Superior memory reduces 8-year risk of mild cognitive impairment and dementia but not amyloid β-associated cognitive decline in older adults

Christa Dang*, Karra D. Harrington, Yen Ying Lim, David Ames, Jason Hassenstab, Simon M. Laws, Nawaf Yassi, Martha Hickey, Stephanie R. Rainey-Smith, Joanne Robertson, Christopher C. Rowe, Hamid R. Sohrabi, Olivier Salvado, Michael Weinborn, Victor L. Villemagne, Colin L. Masters, Paul Maruff, The AIBL Research Group

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Objective: To prospectively examine 8-year risk of clinical disease progression to mild cognitive impairment (MCI)/dementia in older adults ≥60 with superior episodic memory (SuperAgers) compared to those cognitively normal for their age (CNFA). Additionally, to determine the extent to which SuperAgers were resilient to the negative effects of elevated amyloid-beta (Aβ+) on cognition. Method: Participants were classified as SuperAgers based on episodic memory performance consistent with younger adults aged 30-44 and no impairment on non-memory tests (n = 179), and were matched with CNFA on age, sex, education, and follow-up time (n = 179). Subdistribution hazard models examined risk of clinical progression to MCI/dementia. Linear mixed models assessed the effect of Aβ on cognition over time. Results: Prevalence of Aβ+ and APOE ϵ4 was equivalent between SuperAgers and CNFA. SuperAgers had 69%-73% reduced risk of clinical progression to MCI/dementia compared to CNFA (HR: 0.27-0.31, 95% CI: 0.11-0.73, p <. 001). Aβ+ was associated with cognitive decline in verbal memory and executive function, regardless of SuperAger/CNFA classification. In the absence of Aβ+, equivalent age-related changes in cognition were observed between SuperAgers and CNFA. Conclusions: SuperAgers displayed resilience against clinical progression to MCI/dementia compared to CNFA despite equivalent risk for Alzheimer's disease (AD); however, SuperAgers had no greater protection from Aβ+ than CNFA. The deleterious effects of Aβ on cognition persist regardless of baseline cognitive ability. Thus, superior cognitive performance does not reflect resistance against the neuropathological processes associated with AD, and the observed resilience for SuperAgers may instead reflect neuropsychological criteria for cognitive impairment.

Original languageEnglish
Article numberacy078
Pages (from-to)585-598
Number of pages14
JournalArchives of Clinical Neuropsychology
Issue number5
Publication statusPublished - 26 Jul 2019


  • Alzheimer's disease
  • Dementia
  • Elderly/geriatrics/aging
  • Mild cognitive impairment


Dive into the research topics of 'Superior memory reduces 8-year risk of mild cognitive impairment and dementia but not amyloid β-associated cognitive decline in older adults'. Together they form a unique fingerprint.

Cite this