Having watched the minds of prior generations dim with age, many of us are resigned to losing our mental faculties in the decades after retirement. While it is true that the majority of people in their 90s have significant levels of cognitive impairment, recent research suggests that this is due to specific diseases and that it is possible to maintain mental health for over a century. Dramatic evidence for the optimistic view is presented by Dr. Gert Holstege in the June issue of Neurobiology of Aging.

Dr. Holstege presents the case of a remarkable woman who at age 82 decided to will her body to scientific researchers. Amazingly, she lived for more than three decades after volunteering. At age 111, she was sufficient engaged with the world to make inquiries as to how she could best help advance medical knowledge. Dr. Holstege recognized the opportunity and gave the volunteer a battery of cognitive tests every year until her death.

The volunteer scored above average for 60 to 75 year olds. Her autonomy was somewhat impaired by failing eyesight, but she was quicker-witted than people half her age. After her death at 115, autopsy showed that she had no structural signs of dementia, such as beta-amyloid neural plaque or atherosclerotic changes. This supports the hypothesis that age-related decline is not an inevitable process but rather a result of the escalating risk for many diseases.

This issue of inevitability was the crux of the October 2000 Neurology Review. This article used the evidence of a 69 subject study conducted by Dr. John Morris. The study found that there was a small but significant portion of elderly subjects who remain free of disease and thus cognitive impairment. This is consistent with the AARP position that while aging does inescapably cause some brain changes, such as a slight decrease in brain mass and thinning of the cortex, there is no reason why the healthy brain has to fall to dementia. This is good news for those who want to take advantage of life-extending medical technology but worry that their brains wouldn’t be able to keep up with their rejuvenated bodies.