Science Friday - What Makes ‘SuperAgers’ Stay Healthy For So Long?

Episode Date: October 15, 2024

A common worry among older adults is how their brains and bodies might decline as they age.A small but fortunate group will live past their 95th birthdays, while staying cognitively sharp and free of major health complications. They’re called “SuperAgers.”Researchers are working to figure out some of the genetic factors behind SuperAgers’ longevity—and how that knowledge might help the rest of the population live longer and healthier lives.Ira talks with Dr. Sofiya Milman, director of Human Longevity Studies at Albert Einstein College of Medicine and the lead researcher of the SuperAgers Family Study; and one of the study’s participants, Sally Froelich, a 95-year-old New York resident.Transcript for this segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

What are the factors that make it possible to live to nearly 100? Lifestyle alone is not sufficient to get people to 95 or 100 in good health. It's Tuesday, October 15th, and you're listening to Science Friday. I'm SciFri producer Shoshana Bucksbaum. A lucky few will live past their 95th birthdays, all while staying cognitively sharp and free of major health complications. They're called super-agers. Researchers are working to figure out some of the genetic factors behind these super-agers' longevity and how that might help the rest of the population live longer and healthier lives.

Here's Ira with more. Joining me now is a researcher leading an ambitious project with the goal of studying 10,000 super-agers and also one of the studies participants. Dr. Sophia Millman, Director of Human Longevity Studies at Albert Einstein College of Medicine, based to New York. Welcome to Science Friday. Glad to be here. Nice to have you. And Talley Frolic, a 95-year-old New York resident and study participant. Welcome to Science Friday. Thank you. Welcome. Nice to have you. Dr. Millman, let's start with the basics. How do you define someone who is a super ager? We define superager as individuals who are age 95 and have a generally intact cognitive function.

So that typically means they either live independently or really require minimal assistance to do their daily activities. And you're studying 10,000 super-agers? That's our goal to reach 10,000. And what is the goal of the study then? The ultimate goal is to understand what is contributing to healthy longevity in these individuals. Because as we well know, unfortunately, aging is often. and plagued by multiple diseases and disability. And here we have an opportunity to study people who are really unique, or you may even call

them outliers in our society, who are not only living very long lives, but also healthy lives. And so we want to understand what it is about them, what's their secret to not only their longevity, but to their healthy longevity. Sally, how does it feel to be called an outlier? Well, I have to tell you, that's the name I never heard, Outlier. Anyway, I knock wood all the time, which I'm knocking right now. I'm lucky. And never in a million years that I think I was going to live this long.

I go day by day. Right. And what made you decide to be part of this study? Curiosity. And why not? They asked me. and I had the time and the interests. Yeah.

And what do you have to do to be part of the study? What's the experience like? Well, at first, I just thought I had to fill out a few questionnaires, but then there became more and more and more. And quite frankly, I found it interesting because it made me think back on things that I do. And not that I don't remember them, I do, but I don't think about it.

So it made me think about it. So it's been a really interesting experience. And plus, I meet you all, which is nice. What are some of the questions you may have had a difficulty answering on the study? How many blocks I can walk without getting tired? Pretty much, that's the question I found. It's difficult because I don't know how many blocks. It depends on the day, the weather, and my body.

Yeah, yeah. Dr. Milman, for people who live past 95, how much is it genetics versus behavioral or environmental factors, you know? That old question. Yeah, the nature versus nurture, right? So we believe that environment does contribute, but to a point, it is definitely advisable for people to exercise, to get enough sleep, avoid stress, you know, avoid excess. alcohol use and tobacco. But what we're finding is that lifestyle alone is not sufficient to get people to 95 or 100 in good health. It seems that there's something else that's contributing to this healthy longevity. And we believe this is where the genes come in. And the reason we think that there's significant contribution from genes to healthy longevity is because longevity tends to and families. So the parents of these super-agers often have been super-agers themselves, and their children, their offspring, also tend to be healthier as they age.

