have the mental or physical capabilities of counterparts aged decades younger. Think Barry Humphries still slipping into Edna’s stilettos at 83, Frank Lowy an international soccer stalwart at 86, painter John Olsen is as prolific and outspoken as ever at 89, and Dame Judi Dench treading the boards of West End at 82.
But super-agers also exist across our suburbs and country towns. You know the ones — their volunteer schedules rival full-time jobs. They are active great-grandparents, while their peers lead a quieter life in nursing homes. Many have finished a gym workout before most of us have even thought about getting out of bed.
Researchers are finding these people have different-looking brains to many other older people.
The jury is out on whether super-agers are born or made. Genetics will play a role. Luck also. And then there are known environmental factors that contribute to a healthy or damaged brain, such as early poverty or neglect.
But as average life spans increase, the incentive is higher than ever to uncover the secrets of healthy ageing. One in 100 babies born now will live to 100. In 2060, this is predicted to jump to 1 in 25.
Just as the coterie of billionaires such as Warren Buffett and Bill Gates have common traits — a lifelong love of learning, being avid readers and the ability to think outside the square — the lifestyles of supernormals are giving neuroscientists clues about how we can prevent or slow down cognitive decline and protect quality of life. And it’s a concept gaining traction in research labs around the world.
THE Australian Imaging, Biomarker and Lifestyle (AIBL) flagship study of ageing is working to learn why some people avoid neurodegeneration, or at least don’t show its symptoms.
The Melbourne-led study, involving a brains trust of high-profile experts from institutions including the Florey Institute of Neuroscience and Mental Health, Austin Health, University of Melbourne and CSIRO, has been scanning the brains of more than 1500 adults for the past 10 years with the aim of finding the cognitive traits, health and lifestyle factors that determine the development of symptomatic Alzheimer’s disease.
Florey clinical neuropsychologist Dr Jo Robertson, who is co-ordinating AIBL, says
the energetic lifestyle of a supernormal is “certainly something people can aspire to”.
“We have a lot of negative ideas associated with old age, as this inevitable decline,” Robertson says. “But one of the most exciting things of AIBL has been that this is not a given. People can age well.
“We regularly see people in their mid to high 80s and 90s who are still living fit, active and happy lives, both cognitively and physically.”
But are the brains of supernormals different?
To an extent, yes, Robertson says. It is common for there to be changes deep in the brain, in the white matter, in people over 60. The more of these structural changes, the more likely you are to show cognitive decline.
US research groups have found super-agers lose brain volume at a much slower rate, with this slower shrinkage occurring over decades.
The brain regions that help process memories, decision-making, emotions and perceptions are also better connected.
A new Melbourne research project, run by Monash University and Siemens Healthineers, is using new sophisticated imaging technology to reveal the private workings of the brains of super-agers with hopes of developing the first measure of “cognitive reserve”, a person’s capacity to maintain a healthy brain as they age.
In a further study, the team will map the brains of about 200 adults from age 18, to track brain changes through life.
THERE are lifestyle changes that we can make at any age. Melbourne experts were among a group of international dementia experts who last month presented the nine key lifestyle factors that, if removed, could prevent more than a third of dementia cases.
The most important risk-reducing factors were finishing school, preserving hearing in midlife and stopping smoking later in life.
The Lancet paper found that not completing secondary school could raise dementia risk by reducing “cognitive reserve”, resilience to cognitive decline caused by stronger brain networks.
Maintaining good hearing could allow people to experience a cognitively rich environment and build cognitive resilience, which could be lost through impaired hearing.
By stopping smoking, researchers agree, a reduction in exposure to neurotoxins will improve cardiovascular health, which affects brain health.
Others risk factors included high blood pressure, obesity, physical inactivity, social isolation, depression and type 2 diabetes.
EVIDENCE is emerging that it is more than just a build-up of amyloid plaques and tau tangles in the brain that leads to Alzheimer’s.
It’s not as simple as scanning the brain to diagnose dementia. There is no test we can take to determine if we are a true super-ager.
A third of adults over 65 have high levels of the plaque (beta-amyloid protein) in their brain, the equivalent to someone with advanced dementia. But many of these people are cognitively well and may never develop Alzheimer’s.
