Biology plays a role in maintaining physical and mental acuity into your 90s, but it’s not the whole story
Some people reach 90 with the memory of someone 40 years younger, and researchers are trying to figure out how.
They’re finding that a meaningful piece of the puzzle may come from the daily choices people make. And it turns out some of those choices may be within reach for all of us.
“In the early 1900s, one trajectory of aging was thought to be: grow old, become senile, and die — a grim way of looking at aging,” says Emily Rogalski, PhD, a neurology professor at the University of Chicago and lead researcher of the international SuperAging Research Initiative.
Since then, science has distinguished between dementia and the normal cognitive changes of aging.
SuperAgers show little cognitive decline, performing as well on memory tests as people decades younger.
Lawrence Seiger of Crown Point, Indiana, is one of them. At 94, he’s beaten melanoma three times and manages macular degeneration. The former aircraft carrier pilot and life insurance salesman walks two miles a day; meditates; does crossword puzzles and sudoku; and, most evenings, enjoys a glass of wine with his wife, Nancy.
“Everywhere I look, life has been good for me,” he says.
Researchers don’t know how many SuperAgers live in the United States because no universally accepted definition exists. Studies at the University of Chicago and Northwestern include only a few hundred participants, but researchers believe SuperAgers are rare.
Researchers at both institutions define SuperAging as people aged 80 and older whose memory performs as well as that of adults in their 50s and 60s.
“You’ll hear people talk about ‘I’d love for you to meet my grandma, uncle, or neighbor. They’re sharp as a tack,’” Rogalski says. “SuperAging is not common when defined by our research criteria, but most people can think of someone in their family or community who seems unusually sharp in later life, like Chicago native and former Secretary of State Jesse White.”
Most people say they want this version of aging — not just a longer life, but a more vital one. The alternative comes at a steep financial cost. Dementia costs the U.S. an estimated $781 billion a year, according to a 2025 analysis led by the University of Southern California. The figure accounts for medical care, unpaid caregiving, and lost income; researchers expect it to climb as the population ages.
There’s no magic elixir for staying mentally sharp. Biology plays a role, but lifestyle choices may too.
Tamar Gefen, PhD, leads the SuperAging Program at Northwestern’s Mesulam Institute for Cognitive Neurology and Alzheimer’s Disease. She says several biological factors stand out in their memory preservation research.
First, SuperAger brains carry less age-related damage. They show far fewer of the tangles associated with Alzheimer’s than their same-age peers.
They also have a strikingly younger inflammatory profile, based on blood markers of inflammation, suggesting that the immune system plays a role in what distinguishes a SuperAger’s brain from a typical aging brain.
SuperAgers also have unusually high concentrations of rare Von Economo neurons, which are involved in attention and social behavior. They even have more of these neurons than adults decades younger.
According to Rogalski, SuperAgers also retain thickness in the brain region tied to attention, a region that tends to thin as we age. Because attention supports memory, the retained thickness may help explain memory preservation.
Yet, SuperAging isn’t simply the inverse of Alzheimer’s, she says. Some SuperAgers’ brains do show the plaques and tangles typically associated with Alzheimer’s disease, but they never develop the cognitive impairment that would typically be expected.
“Something else is driving it,” she says. That something else may, in part, be within our control.
The 2024 Lancet Commission identified 14 modifiable factors that are associated with a reduced risk of dementia, including lowering LDL cholesterol and treating obesity. There is no single formula, however, and healthy aging isn’t guaranteed.
Fortunately, addressing many of these factors is free or inexpensive.
Exercise habits among SuperAgers, however, vary widely. Some work around physical limitations with chair yoga or stretching; others ski or bike. The form of activity seems to matter less than staying consistently active.
Michael Lewis, MD, of Bannockburn, illustrates that range. At 84, the former orthopedic surgeon still competes nationally in his age group in tennis singles. He served as team physician for the Chicago White Sox and the Chicago Bulls, winning championship rings during the Bulls’ final two championship seasons.
“I feel insanely blessed,” he says. “While lifestyle factors contribute to being a SuperAger, genetics also plays an essential role. So, much of this being a SuperAger is the luck of the draw. It’s not something you accomplished. It’s being in the right place at the right time genetically.”
Genetics matter, but so do social interactions. In fact, it’s one of the biggest factors. SuperAgers report valuing social connection more than their cognitively average peers. Lewis, for example, has been in a book club for more than 20 years and has led it for the past 10.
“SuperAgers tend to be highly engaged in social activities and their social networks, and in their community,” Gefen says. “They value high-quality friendships.”
Gefen suspects biology and social connection reinforce each other. Lewis credits both good fortune and strong relationships.
“I never dreamed that I would still be at the peak of my powers,” the 84-year-old says, “and that it would be the best time in my life.”
Healthy Aging Habits
While we may not all be SuperAgers, research shows there are steps we can take to support healthy aging — and, as a bonus, most of them won’t break the bank.
• Stay active. You don’t have to run marathons. Walking, yoga, and low-impact activities all help. Just stay consistent.
• Maintain a healthy weight, which also helps reduce the risk of diabetes.
• Don’t smoke. If you do, quit.
• Cut back on alcohol, or don’t drink.
• Keep LDL cholesterol at a healthy level. High levels can increase dementia risk.
• Manage blood pressure. Keep hypertension under control, especially in midlife.
• Protect your hearing, and wear hearing aids if needed.
• Wear glasses or contacts. Seek treatment for vision loss when needed.
• Treat depression. Talking with a therapist and seeing friends and family regularly can help.
• Protect your brain. Wear a helmet during sports and when biking.
And, finally, make social connections a priority, even when your closest friends and family are gone. Mentor someone younger. Find new activities, take a class, or go to a lecture.
Rogalski recalls one 111-year-old study participant who didn’t have any peers left. “She knew how to be adaptable and connect with younger generations to avoid social isolation.”
Originally published in the Fall 2026/Winter 2027 print issue.
Erika Hobbs is an award-winning journalist, newsroom leader, strategist, storyteller, and coach based in Chicago. As an independent journalist, Erika has written about tackling breast cancer, healthcare inequities in people of color, undocumented immigrants in the Chicago suburbs, and the power of yoga in combating the aging process. Read more
