Results from a new study published in the Open Access journal Geriatrics may be flipping the script on our understanding of ageing. The study, carried out by researchers from Yale University, finds that this natural process is not always associated with a physical and mental ‘decline’ but can bring a positive shift to an individual’s health and well-being.

The researchers assessed the cognitive and physical health of a cohort of adults aged 50 for more than 12 years. They found that a significant proportion of the participants demonstrated improvements in their physical or cognitive health, as well as developing more positive attitudes towards ageing.

These results challenge the current perception and stigma towards ageing, opening a broader discussion, both within medicine and society, on what it means to age.

What does it mean to age?

Scientifically, ageing is a well-defined process, referring to the natural, time-dependent biological and physiological decline of an organism. The scientific term for biological ageing is ‘senescence’, which alludes to the occurrence of ageing on a cellular  level. Upon the commencement of senescence, cells stop dividing but remain metabolically active, releasing inflammatory signals that damage surrounding tissue. This can be a major contributing factor to age-related diseases such as cardiovascular disease, diabetes, and arthritis. This means that over time, many people feel more unwell as they age.

However, in certain individuals, age related disease may be avoidable. According to the World Health Organization, forming healthy habits and creating positive physical and social environments are crucial for nurturing good health throughout life and into old age. It can also reduce the risk of developing non-communicable diseases later in life.

There is a broad variation in how people age which is highly influence by genetics and lifestyle. The Decade of Healthy Ageing 2021-2030 was declared by the United Nations General Assembly in an effort to encourage collaboration between governments and other relevant stakeholders to help foster healthier lives across populations globally.

The current research shows that improvements in health and wellbeing can be made later in life and that getting older does not always equate to deterioration. Prof. Becca Levy, Professor of Epidemiology at Yale School of Public Health and an international expert on psychosocial determinants of ageing health explains:

“Many people equate ageing with an inevitable and continuous loss of physical and cognitive abilities. What we found is that improvement in later life is not rare, it’s common, and it should be included in our understanding of the ageing process.”

Study finds many adults improve with age

The study included the analysis of 11,314 participants between the ages of 50-99 years old, with an average age of 68 years old. They measured the following:

• Attitude towards ageing, measured using the Attitude Toward ageing subscale using the Philadelphia Geriatric Center Morale Scale.
• Cognitive improvement, assessed with a 27-point cognitive test, encompassing short- and long-term memory recall and mathematical skills.
• Physical improvement, measured by walking speed, a global measure of physical function.

The study also included other important independent variables that could typically impact the outcome of the results. These included: race, ethnicity, depressive symptoms, sleep problems, marital status, education status, social isolation, the presence of APOE4 – a genetic variant which is a strong risk-factor for late-onset Alzheimer’s Disease, and reports of previous health issues.

Several sensitivity analyses were carried out to consider these variables. They found that a substantial proportion of adults exhibited improved physical and cognitive function, with around 45% of participants showing improvement in at least two of these components over the span of 12 years.

Specifically, 28% of participants demonstrated improvement in cognition, and 32% improved physically. The attitudes towards ageing, referred to as ‘age beliefs’, demonstrated the internal perceptions of the individual towards . It included beliefs such as “I am happy now as I was when I was younger”, or “the older I get, the more useless I feel”.

Notably, they found that people with a more positive attitude towards ageing showed better cognitive and physical improvements.

Re-evaluating the ageing process

Statistical analysis suggests that over 26 million older adults across the US could be exhibiting substantial improvements to their health and wellbeing as they get older, rather than the decline traditionally attested to growing older.

The authors discuss the importance of positive age beliefs in predicting these improvements of physical and cognitive function. These progressions were not only seen in people who had previously been sick, but also in those who were healthy from the start of the study.

This suggests that there is consistent opportunity for healthy adults across a range of backgrounds to exhibit improvements in their well-being, not only those recovering from sickness.

“Our findings suggest there is often a reserve capacity for improvement in later life and because age beliefs are modifiable, this opens the door to interventions at both the individual and societal level.” – Prof. Becca Levy

The authors discuss how these results could challenge the way ageing is currently evaluated in research.

With certain age-related diseases assessed using specific biomarkers, the results of this study questions whether alternate biomarkers could be used to assess the recovery and improvements made in potentially millions of older adults worldwide.

Furthermore, it provokes further questions on how an ageist society understands and perceives ageing, and how there needs to be more room to re-evaluate this natural process.

Current perceptions lean towards the belief of an inevitable, morbid decline with no room for improvement. This new research provides a fresh perspective on how people may settle into the later years through a lens of positivity and optimism, which could in turn, nurture a healthier, active and more content period of life.

To read more about the science of ageing, you can access the MDPI journal Geriatrics, or the Journal of Gerontology and Geriatrics. Alternatively, you can browse the full list of MDPI Journals.