What Makes ‘SuperAgers’ Stay Healthy For So Long?

IRA FLATOW: This is Science Friday. I’m Ira Flatow. My mother was what is called a SuperAger. She lived almost to a hundred years of age and was one of the lucky few who lived past their 95th birthdays while staying cognitively sharp and free of major health complications.

Researchers are working to figure out some of the genetic factors behind these SuperAgers’ longevity and how that might help the rest of us live longer and healthier lives. Joining me now is a researcher leading an ambitious project with the goal of studying 10,000 SuperAgers and also one of the study’s participants.

Dr. Sofiya Milman, Director of Human Longevity Studies at Albert Einstein College of Medicine based in New York, welcome to Science Friday.

SOFIYA MILMAN: Glad to be here.

IRA FLATOW: Nice to have you. And Sally Froelich, a 95-year-old New York resident and study participant, welcome to Science Friday.

SALLY FROELICH: Thank you. Welcome.

IRA FLATOW: Nice to have you. Dr. Milman, let’s start with the basics. How do you define someone who is a SuperAger?

SOFIYA MILMAN: We define SuperAgers as individuals who are age 95 and have a generally intact cognitive function. So that typically means they either live independently or really require minimal assistance to do their daily activities.

IRA FLATOW: And you’re studying 10,000 SuperAgers?

SOFIYA MILMAN: That’s our goal, to reach 10,000.

IRA FLATOW: And what is the goal of the study, then?

SOFIYA MILMAN: The ultimate goal is to understand what is contributing to healthy longevity in these individuals because, as we well know, unfortunately, aging is often plagued by multiple diseases and disability. And here we have an opportunity to study people who are really unique, or you may even call them outliers, in our society who are not only living very long lives, but also healthy lives. And so we want to understand what it is about them, what’s their secret to not only their longevity, but to their healthy longevity.

IRA FLATOW: Sally, how does it feel to be called an outlier?

SALLY FROELICH: Well, I have to tell you, that’s a name I’ve never heard, outlier. Anyway, I knock wood all the time, which I’m knocking right now. I’m lucky. And never in a million years did I think was going to live this long. I go day by day.

IRA FLATOW: Right. And what made you decide to be part of this study?

SALLY FROELICH: Curiosity. [LAUGHS] And why not? They asked me, and I had the time and the interest, so.

IRA FLATOW: Yeah. And what do you have to do to be part of this study? What’s the experience like?

SALLY FROELICH: Well, at first, I just thought I had to fill out a few questionnaires. But then there became more and more and more. And quite frankly, I found it interesting because it made me think back on things that I do. And not that I don’t remember them; I do, but I don’t think about it. So it made me think about it. So it’s been a really interesting experience. And plus I meet you all, which is nice.

IRA FLATOW: What are some of the questions you may have had a difficulty answering on the study?

SALLY FROELICH: How many blocks I can walk without getting tired. Pretty much that’s the question I found difficult because I don’t know how many blocks. It depends on the day, the weather, and my body.

IRA FLATOW: Yeah. Yeah. Dr. Milman, for people who live past 95, how much is it genetics versus behavioral or environmental factors? You know, that old question.

SOFIYA MILMAN: Yeah, the nature versus nurture, right? So we believe that environment does contribute, but to a point. It is definitely advisable for people to exercise, to get enough sleep, avoid stress, avoid excess alcohol use and tobacco. But what we’re finding is that lifestyle alone is not sufficient to get people to 95 or 100 in good health.

It seems that there’s something else that’s contributing to this healthy longevity, and we believe this is where the genes come in. And the reason we think that there’s significant contribution from genes to healthy longevity is because longevity tends to run in families. So the parents of these SuperAgers often have been SuperAgers themselves. And their children, their offspring, also tend to be healthier as they age.

IRA FLATOW: Are there certain diseases that stand out to you that the SuperAgers seem to be protected against?

SOFIYA MILMAN: I’d say most diseases. They delay the onset of most diseases that we associate with aging, including cancer, Alzheimer’s disease, heart disease, diabetes. They often don’t get it at all. Or if they do, they get it 20 to 30 years later than the general population.