Another Florey and CSIRO group has found iron in the brain may play a role. Their studies have shown that levels of iron in the brain — particularly in the hippocampus, the part of the brain involved in memory formation — show who progresses faster to disease.
They are preparing to trial the use of an iron chelator in those at risk to test whether the drug can delay or prevent the onset of dementia in at-risk people.
Another hypothesis is that it is our vascular system — damage to the vessels and tissues that transport blood around the body — that accelerates neurodegeneration and dementia.
Florey stroke and cognitive neurologist Dr Amy Brodtmann is untangling why it is not just speech, movement and memory that people struggle with after a stroke, but why a third of patients go on to develop dementia.
In one of just three such studies in the world, the Florey team found the brains of these patients were shrinking at higher rates than healthy controls, particularly the areas of the brain important to memory and attention.
“These parts of the brain haven’t even been affected by the stroke, but they are shrinking at a far greater rate,” Brodtmann says. “We know that brain shrinkage is something that precedes and actually predicts cognitive decline.”
Just as vascular risk factors, such as blocked arteries, high cholesterol and blood pressure, type 2 diabetes, smoking and inactivity, increase risk of heart disease, Brodtmann says they also increase the risk of dementia.
“I believe those risk factors and that vascular burden are the biggest determinants of how we age cognitively,” she says. “Super-agers show us that they are a group of people who in general don’t have that vascular risk.
“They haven’t necessarily been skinny, but they’ve been in the healthy weight range.
“They are people who have been active — both physically and socially — throughout their lives. They’re people who haven’t had terrible blood pressure or diabetes or, if they have, had it treated.”
But how much exercise do we need to ward off dementia?
Some studies have shown that vigorous exercise, pushing past the point of discomfort, can improve the connectivity and thickness of those important brain regions.
The AIBL study is analysing results from its research, testing whether 150 minutes a week of moderate-intensity exercise can replicate observational studies suggesting physical activity is related to reduced rates of dementia.
Tapping into the knowledge that exercise is a powerful protectant for the brain — the “only neuroprotective thing we have”, Brodtmann says — researchers tracked the physical activity of
135 stroke patients at the Austin Hospital over a week, and then tested their cognitive function and conducted brain scans.
The CANVAS study (Cognition and Neocortical Volume After Stroke) found that those who were more physically active performed better on those memory and attention tasks. Brain scans showed they had stronger connections within their brains.
Brodtmann’s fellowship with the National Heart Foundation is allowing her to extend these findings and test whether intervening with exercise — getting stroke patients on the ward to attend a group exercise session three times a week — can prevent these patients’ brains shrinking.
“We can look at brain scans of people who look as though their brains are not in good shape, but their thinking and memory skills surprisingly seem OK. And vice versa,” she says.
“There is no diagnostic brain scan that tells you there’s no hope, that there’s no point doing anything.
“Irrespective of what your risk factors are, what your past history has been, and how your memory and thinking skills are going at the moment, we don’t think that’s justification for not doing anything about improving your health. There is so much you can do. One of the things about super-agers is that they are often quite self-motivated people.
“They do their own thing. They don’t need me to tell them to swim 1.5km a day. They’re doing it already.”
SUPER-AGER TIPs
EXERCISE: Regular cardiovascular exercise that requires you to “huff and puff” is good for the heart, and consequently good for the brain.
HEALTH CHECKS: Get up to date with checks relevant for your age, including blood pressure, cholesterol, diabetes sugar levels and weight.
DIET: Follow a Mediterranean-style diet, heavy on vegetables, fruit, nuts, seeds, fish, olive oil and whole grains. Reduce consumption of red and processed meat, and limit alcohol.
MENTAL CHALLENGES: Stretch your brain power and preserve the brain areas involved in memory and attention by learning new skills, teaching something or volunteering.
SOCIAL CONNECTIONS: Take part in physical and mental activities in a group. Studies show close relationships and being part of clubs or groups can have a protective effect against dementia.
JEANNE PRATT
JEANNE Pratt has a running joke with her family about slowing down.
“I have this fantasy where I have a day in bed,” she says.
Her daughter-in-law Claudine Revere raises her eyebrows and laughs, “It hasn’t happened yet.”
Pratt often attends events and dinner parties where she is surrounded by big names. It’s not unusual for a dining companion, one of the richest men in the world, to ask, “And what do you collect?”
