On the day before her 111th birthday in late July, Edith Renfrow Smith wasn’t sitting still. She was busy teaching a young visitor how to bake a cherry-raspberry pie.
It was more than recalling a familiar recipe; it was a hands-on lesson — warm, precise and delivered with the easy authority of a woman who has spent more than a century turning grit into grace.
Smith, the first Black woman to graduate from Grinnell College, is one of Chicago’s oldest residents, and her days are busy with cooking, reading and dispensing practical wisdom.
“The word ‘can’t’ is not in my vocabulary,” she said.
This story appeared in Medicine on the Midway magazine. Read the Fall 2025 issue here.
As a participant in the University of Chicago’s SuperAging Research Initiative — an international, multicenter study designed to better understand the factors tied to longevity — Smith and her vibrant life offer more than inspiration. Her history, habits and health give clues to answering big questions that could unlock a brighter future for more older adults.
Among them: Why do some people maintain memory, independence and psychological well-being in their 80s, 90s and beyond? In what ways do genetic, biological and lifestyle factors shape health? Which simple changes — a slightly faster walking pace, for instance, or staying socially connected — benefit independence? And how can healthcare systems better support older adults beyond a clinical setting?
Some answers come from brain scans and blood biomarkers; others from microscopes or wearable sensors. The work, part of a broad and collaborative effort across multiple universities, has a shared purpose.
“We want to increase awareness and the scientific probability of positive trajectories of aging for all,” said SuperAging researcher Emily Rogalski, PhD, the Rosalind Franklin Professor of Neurology at UChicago.
‘For life and beyond’
Early in her career, Rogalski established a clinical definition for a demographic known as “SuperAgers”: people over 80 whose memory still functions at least as well as that of someone in their 50s or 60s.
“We have so much to learn from these remarkable people who are staying mentally sharp, learning new things and enjoying life in defiance of society’s expectations,” Rogalski said.
Rogalski heads up UChicago’s Healthy Aging & Alzheimer’s Research Care (HAARC) Center, a newly established research hub where neuroscientists, geneticists, clinical neurologists, psychiatrists, neuropathologists, radiologists, data scientists, immunologists and more are studying the many factors tied to cognitive resilience and preservation.
The center’s core approach flips a common script: Rather than only cataloging decline, the team studies what’s going right in the lives of healthy, high-functioning individuals.
To that end, participants in the SuperAging Research Initiative share medical and family histories, complete detailed memory testing, undergo brain scans and contribute blood samples so scientists can look for genetic and other biomarkers. Wearable sensors add a window into aspects of daily life such as sleep, activity and even patterns of social interaction.
Beyond collecting people’s physical data, UChicago clinicians are examining the role of lifestyle, personal history and resilience. Consider Smith, who is the granddaughter of slaves and grew up without a refrigerator. A dedicated schoolteacher, she volunteered at the Art Institute of Chicago and Goodwill well until her 90s.
Today, as an independent resident in a senior living community, she still hosts guests in her apartment and remains an active member of her church.
“You’ve got to do something,” Smith said. “That’s why the Lord sent you here.”
The initiative conducts testing over time. As Rogalski puts it, enrollment is “for life and beyond,” with many South Side and UChicago Medicine patients eager to participate in positive research focused on a diverse population.
“People’s faces light up when we ask questions about what’s helping people live long and live well, and they get to tell us about a friend, neighbor or relative who fits that positive description,” Rogalski said.
Some have even consented to donate their brains after death, allowing Rogalski’s team to study how years of cognitive testing and real-world data collection correlate with cell types, circuitry and the presence or absence of disease hallmarks.
Smith, the initiative’s oldest participant, is already on board as a donor. “If somebody can look at my brain and get some information that will help other people like me, then I absolutely want them to do that,” she said.
Reclaiming sensory declines
Much of the research is focused on spotting — and slowing — the signs of old age. After all, loss of vision, hearing and other senses can have far-reaching consequences on quality of life. Up to 94% of U.S. adults experience some sensory dulling as they grow older, according to a nationwide data analysis by NORC at the University of Chicago.
Jayant Pinto, MD, a Professor of Surgery and Medicine, argues these changes are not mere inconveniences.