IRA FLATOW: Now, Sally, you said you think that you’re just lucky. Do you really believe that?

SALLY FROELICH: Absolutely. [LAUGHS] Because when my father died, he was 79, and my mother was 87. I thought they were– I don’t know, they were both old. And I’m old, but I don’t, in my head, think I am.

IRA FLATOW: You know, that’s interesting because that’s what my mother said. She lived to 99-plus years. She never really considered herself to be old. I once found her in the drugstore looking for a birthday card for one of her friends. And she was in an argument with the druggist about the birthday cards because she was astounded that he didn’t have anything for a woman who was 102.

SALLY FROELICH: [LAUGHS] Today, maybe they will do that.

[LAUGHTER]

IRA FLATOW: Dr. Milman, are there specific genetic variations that SuperAgers have in common, things that protect them against cognitive decline?

SOFIYA MILMAN: So there have been several genes that have been identified that confer protection for centenarians. There are genes that contribute to higher levels of good cholesterol or the HDL, high density lipoprotein cholesterol. And then there are genes that actually reduce the signaling through the growth hormone pathway.

So the growth hormone pathway, as the name suggests, is important for growth, and it goes up in kids so that they can get taller, but the levels actually go down as we age. But what has been shown in SuperAgers is that they have rare genetic variations that actually reduce their growth hormone or the signaling through their growth hormone axis. And that may be protective for people as they age and get older.

IRA FLATOW: I know there are medications that lower growth hormone levels for people who produce excess amounts. Would the treatment be possibly taking those medications?

SOFIYA MILMAN: So that’s certainly a possibility that we’re interested in exploring. There was a study a number of years ago by a colleague of mine that actually gave a medication that is not currently FDA approved, but it lowered IGF-1 levels in mice and has shown that if you administer this anti IGF-1 monoclonal antibody to middle-aged mice, they will actually live longer. And so that inspired us to take some of the FDA approved medications, or something that is similar to that, and study that for healthy aging and longevity. And we’re launching a study now to study a drug that will lower growth hormone levels as a potential therapeutic for Alzheimer’s disease.

IRA FLATOW: OK, I know this is still very early research, but let’s say you’re able to figure out a genetic variation that would increase longevity. How would you know when someone should start taking that medication? Would it be based on risk factors for dementia or Alzheimer’s or how old you were?

SOFIYA MILMAN: Yeah, this is a very active area of research– when is the right time to start an intervention? And right now, what most experts believe is the right time will be when that individual is found to be at increased risk. The key is to start it early enough before disease onset, because once the disease onsets, it may be too late to intervene, but maybe not too prematurely.

So what is that sweet spot, where someone is shown to be at risk. And maybe they already have some early signs of disease, but they’re not really impacted by disease yet. And maybe that’s the right time. People are also studying biomarkers or certain proteins or metabolites that we can measure in the blood that can be markers of future disease. And all that information together hopefully will help us understand who is at risk at what time point so we can initiate these preventative treatments.

IRA FLATOW: Any idea, any links, any ideas of why SuperAgers are so free from cognitive disorders like Alzheimer’s and other brain disorders?

SOFIYA MILMAN: So this is an area of intense investigation. And it’s very possible that it’s the same factors that protect them from heart disease, that protect them from cancer, that protect them from diabetes, that are also protecting them from cognitive decline and Alzheimer’s disease. Aging is really a systemic process, and it impacts all organ systems and contributes to all diseases. And if we think about it– we sometimes don’t stop and think about it, but young people don’t get heart disease, cancer, Alzheimer’s disease at the same rates as older people do.

And so there’s something about aging, or as our body ages, that it becomes more predisposed to all of these conditions at once. And so the risk factors that are driving all of these diseases may actually be common and be driven by aging itself. And so if we can target those common risk factors that contribute to aging, we think that we can impact all the diseases at once. And I think that’s what we’re seeing in SuperAgers. It’s not just one disease; it’s all diseases that are being delayed.