Are there certain diseases that stand out to you that the super-agers seem to be protected against? Let's say most diseases, they delay the onset of most diseases that we associate with aging, including cancer, Alzheimer's disease. heart disease, diabetes. They often don't get it at all, or if they do, they get it 20 to 30 years later than the general population. Now, Sally, you said you think that you're just lucky. Do you really believe that?

Absolutely. Because when my father died, he was 79, and my mother was 87, I thought they were, I don't know, they were both old. and I'm old, but I don't in my head think I am. You know, that's interesting because that's what my mother said. I mean, she lived to 99 plus years. She never really considered herself to be old. I once found her in the drugstore looking for a birthday card for one of her friends,

and she was in an argument with the druggist about the birthday cards because she was astounded that he didn't have anything for a woman who was 102. Today, maybe they will do that. Dr. Milman, are there specific genetic variations that super-agers have in common, things that protect them against cognitive decline? So there have been several genes that have been identified that confer protection. For centenarians, there are genes that contribute to higher levels of good cholesterol or the HDL, high-density lipoprotein cholesterol.

And then there are genes that actually reduce the signaling through the growth hormone pathway. So the growth hormone pathway, as the name suggests, is important for growth. And it goes up in kids so that they can get taller. But the levels actually go down as we age. But what has been shown in super agers is that they have rare genetic variations that actually reduce their growth. hormone or the signaling through their growth hormone access. And that may be protective for people as they age and get older. I know there are medications that lower growth hormone levels for people who produce excess amounts. Would the treatment be possibly taking those medications?

So that's certainly a possibility that we're interested in exploring. There was a study a number of years ago by a colleague of mine that actually gave a medication that is not currently FDA approved, but it lowered IGF1 levels in mice and has shown that if you administer this anti-IGF-1 monoclonal antibody to middle-aged mice, they will actually live longer. And so that inspired us to take some of the FDA-approved medications or something that is similar to that and study that for healthy aging and longevity. And we're launching a study now to study a drug that will lower growth hormone levels as a potential therapeutic for Alzheimer's disease.

Okay. I know this is still very early research, but let's say you're able to figure out a genetic variation that would increase longevity. How would you know when someone should start taking that medication? Would it be based on risk factors for dementia or Alzheimer's or how old you were? Yeah, this is a very active area of research. When is the right time to start an intervention? And right now, what most experts believe is the right time will be when that individual is found to be at increased risk.

The key is to start it early enough before disease, onset because once the disease onsets it may be too late to intervene, but maybe not too prematurely. So what is that sweet spot where someone is shown to be at risk and maybe

they already have some early signs of disease, but they're not really impacted by disease yet. And maybe that's the right time. People are also studying biomarkers or certain proteins or metabolites that we can measure in the blood.

that can be markers of future disease, and all that information together hopefully will help us understand who is at risk at what time point so we can initiate these preventative treatments. Any ideas, any links, any ideas of why super-agers are so free from cognitive disorders like Alzheimer's and other brain disorders? So this is an area of intense investigation. and it's very possible that it's the same factors that protect them from heart disease, that protect them from cancer, that protect them from diabetes that are also protecting them

from cognitive decline and Alzheimer's disease. You know, aging is really a systemic process, and it impacts all organ systems and contributes to all diseases. And if we think about it, right, we sometimes don't stop and think about it, but young people don't get heart disease, cancer, Alzheimer's disease at the same rates as older people too, right? And so there's something about aging or as our body ages that it becomes more predisposed to all of these conditions at once. And so the risk factors that are driving all of these diseases may actually be common and be driven by aging itself. And so if we can target those common risk factors,

that contribute to aging, we think that we can impact all the diseases at once. And I think that's what we're seeing in super-ageers, right? It's not just one disease. It's all diseases that are being delayed. This all sounds wonderful, but how can this research help those of us who won't live past 95? So we will identify these genes that contribute to longevity and healthy aging, but then what? because what we're hoping to do with that information is then to create medications or drugs that will mimic the function of these protective genes and will allow the rest of individuals who were not so lucky, right, to inherit these genes to live longer and healthier lives too. We're talking with Dr. Sophia Milman and Sally Frolic about the science of superagers,