“When your senses decline, you can’t experience the world as well,” said Pinto, who is an expert in olfactory dysfunction. “You can’t hear friends at the dinner table or read the menu or enjoy the flavor of food. It makes all your cognitive burdens a little harder, and that probably wears you down over time and causes mental health problems.”
In a study published in June 2024 in the Journal of the American Geriatrics Society, Pinto and colleagues analyzed sensory function and self-reported mental health in nearly 4,000 older adults over a decade. People with multiple impairments reported more loneliness and lower overall mental health; those with three or more sensory disabilities were likelier to experience frequent depressive episodes.
When the impairments and their associated effects were examined separately, vision loss showed the strongest association with loneliness and poor self-rated mental health. Co-author Alexander Wang, currently a fourth-year student at the Pritzker School of Medicine, noted that hearing and vision disabilities can carry heavy social stigma, which may amplify distress.
The solutions, Pinto said, start with acceptance and access: hearing aids and other assistive devices (which may also support cognitive health), cataract surgery and other vision interventions, and even smell training and treatments that reduce sinus inflammation for certain types of olfactory loss.
“In many cases, we can mitigate sensory difficulties in ways that might actually improve people’s lives, mental health and sense of loneliness — which is a huge epidemic,” Pinto said. “These are simple ways we can intervene to help people and potentially have a huge impact on society.”
Small steps fight frailty
For many older adults, the onset of frailty manifests in the basic parts of daily life, such as difficulty getting up from their favorite chair or struggling to keep up with grandchildren. And because frailty — a condition marked by muscle weakness, slowness and exhaustion — is closely linked to physical function, walking is one of the easiest, most impactful areas to target.
Daniel Rubin, MS, MD, Associate Professor of Anesthesia and Critical Care, in July published research in PLOS One focused on a metric people can feel underfoot: cadence, or steps per minute.
A structured walking program for older adults who were frail or at risk of becoming frail revealed that those who increased their cadence by about 14 steps per minute above their usual pace — about 100 steps per minute in most cases — improved their ability to walk longer distances in standardized tests.
“People who haven’t experienced frailty can’t imagine how big a difference it makes to be able to not get tired going to the grocery store or not need to sit down while they’re out,” said Rubin, who in 2022 received prestigious Grants for Early Medical/ Surgical Specialists’ Transition to Aging Research (GEMSSTAR) funding from the National Institute on Aging.
“Even casual walking had positive effects on our study participants.”
To study the findings outside a lab, Rubin’s team developed a smartphone app that counts steps with research-grade accuracy. Although the tool is still in testing, the approach doesn’t require specialized gear: Anyone can count their steps for a minute to determine their usual pace, then experiment with a small increase. A metronome app can help keep a steady, elevated rhythm to guide their pace.
The point, Rubin said, isn’t increasing walking cadence for its own sake. Preserving stamina that allows people to visit friends, enjoy hobbies and manage everyday tasks is the goal.
Earlier detection of Parkinson’s
Observance and action are common threads across aging research. And they’re critical in Parkinson’s disease, where slowness, tremor and rigidity often define the public image but the earliest hints may be quieter — such as constipation, loss of smell, acting out dreams during sleep or mood changes.
Those clues can emerge years before classic motor symptoms do, said Tao Xie, MD, PhD, Professor of Neurology and Director of UChicago Medicine’s Parkinson’s Disease and Movement Disorder Clinic.
“We want to pay especially close attention to the prodromal patient population, those exhibiting very early symptoms possibly leading to Parkinson’s disease, because studying this group well might help us modify the disease in the future by slowing progression or even achieving prevention,” Xie said.
In a large electronic health record study published in 2021, Xie and his team found that Black patients were diagnosed about four years later than white patients and were less likely to be on Parkinson’s medication, despite receiving more of their care in an emergency department setting.
The implication, Xie said, is practical and urgent: “If we’re seeing someone four years later than we should have, that’s four years we could otherwise have helped.”
Nationally, Xie co-leads a National Institutes of Health-funded, multisite study examining the gut-brain axis in Parkinson’s disease. He and other researchers hypothesize that environmental exposures and aging can drive changes in the microbiome and lead to gut inflammation, seeding misfolded proteins that migrate to the brain.
