Many of us are used to thinking of aging as an almost inevitable process of decline in the abilities of the body and mind. But a new Yale University study, published in the medical journal Geriatrics, presents a much more optimistic picture: many older adults actually improve over the years, and the way they view aging may play a significant role.
The researchers based their work on data collected over more than a decade as part of a large national survey of older adults in the United States. According to the findings, nearly half of people aged 65 and over showed measurable improvement in cognitive function, physical function or both. In other words, functional improvement in older age is far more common than is generally assumed.
“Many people see aging as a process of continuous and inevitable decline in abilities,” explains Prof. Becca R. Levy, the study’s lead researcher and a professor of social and behavioral sciences at Yale School of Public Health. “But we found that improvement in function at older ages is not rare. On the contrary, it is quite common, and it should be part of the way we understand aging.”
Aging and growing stronger at the same time
The research team analyzed data from more than 11,000 participants in the Health and Retirement Study, a long-term survey of older adults in the United States.
To examine changes in cognitive abilities, the researchers used comprehensive cognitive tests. Physical function was assessed using walking speed. Geriatric physicians consider walking speed an important measure of general health because it is linked to the risk of disability, hospitalization and even mortality.
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The researchers followed the participants for up to 12 years. During that period, 45% of them showed improvement in at least one of the two areas examined. About 32% improved cognitively, and 28% improved physically. For many of them, the improvement was also clinically significant. When the researchers also included participants whose cognitive abilities remained stable and did not decline, it emerged that more than half did not experience the cognitive decline many expect in older age.
“What is surprising is that these achievements simply disappear when you look only at the average,” explains Levy, author of the book Breaking the Age Code. “When everyone is averaged together, we see a decline in function. But when each person is examined individually, a completely different story emerges. A significant proportion of the older adults we examined simply improved.”
The way we see aging
The researchers also tried to understand why some older adults showed improvement in physical or cognitive function while others did not. One hypothesis was that the answer was connected to the way participants viewed aging at the start of the study. More specifically, the researchers examined whether the participants saw the aging process in a positive or negative light.
The results supported that hypothesis. Older adults who viewed aging more positively were more likely to show improvement, both in cognitive function and in walking speed. That link remained strong even after the researchers took into account factors such as age, sex, education, chronic illness, depression and the duration of the follow-up period.
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The findings strengthen Prof. Levy’s “stereotype embodiment theory.” According to the theory, stereotypes about age and aging that we absorb from our surroundings, for example through social media or advertising, gradually become personal beliefs over the years, and those beliefs may also affect the body biologically.
Previous studies led by Levy have already found that negative perceptions of aging are linked to weaker memory, slower walking, a higher risk of cardiovascular disease and even biological signs associated with Alzheimer’s disease.
Now, Levy explains, it turns out that the opposite direction may also be possible. “The current study shows that people who adopt more positive perceptions of their age often show improvement in function. The results indicate that, even at an older age, there is often an ability to improve. Since the way people perceive age can be changed, this finding opens a real door to change, both on the personal level and on the social level.”
Shattering the myth
Improvement in function did not appear only among people who began the study with a physical or cognitive limitation. The researchers found that participants who began the study with completely normal function were also able to improve over time. This finding challenges the perception that functional improvement in older age is only recovery from illness or a return to a previous state after a medical crisis.
The study’s authors hope the results will help change the way the public views aging and weaken the belief that functional decline is inevitable. They also believe the findings reinforce the need to invest more in preventive medicine, rehabilitation programs and health services that help older adults make the most of their ability to recover and improve.