those lucky few who live to age 95 and beyond. Are there places in the world where there are more superagers than others? I think the popular press has recently brought attention to some of these blue zones, these areas where their concentrations of superagers. So these may be some geographic areas. Across the United States, we do see larger numbers of superagers in states like New York, California, Texas, Florida, but that may just be, you know, a numberous game because you have larger population, and so you have more people who are likely to reach super-ager status.

I know that you're still recruiting participants. I mean, you want to get up to 10,000. Who is eligible and how can folks participate if they want to? Yeah, we're actively recruiting individuals who are age 95 and older. So people like Sally, the super-aagers themselves, as well as their children and the spouses of their children. And the spouses of the children are just as necessary for this research because we can't learn anything about super-agers or what contributes to longevity without understanding the general population, right, and the general aging trends.

And that's where the spouses of the offspring who may not have longevity in their family will be very important for our research. Anyone who's interested can go to our study website, which is superagers study.org. Study participation can be done entirely remotely online. There's a video that explains what the study is about. And then there are online questionnaires that ask about wants health, once medical history, lifestyle. and then we mail a kit to the individual's home, which is a plastic tube for saliva collection.

And we only ask for two millimeters of saliva that then gets shipped back to us. And then we use that saliva to isolate DNA that we will study for the identification of genes that contribute to longevity. For those people who cannot participate online using our website, which is HIPAA protected, So we take very seriously the protection of everyone's personal health information. But if someone is unable to, doesn't want to participate online, then they can get in touch with us. Our phone number is on the website, email address, and we can mail them the questionnaires by mail. They can complete them, send them back to us, and then they'll get their saliva kit in the mail. And as a thank you from the study, what we will do is share the participants' ancestral information with them.

if they'd like it. And, Sal, any advice for listeners are hoping to live a longer and healthier life? I mean, we've seen research about depression and the need for happiness and interaction with other people. What do you say to people who are looking for advice? Well, I got a lot to say. I had neglected to say that I happen to be very lucky because I have a very large family. And I have three kids and nine grandchildren. Many live around in my area in New York. So they come over.

We have locks and bagel. We have pizza. Another very important part of our relationship is we play Rummy Q, which is a wonderful game for anyone to play. And especially at my age, I got the big numbers instead of the small numbers. So it's easy. and the kids love it and we're very competitive. You have to keep yourself busy.

I happen to love series on television and I love the movies. I don't go to the movies too often anymore. I actually did go to the theater yesterday. Another thing is I'm very lucky because I can eat everything. I don't binge, but I love bread and butter if you ask me what my favorite food is, is bread and butter and mashed potatoes with gravy. So the hook of my favorites. You eat what you want to is basically what you're saying. But every night, I have a couple of candy kisses. Maybe that's the secret to longevity, Sally. Chocolate, yes. Sally Frolic, a 95-year-old resident

and study participant of the study being conducted by Dr. Sophia Millman, Director of Human Longevity studies at Albert Einstein College of Medicine based in New York. Thank you both for taking time to be with us today. Thank you. And thank you. One more thing before we wrap, we need you for just a couple of minutes. See, we're surveying our listeners to our radio show on our podcast, folks who attend live or virtual events, who follow us on social media, who are dedicated to our book club. We want to hear from all of you. So go to sciencefriety.com slash survey. It's your chance to help write the next chapter of Science Friday. That's ScienceFriiday.com slash survey. That's all the time we have for today. Lots of folks help make this show happen, including

Dee Petersmith, Felice Amherst, Emma Gomez, Jackie Hirschfeld. Tomorrow, using massive astronomy to look for tiny quantum physics effects. I'm SciFRI producer Shoshana Bucksbow. Thanks for listening. Catch you next time.