The UChicago arm of the study pairs clinical assessments with stool samples for metabolomics and microbial signatures, and even skin biopsies to detect pathology markers to build a layered picture across diagnosed patients, prodromal individuals and healthy controls.
Medications and, for select patients, deep brain stimulation can remain key to improving motor symptoms. But Xie emphasizes the value of nonpharmacologic elements such as physical, occupational and speech therapy. At UChicago Medicine, social workers are on call next door to the clinic to connect families with community resources in a timely manner.
“Diagnosis and medication are just part of a larger picture,” Xie said. “People need systemic support — not just medical, but social and financial systems as well.”
Age-friendly infrastructure
Biomedical aging research, though valuable, is limited if care sites and clinical training aren’t attuned to how older adults actually live.
That notion drives Katherine Thompson, MD, and Megan Huisingh-Scheetz, MD, MPH, UChicago Medicine geriatricians who have spent more than a decade building programs that start with function, goals and context.
Thompson, a Professor of Medicine, cites the Institute for Healthcare Improvement’s Age-Friendly Health Systems framework that encompasses the four M’s — mobility, medications, mentation (cognitive and behavioral health) and what matters to the person — as a practical blueprint for hospitals and clinics.
The framework, she said, focuses on the whole patient rather than just their chronic conditions. “What’s important for you, and then how do we shape your care around that?”
As director of the Supporting Healthy Aging Resources & Education (SHARE) Network, Illinois’ federally funded Geriatrics Workforce Enhancement Program, Thompson manages a team dedicated to helping upskill the existing healthcare workforce to better integrate age-friendly practices in the exam room and at the bedside.
Their work includes training primary care physicians using online case-based sessions; hosting hands-on workshops for nursing home teams; and moderating community health talks on the South Side.
Inside UChicago Medicine, Thompson and Huisingh-Scheetz co-direct the Supporting Age-Friendly Evaluation and Care (SAFE) Clinic, a standardized consult pathway for older adults — especially individuals preparing for major surgery, chemotherapy or transplant.
Every patient receives the same core assessment: cognition and delirium risk; gait, balance and falls; medication safety; nutrition; social supports; and what success looks like to them.
“Our job is to maximize quality of life and independence for each patient as long as long as possible, whether that means preventing or slowing decline or trying to salvage or augment key areas of loss,” said Huisingh-Sheetz, an Associate Professor of Medicine.
That’s why she and her research collaborators have begun to deploy wearable sensors and advanced digital analytics to detect patterns in patients’ movement and rest that can reveal small declines before they escalate. A separate project delivers exercise and social-engagement programming via a custom app on voice-assistant devices.
Both projects are tailored to recruit people who are often left out of research: those who meet criteria for frailty and overlapping conditions.
“The people who have the most need for interventions are unfortunately the least likely to be in our trials,” Huisingh-Scheetz said. “Early assessments, frequent monitoring and early intervention to preserve independence as much as possible – that’s the name of the game.”
A winning combination
Aging well, researchers know, isn’t a single breakthrough. It’s a series of choices that compound: scientists who study resilience instead of resignation; clinicians who standardize assessments that catch problems early; families who nudge a walking pace, schedule a hearing check or learn a new way to keep a conversation going.
It’s also a policy decision to prioritize independence-preserving care, even when it doesn’t involve pharmaceutical treatments. The ongoing work at UChicago aims to help older adults make important choices sooner — and in ways that are easier and more equitable.
“Finding a cure for a given aging-associated condition isn’t the only way we can help people,” Rogalski said. “Maximizing independence, emotional well-being and confidence — if we can ramp those up while we’re still simultaneously looking for pharmacological solutions, that’s a winning combination.”
Smith is a prime example. Speaking to a Chicago Sun-Times reporter at her birthday party, she offered her own prescription: “Every day that God gives you, use it,” she said. “You can do what you like, because someone has said, ‘Oh hey. Try it. Try it and see.’ You don’t know unless you try. Don’t let anybody tell you, ‘I can’t.’ You say, ‘I’ll try.’
“That’s the difference between living and not living.”
The SuperAging Research Initiative is supported in part by the National Institute on Aging (U19AG073153) and the McKnight Brain Research Foundation.
