Super agers show that sharp memory into the 80s is possible, and a protective APOE gene variant appears to lower Alzheimer’s risk and help preserve cognition late in life.
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Super agers, the rare group of people in their 80s who think and remember like someone in their 50s, are proving that cognitive decline is not inevitable and that genetics can tilt the odds toward resilience. Recent research shows that a variant of the gene that carries fats in the blood may help protect the brain as we age. As covered in my book, Live Longer: The Science and Technology of Longevity, another variant of this same gene is one of the best-established common genetic risk factors for late‑onset Alzheimer’s disease.
A new study shifts attention to a neglected counterpart, which appears to help some people reach very old age with unusually preserved memory, despite the broad background risk of age‑related brain disease. It reframes Alzheimer’s genetics from a story of vulnerability alone to one that also includes biological protection and the possibility of mimicking that protection therapeutically.
How The Gene Impacts The Brain
The apolipoprotein E gene, called APOE, encodes the protein involved in fat transport and cholesterol metabolism in the brain and throughout the body. Humans most commonly carry one of three possible forms—ε2, ε3 or ε4. Each of these encodes a variant that influences how neurons handle cholesterol and repair membranes. The third form is considered the neutral baseline. The fourth increases risk for late‑onset Alzheimer’s, while the second is associated with a lower probability of clinically diagnosed Alzheimer’s disease.
Apolipoprotein E, or ApoE, comes in three main forms: E2, E3, and E4. These forms differ at two positions in the protein, called 112 and 158, where the building blocks cysteine or arginine can appear in different combinations.
From Zhang L, Xia Y, Gui Y. Neuronal ApoE4 in Alzheimer’s disease and potential therapeutic targets. Frontiers in Aging Neuroscience. 2023;15: 1199434. CC BY 4.0.”
The second form of the gene does more than simply “block” Alzheimer’s disease. It modifies multiple pathways that contribute to brain health and disease progression. Human and animal studies suggest that it enhances resilience and may dampen certain inflammatory responses in the brain.
Unlocking the Secrets of Sharp Minds and Super Agers
Large genetic studies show that carrying at least one APOE‑ε2 gene cuts your risk of Alzheimer’s in half, while two copies can reduce risk much more dramatically. The gene appears to slow functional and cognitive deterioration once the disease is underway. Still, it is not an absolute shield. It is a modifier that both lowers the probability of developing Alzheimer’s dementia and slows its progression when it does occur.
The new study builds on this protective story by asking which APOE variants are over- or underrepresented among people who reach age 80 or older with above-average memory performance. Using data from the Alzheimer’s Disease Sequencing Project Phenotype Harmonization Consortium, the study assessed over 18,000 participants. It compared the gene forms and their frequency in the participants. Those over 80 with memory scores as good or better than those of the average 50-64-year-old were labeled “Super Agers”. These participants remained mentally sharp as they aged.
It was found that Super Agers were 68% less likely to carry the ε4 gene variant than those with Alzheimer’s dementia. It also found that these individuals were 19% less likely to carry ε4 than healthy people their age. These findings underscore that reduced genetic risk is part of what distinguishes this group even from other healthy older adults. The most striking new finding, however, was that the Super Agers were 28% more likely to carry the second form of the APOE gene than the average participant and 103% more likely than participants with Alzheimer’s dementia in the same age group.
These results extend earlier studies by demonstrating that the frequency of this gene is closely tied to reduced disease risk and to the preservation of high‑level memory function late in life. It is critical to note, however, that as an observational study, the work cannot prove that this form of the gene causes Super Aging, nor can it exclude contributions from other genes, lifetime health behaviors or environme
