Neurology

Successful cognitive aging: What the oldest-old can teach us about resistance and resilience




Over the past century, we have witnessed a remarkable extension of human life expectancy by >27 years. Reflecting this accomplishment, people ≥90 years of age are now the fastest-growing segment of the population in most of the world. Indeed, more than half of all children born today in developed countries are expected to live to 100 years of age or beyond,1 and it is remarkable how little we know about these pioneers of aging. Biomedical research tends to focus on disease and poor outcomes, but the oldest-old individuals who have reached extreme age with preserved cognitive health present an unparalleled opportunity to investigate factors that may promote successful cognitive aging throughout the lifespan, even in the presence of neuropathologic changes associated with cognitive loss and dementia.

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