Beker N, Sikkes SA, Hulsman M, Tesi N, van der Lee SJ, Scheltens P, Holstege H. Longitudinal Maintenance of Cognitive Health in Centenarians in the 100-plus Study. JAMA Netw Open. 2020 Feb 5;3(2):e200094. PubMed.

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  1. This is an interesting study, as are most studies on centenarians. I suspect that these survivors have some unique genetic resilience factors operating. Lifestyle might be part of it, but I am more inclined to invoke a “polygenic resilience” in these unusual people. I think they are quite rare, and the authors acknowledge that these individuals may not be representative of Dutch centenarians. ApoE4 has likely played itself out before these people reach 100 and is likely not a factor. We have much to learn from them.

    View all comments by Ron Petersen

  2. This study adds to the growing evidence that even though centenarians have reached advanced ages and thus have the largest risk factor for Alzheimer's disease and related dementias, there are a subset of centenarians who are resistant to dementia. These individuals may help us to understand the pathways and mechanisms underlying the ability to avoid Alzheimer's disease and related dementias and maintain good cognitive health until the very end of life. More specifically, they may help us to identify novel protective factors that help to fight off the negative effects of age and risk-increasing genetic variants on cognitive function.

    Although it might be intuitive to say that centenarians who receive a full score on a screening test such as the MMSE would be more likely to maintain good cognitive function, in our centenarian study we see a high prevalence of hearing and vision impairment that may cause errors on cognitive tests that are not necessarily related to cognitive impairment. This cut point of 26 that is associated with maintaining good cognitive function likely reflects the noncognitive contributions to cognitive test performance among centenarians.

    View all comments by Stacy Andersen

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  1. Resilience Redefined: Sharp at Age 100, Still Sharp at 102