Stories, she tells them.
There are many moments in Pratt’s week to collect them. In between her weekly croquet game with friends on the front lawns of her Raheen mansion in Kew, and Friday yoga and canasta dates, she attends Carlton Football Club matches and board meetings as its vice-president.
She is co-chair of Visy, the packing boxes business started by her late husband Richard and which has doubled in recent years with son Anthony at the helm, expanding into the US market.
Pratt reads four newspapers a day, completes two crosswords and has dozens of Scrabble games on the go at one time.
“I feel like I’m the bridesmaid dancing at too many weddings. I’m always busy,” she says. “I rarely have a day off.”
It’s the social connections she seeks out that are her fuel.
She starts each day with breakfast with her grandchildren — Anthony’s children Lilly, 6, and Leon, 8, who live with her at Raheen.
She attends each night of The Production Company, the non-profit theatre group she founded, welcoming each guest at the door.
“The upside of that is I never get a cold,” she says. “We might have tens of thousands of people at our show and they all know they can come and give me a kiss at the door.”
Each week, Raheen hosts two functions for various charities, at which Pratt also greets guests at the gate.
While she doesn’t consciously follow a playbook for healthy living — “it’s just evolved” — a recent “football injury” of sciatica nerve pain from sitting on hard stadium seats has made Pratt take stock of her health.
“Until I sustained my football injury, I never thought about ageing,” she says. “I talk about the arrogance of good health. If you don’t have a pain, or you don’t feel unhealthy, you never think about it.
“Wearing stilettos is a challenge. That’s one thing that has crept up on me. I’m just hoping for a comfortable pair of brown shoes.”
Another difficult part of ageing is loss. Richard died eight years ago. And last year she lost her best friend Felicity Beale, to whom she spoke every day for 60 years.
“That’s the terrible part about ageing, you lose your friendship group,” she says. “I do about two funerals a week.”
Pratt only needs to look out from her breakfast table to see her next project. A marquee is being assembled for her grandson’s bar mitzvah, with the guest list a who’s who of the country’s elite.
In October she will host a barbecue catering for 2500 people and co-ordinating 800 horsemen to re-enact the charge of the 4th Australian Light Horse at Beersheba, an event that helped turn the tide of World War I. She also has her eyes on getting the rights to her next theatre production from the US for next year’s season.
“I really do believe it’s terribly important for everyone to have a purpose in life, other than just enjoying yourself,” she says. “On the other hand, if you can enjoy yourself and have a purpose, that’s the ideal combination.”
ELAINE TISHER, 81
THIS Carlton great-grandmother has more reason than most to ensure her twilight years are as healthy as possible — Tisher’s own mother lived until 106.
The retired secondary school teacher had three things she wanted to do when she left the workforce: become a guide at Melbourne Museum, work at the Yooralla op-shop, and volunteer her time at the Royal Women’s Hospital.
While she gave up the first two volunteer positions in her mid-70s after a stroke, Tisher has walked to The Women’s once a fortnight for 22 years.
As one of the hospital’s longest serving volunteers, she supports nursing, clinical and administrative staff by tending to behind-the-scenes duties such as stocking and reordering supplies.
“Volunteering runs in the family; we all do it,” she says. “It gets you in contact with people, and you make more friends that way.”
She needs to consult the calendar for any new invitation that comes her way. When she’s not using Skype or WhatsApp to talk to her children and grandchildren overseas, her week is heavily booked with an aerobics class, Scrabble dates with her neighbour and day outings with her Probus Club.
KEN LYONS, 92
KEN Lyons has been thinking a lot lately about his advice for healthy ageing.
As he completed his first charity walk in memory of his beloved wife Jill last month, he realised his Probus Club has been going to more funerals than outings lately.
He compiled an 18-point list of tips for healthy ageing, which he shared with listeners to his radio show last week. They include: have goals; get rid of unwanted things; keep cheerful friends; laugh often; and plan and take a holiday. Follow your dream finishes the list — unless you dream about turning up to work naked.
Twice a week Lyons hosts a show on community radio station 3WBC 94.1 FM, drawing from knowledge and stories gathered over his 60-year pharmacy career and time
as a World War II veteran.
