Cognition in Whitehall II ’SuperAgers’: An Analysis of Dementia Risk Factors

Abstract While many experience cognitive decline, a subset called SuperAgers can reach late life with cognitive functioning comparable to those decades younger. We aimed to categorise whether dementia risk factors may be responsible for SuperAger status in old age. SuperAgers were identified in the UK Whitehall II cohort (n = 3513, 25.88% female) as participants 65 years or older who scored above the sex specific mean of mid-life individuals on a test of verbal memory and who scored within one standard deviation above the mean on a test of fluency in older age. Logistic regression was used to examine associations between late-life dementia risk factors and SuperAger status. Higher education (OR = 1.23, SE = 0.05, 95% CI = [1.10, 1.36], p < 0.001), female sex (OR = 1.30, SE = 0.09, 95% CI = [1.10, 1.55], p = 0.003), and lower age (OR = 0.67, SE = 0.04, 95% CI = [0.61, 0.73], p < 0.001) were associated with increased odds of SuperAger status. Absence of hypertension (OR = 0.76, SE = 0.08, 95% CI = [0.64, 0.89], p < 0.001), lower depressive symptoms (OR = 0.99, SE = 0.01, 95% CI = [0.98, 1.00], p = 0.05), higher fruit and vegetable intake (OR = 1.08, SE = 0.03, 95% CI = [1.02, 1.15], p = 0.01), and greater social activity engagement (OR = 1.03, SE = 0.01, 95% CI = [1.01, 1.06], p = 0.02) were also associated with higher odds. These findings suggest hypertension, depressive symptoms, diet, and social engagement show promising but modest associations with SuperAger status, however, they do not fully explain exceptional cognitive ageing. Author summary While many people experience cognitive decline as they age, a subset of older adults, known as “SuperAgers”, reach later life with cognitive functioning comparable to people decades younger. SuperAgers appear to resist age-related cognitive decline and can, for example, perform as well as or better than healthy adults 20–30 years younger on tests of memory. We aimed to investigate whether established dementia risk factors are associated with SuperAger status in older age. SuperAgers were identified in the UK Whitehall II cohort as participants aged 65 years or older who performed above the sex-specific mean of mid-life individuals on a test of verbal memory and within one standard deviation of the mean on a test of verbal fluency in older age. We examined associations between late-life dementia risk factors and SuperAger status. We found that the absence of hypertension, lower depression scores, greater fruit and vegetable intake, and higher social engagement were associated with an increased likelihood of being a SuperAger, although these associations were modest. Our study provides new insights into factors associated with exceptional cognitive ageing and suggests that established late-life dementia risk factors may contribute to, but do not fully explain, why some individuals maintain exceptionally high cognitive function into older age.