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Frequency of cognitive “super-aging” in three Australian samples using different diagnostic criteria

Published online by Cambridge University Press:  24 November 2023

Alice Powell Open the ORCID record for Alice Powell [Opens in a new window] ,
Ben C.P. Lam ,
David Foxe ,
Jacqueline C.T. Close ,
Perminder S. Sachdev Open the ORCID record for Perminder S. Sachdev [Opens in a new window]  and
Henry Brodaty Open the ORCID record for Henry Brodaty [Opens in a new window]
Alice Powell*
Affiliation:
Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
Ben C.P. Lam
Affiliation:
Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
David Foxe
Affiliation:
Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
Jacqueline C.T. Close
Affiliation:
Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
Perminder S. Sachdev
Affiliation:
Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
Henry Brodaty
Affiliation:
Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
*
Correspondence should be addressed to: Alice Powell, Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW 2052, Australia. Email: alice.powell@unsw.edu.au.
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Abstract

Objectives:

To investigate the frequency of exceptional cognition (cognitive super-aging) in Australian older adults using different published definitions, agreement between definitions, and the relationship of super-aging status with function, brain imaging markers, and incident dementia.

Design:

Three longitudinal cohort studies.

Setting:

Participants recruited from the electoral roll, Australian Twins Registry, and community advertisements.

Participants:

Older adults (aged 65–106) without dementia from the Sydney Memory and Ageing Study (n = 1037; median age 78), Older Australian Twins Study (n = 361; median age 68), and Sydney Centenarian Study (n = 217; median age 97).

Measurements:

Frequency of super-aging was assessed using nine super-aging definitions based on performance on neuropsychological testing. Levels of agreement between definitions were calculated, and associations between super-aging status for each definition and functioning (Bayer ADL score), structural brain imaging measures, and incident dementia were explored.

Results:

Frequency of super-aging varied between 2.9 and 43.4 percent with more stringent definitions associated with lower frequency. Agreement between different criteria varied from poor (K = 0.04, AC1 = .24) to very good (K = 0.83, AC1 = .91) with better agreement between definitions using similar tests and cutoffs. Super-aging was associated with better functional performance (4.7–11%) and lower rates of incident dementia (hazard ratios 0.08–0.48) for most definitions. Super-aging status was associated with a lower burden of white matter hyperintensities (3.8–33.2%) for all definitions.

Conclusions:

The frequency of super-aging is strongly affected by the demographic and neuropsychological testing parameters used. Greater consistency in defining super-aging would enable better characterization of this exceptional minority.

Keywords

super-ageingsuper-agerscognitiondefinitionimaging
Type
Original Research Article
Information
International Psychogeriatrics , First View , pp. 1 - 17
Copyright
© International Psychogeriatric Association 2023

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