“I’ve been very fortunate that I have kept in reasonably good health,” he says. “It’s a bit of good luck, good genes and hard work.”
But with this blessing comes a curse — outliving your loved ones.
Human connections are paramount to Lyons. He gives shout-outs to regular listeners on air, is organising a weekend reunion for the handful of remaining members of his Beaufighter squadron, and so wanted to give other retired locals somewhere to meet and something to do he started the Windsor chapter of the Probus Club.
“I’m always busy. It’s a bit of not being able to say no, but it’s also about learning, meeting people and doing what I love.”
When the Stroke Foundation asked him to take part in its team for the Run Melbourne charity event last month, Lyons replied in trademark style, “Why not? Sign me up.”
Just two months shy of his 93rd birthday, he walked 3km, taking part in memory
of Jill, who died after a stroke nine years ago.
ALBY CLARKE, 82
ALBY Clarke is as iconic a fixture on the Warrnambool foreshore as southern right whales. Year-round, always in shorts and with a headband taming his trademark long blue hair in the sea breeze, he will be running.
Despite being active with boxing and karate in his youth, the Gunditjmara elder was diagnosed with type 2 diabetes in his 60s.
“They said if I didn’t do something I didn’t have long to live,” he says. “I haven’t had a drink since.”
Clarke changed his diet and took up cycling. A few years later, he was riding more than 1000km each week around his hometown in the state’s southwest. He won the Horsham Cycling Classic
at 64. At 67, he became the first indigenous man to complete the 275km Melbourne to Warrnambool classic. Next he cycled 3300km to Perth, raising awareness of indigenous reconciliation along the way.
Eager for his next challenge, Clarke took up running. Before long, he was running six-day, 350km ultra-marathons at 70.
Each time he hit the pavement he would carry with him a cause — local sick children, Closing the Gap, Koori youth education or funds for diabetes research. He completed his last two ultra-marathons at 75, before competing at the Australian Masters Games at 80.
“I get up at 6.30am to train in the gym and then I go for a 10-15km run to keep fit,” he says. “My body isn’t a problem. I’m as fit as a bloody fiddle. I’m slowing down a bit now. I’ve got all the titles in the world, I’ve just got to keep myself fit now. Being lonely helps keep you out of the house. It stops you moaning and groaning.
“It’s like a bike chain. You take off the chain and hang it up, don’t use it and it will just get stiff and sore and not work any more.”
EMERITUS PROFESSOR DEREK DENTON, 93
SOMEONE once warned Emeritus Professor Derek Denton that ageing isn’t for sissies.
“It’s true,” Denton says. “There is no way of avoiding it. Certain things go wrong. It’s part of the ageing process. The sands run out: the second law of thermodynamics.”
Denton isn’t settling in to watch the sands pass. He is still driven by the same central purpose that motivated him in founding the Howard Florey Institute in 1971, and striving for novel findings in his research into the nature of consciousness in animals.
He can be found at his Carlton office most days of the week, and regularly walks the kilometre to his research centre — now known as the Florey Institute of Neuroscience and Mental Health — on Royal Parade to collaborate with peers.
Denton has been a leading international expert on how genetically determined behaviours such as thirst or salt appetite are controlled by chemical and hormonal changes in the brain. And there remain many unanswered questions he is pursuing.
“It puts your spirits up. It probably puts your blood pressure up. It’s good,” he says.
The advent of next-generation scanners that can reveal things about the inner workings of the brain — secrets that Denton could not have dreamt to unlock when starting his career — are new tools to help him settle research riddles.
“It’s a stimulus to keep at it. There is an intrinsic excitement of treading in areas and possibly elucidating areas that nobody has been in before, and that’s very exciting.”
Alongside his wife, Dame Margaret Scott, 95, who founded the Australian Ballet School and returned to the stage in her late 70s for a guest performance in The Nutcracker, the couple epitomise super-agers. And Denton’s secret to becoming a super-ager?
“A melange, without a doubt,” he says. “If you’re lucky you get dealt certain genetic cards. Probably it’s about your enthusiasm and curiosity.
“I think there is a distributional curve to the degree which people remain vital, curious, interested and enthusiastic. That spread reflects genetic propensity to an extent. Also, the shape of the mind
that happened during the course of education and existence.”
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