Despite Alzheimer’s plaques, some seniors remain mentally sharp

SAN DIEGO — A small number of people maintain razor-sharp memories into their 90s, despite having brains chock-full of the plaques and tangles linked to Alzheimer’s disease. Researchers suspect that these people’s brains are somehow impervious to the usual devastation thought to be caused by those plaques and tangles.

Researchers studied the brains of people 90 years old or older who had excellent memories, performing as well as people in their 50s and 60s on some tests. Postmortem brain tissue from eight such people revealed a range of Alzheimer’s features. Two participants had remarkably clean brains with few signs of amyloid-beta plaques and tangles of tau protein. Four participants had middling levels.

Surprisingly, the other two samples were packed with plaques and tangles, enough to qualify those people for an Alzheimer’s diagnosis based on their brains. “These people, for all practical purposes, should be demented,” study coauthor Changiz Geula of Northwestern University’s medical school said November 15 in a news briefing at the annual meeting of the Society for Neuroscience.

Further tests revealed that even in the midst of these Alzheimer’s hallmarks, nerve cells survived in people with strong memories. Those people had more healthy-looking nerve cells than people with dementia and similar plaque and tangle levels. The researchers don’t know how these mentally sharp people avoid the ravages thought to be caused by plaques and tangles. “What’s surprising is this segment of people does exist,” Geula says. “We have to find out why.”

Memory mystery

A small study reveals a wide range in brain signatures linked to Alzheimer’s disease. Despite having a superior memory, an elderly person had large quantities of plaques and tangles (left). Another person had moderate levels (middle), and another senior had almost none (right).