Understanding brain resilience in superagers: a systematic review.
Level 3 - non-randomized controlled study
Systematic review of non-randomized observational/cross-sectional imaging and biomarker studies.
PubMed 32995945 · doi:10.1007/s00234-020-02562-1
What was done
A systematic review of PubMed and ScienceDirect was conducted to identify studies evaluating biomarkers in superagers defined by validated neuropsychological testing. Study quality and risk of bias were assessed using the QUADAS-2 tool.
What was found
Twenty-one studies were analyzed, consisting mainly of neuroimaging investigations alongside histological, genetic, cognitive, and a single plasma analysis. Superagers displayed selective preservation in specific cortical areas—predominantly the anterior cingulate cortex and hippocampus—rather than global preservation. Amyloid deposition did not differ significantly between superagers and typical older controls, while superagers' functional oscillation patterns resembled those of young adults. Most studies had a medium risk of bias. The abstract reports no numerical effect estimates.
Why it matters
This review highlights that superaging is marked by localized structural and functional network resilience rather than broad resistance to age-related amyloid accumulation.
Limits
No quantitative meta-analytic data or effect sizes are provided in the abstract. Most included studies had a medium risk of bias. Only two search databases were utilized, and non-imaging biomarker data (such as blood plasma markers, represented by only one study) remain severely limited.