Thinking Positively About Getting Older May Shape How You Age, Yale Study Finds

(Credit: PeopleImages on Shutterstock)

Researchers followed thousands of older people up to 12 years old and almost half improved their situation..

Most Americans expect their minds and bodies to slowly break down as they age. This is also the case for most of their doctors. A Yale University study indicates that expectations aren’t just wrong for many older adults. Turns out that may be part of what makes it come true.

Researchers found that nearly half of adults 65 and older had measurable improvement in brain function, physical mobility, or both between their first and final assessment over a follow-up period of up to 12 years. People who had more positive beliefs about aging were significantly more likely to be in this improving group. This was true even for people who were already healthy and functioning well to begin with. A sunnier outlook on aging has been shown to predict genuinely better health in the future.

The study, published in Geriatricsgoes against what most people and most medical professionals believe. A global survey cited in the paper found that 65% of health care providers and 80% of lay people incorrectly believed that all older people develop dementia. Another US survey found that 77% of Americans aged 40 and over expect their own cognition to decline. Given all of this, the Yale findings are something of a wake-up call: They raise the pointed question of whether expectations about aging might influence the very outcomes people experience later in life.

When beliefs about aging become part of the skin

Lead author Becca R. Levy, a professor in the Yale School’s Department of Public Health and Psychology, has spent her career demonstrating that cultural attitudes toward aging are not abstract; they have real and measurable effects on health. Its framework, Stereotype Embodiment Theory, argues that people absorb beliefs about aging early in life, through media, family, and the attitudes of the institutions around them. When these beliefs are mostly negative, they tend to become self-reinforcing once a person gets older. When they are positive, the body seems to react in the same way.

Levy and co-author Martin D. Slade of the Yale School of Medicine used data from the Health and Retirement Study, a nationally representative survey of Americans aged 50 and older, supported by the National Institute on Aging and conducted by the University of Michigan. Participants’ attitudes toward aging were measured using a five-item questionnaire, such as whether they felt increasingly worthless as they got older, or whether they felt as satisfied later in life as they had in their youth.

Cognitive health was tracked using a validated 27-item telephone test covering memory, recall, and basic mathematics; the kind of mental tasks that reflect how a person actually functions on a daily basis. Physical health was measured by walking speed, timed over approximately eight feet. This may seem trivial, but walking pace is widely used in geriatric medicine as an indicator of hospitalization, disability and death. Some clinicians call it the “sixth vital sign.”

Study on positive age beliefs followed two groups of adults up to age 12

Two separate groups were followed for a maximum of 12 years. The cognitive group included 11,314 participants with a mean baseline age of approximately 68 years. The walking speed group included 4,638 participants with a mean starting age of approximately 74 years. Both groups were a little more than half female, mostly married, and the majority had at least a high school diploma.

Of those with data on both outcomes, 45.15% showed improvement in cognitive function, walking speed, or both at the end of the follow-up period. About 32% improved their cognition and 28% improved their walking speed: both figures well above the federal government’s benchmark of 11.5% for what counts as a significant share of seniors showing improvement.

Positive age beliefs predicted gains in both areas, even after researchers controlled for age, gender, race, education, depression, sleep problems, heart disease, diabetes, social isolation and a genetic marker linked to Alzheimer’s risk.

A natural setback to such findings is that people might simply be recovering from previous poor health: returning to their baseline level rather than truly gaining ground. The research team tested this. When the analysis was limited to participants who were already healthy to begin with, those with more positive age beliefs were even more likely to improve. Gains above initial values, among people who had no deficit to recover, were always predicted by attitude alone.

Something else emerged when the researchers looked at the data in a different way. When all participants’ scores were averaged (which is the case in most aging research), the familiar story of decline emerged. Cognitive scores dropped and walking speed slowed. Once individual trajectories were examined and improvements actively sought, a very different picture emerged.

A possible reason why attitude could shape biology

Previous work from Levy’s group offers a plausible explanation. Negative beliefs about aging have been linked to biological markers associated with Alzheimer’s disease, including the accumulation of plaques and tangles in the brain, as well as a reduction in the volume of the hippocampus, the most central region of memory. If a pessimistic view of aging can leave a physical mark on brain tissue, it is reasonable to think that a more optimistic view could have the opposite effect, although this study was not designed to test this directly.

Previous research by the same team also found that older adults who participated in a positive age belief intervention continued to improve physically over the following two months, with better mobility appearing to fuel more optimistic attitudes, which in turn appeared to support further gains. It remains an open question whether this feedback loop manifests itself significantly over years and decades, but a 12-year study showing consistent improvement in people with positive age beliefs is at least consistent with this idea.

About 66% of participants who improved did so in just one area: either cognition or walking speed, not both. This goes against the common assumption that mental and physical decline in older people always progress hand in hand. In these data, this is often not the case.

Across the entire U.S. population, the authors estimate that more than 26 million older Americans could currently experience measurable improvement. As nearly half of older adults improve rather than deteriorate between their first and final assessments, the long-held assumption that aging means inevitable decline begins to seem less like a biological fact and more like a story in need of revision.

Disclaimer: This article is based on an observational study and does not establish that positive thinking directly leads to improvements in cognitive or physical health. Individual health outcomes later in life are influenced by a wide range of genetic, medical and lifestyle factors. Readers should consult a qualified healthcare professional with any concerns regarding cognitive or physical health.