IRA FLATOW: This all sounds wonderful, but how can this research help those of us who won’t live past 95?

SOFIYA MILMAN: So we will identify these genes that contribute to longevity and healthy aging. But then what? Because what we’re hoping to do with that information is then to create medications or drugs that will mimic the function of these protective genes and will allow the rest of individuals who were not so lucky to inherit these genes to live longer and healthier lives, too.

IRA FLATOW: This is Science Friday from WNYC Studios. If you’re just joining us, we’re talking with Dr. Sofiya Milman and Sally Froelich about the science of SuperAgers, those lucky few who live to age 95 and beyond.

Are there places in the world where there are more SuperAgers than others?

SOFIYA MILMAN: So I think the popular press has recently brought attention to some of these blue zones, these areas where there are concentrations of SuperAgers. So these may be some geographic areas across the United States. We do see larger numbers of SuperAgers in states like New York, California, Texas, Florida, but that may just be a numbers game because you have larger population, and so you have more people who are likely to reach SuperAger status.

IRA FLATOW: I know that you’re still recruiting participants. I mean, you want to get up to 10,000. Who is eligible, and how can folks participate if they want to?

SOFIYA MILMAN: Yeah, we’re actively recruiting individuals who are age 95 and older, so people like Sally, the SuperAgers themselves, as well as their children and the spouses of their children. And the spouses of the children are just as necessary for this research because we can’t learn anything about SuperAgers or what contributes to longevity without understanding the general population and the general aging trends. And that’s where the spouses of the offspring, who may not have longevity in their family, will be very important for our research.

Anyone who is interested can go to our study website, which is superagersstudy.org. Study participation can be done entirely remotely online. There’s a video that explains what the study is about, and then there are online questionnaires that ask about one’s health, one’s medical history, lifestyle. And then we mail a kit to the individual’s home, which is a plastic tube for saliva collection. And we only ask for 2 milliliters of saliva that then gets shipped back to us. And then we use that saliva to isolate DNA that we will study for the identification of genes that contribute to longevity.

For those people who cannot participate online using our website– which is HIPAA protected, so we take very seriously the protection of everyone’s personal health information. But if someone is unable to– doesn’t want to participate online, then they can get in touch with us. Our phone number is on the website, email address, and we can mail them the questionnaires by mail. They can complete them, send them back to us, and then they’ll get their saliva kit in the mail. And as a thank-you from the study, what we will do is share the participant’s ancestry information with them if they’d like it.

IRA FLATOW: And Sally, any advice for listeners who are hoping to live a longer and healthier life? I mean, we’ve seen research about depression and the need for happiness and interaction with other people. What do you say to people who are looking for advice?

SALLY FROELICH: Well, I got a lot to say. [LAUGHS] I neglected to say that I happen to be very lucky because I have a very large family. And I have three kids and nine grandchildren. They live around in my area in New York. So they come over, we have lox and bagel, we have pizza.

Another very important part of our relationship is we play Rummikub, which is a wonderful game for anyone to play and especially at my age. I got the big numbers instead of the small numbers, so it’s easy and the kids love it. And we’re very competitive. You have to keep yourself busy. I happen to love series on television, and I love the movies. I don’t go to the movies too often anymore. I actually did go to the theater yesterday.

Another thing is I’m very lucky because I can eat everything. And I don’t binge, but I love bread and butter. If you ask me what my favorite food is, it’s bread and butter and mashed potatoes with gravy. So those are my favorites.

[LAUGHTER]

IRA FLATOW: You eat what you want to, is basically what you’re saying.

SALLY FROELICH: But every night, I have a couple of candy kisses.

SOFIYA MILMAN: Maybe that’s the secret to longevity, Sally.

IRA FLATOW: Chocolate, yes. Sally Froelich, 95-year-old resident and study participant of the study being conducted by Dr. Sofiya Milman, director of Human Longevity Studies at Albert Einstein College of Medicine based in New York, thank you both for taking time to be with us today.

SOFIYA MILMAN: Thank you.

SALLY FROELICH: And Thank you.

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