A new study has found that older adults who had more positive beliefs about ageing were more likely to show improvement in their cognitive and physical functioning over time, challenging the widespread assumption that growing old means inevitable decline. 

The study published in the journal Geriatrics, conducted by researchers at Yale University, tracked about 11.314 Americans aged 65 and above for up to 12 years. They studied their physical health, assessed by walking speed and their cognitive health, assessed by a global performance measure.  

The study found that about half of the participants, about 45.15%, showed improvement in either mental or physical functioning, or both, over the study period. 

The researchers also found that those who held more positive views about ageing were significantly more likely to be among those who improved.

What the study measured

The study drew participants from the Health and Retirement Study, a nationally representative longitudinal survey supported by the National Institute on Aging and conducted by the University of Michigan. The study followed Americans aged 50 and older through biennial surveys.

Cognitive health was assessed using the Telephone Interview for Cognitive Status, a 27-point test that covers short-term memory, delayed recall, and mathematical skills. Physical health was measured through walking speed, which the study described as the “sixth vital sign” because of its established links to hospitalisation rates, disability, and mortality in older adults.

Age beliefs were measured using a five-item scale drawn from the Philadelphia Geriatric Center Morale Scale, which asked participants about their attitudes toward growing older. Responses were scored so that higher numbers reflected more positive views about ageing.

The cognitive sample consisted of 11,314 participants with an average baseline age of 68.15 years. The walking speed sample consisted of 4,638 participants with an average baseline age of 74.03 years. Participants were followed for an average of roughly eight years each.

What the findings showed

When researchers examined the full sample by averaging scores across all participants, which is the approach used in most ageing studies, both cognitive scores and walking speeds declined over the study period. Cognitive scores fell by 1.39 points on average and walking speed decreased by 11.69 centimetres per second.

When the study looked at individual trajectories rather than group averages, it showed a different result. Among those with measurements in both domains, 45.15% showed improvement in cognition and/or walking speed from the start of the study to their last recorded measurement. However, 31.88% improved their cognitive scores and 28%  improved their walking speed.

These data exceeded the United States Department of Health and Human Services’ Healthy People 2030 target, which sets 11.5% as the threshold for a “meaningful number” of older persons benefiting from an intervention, by a significant margin.

When those who neither improved nor declined, that is, those who remained stable, were added to the count, the proportion who defied decline rose further/ That is about 51.06% for cognition and 37.56% for walking speed.

When linked between age beliefs and outcomes, positive age beliefs predicted cognitive improvement both with and without adjustment for factors such as age, sex, education, depressive symptoms, cardiovascular disease, and diabetes. The same was found for physical improvement. 

The pattern held across several sensitivity analyses, including one that limited the sample to participants with normal cognitive and physical functioning at the start of the study. This suggests that the improvement was not simply a matter of people with deficits recovering to normal levels.

Why the findings matter

The study noted that the dominant scientific and public understanding of ageing framed it almost entirely as a process of loss. The study cited, “A global survey of nearly 40,000 people found that 65% of health care professionals and 80% of lay persons falsely believed that all older persons develop dementia.” 

It also pointed to the World Health Organisation’s assessment tool for cognitive and physical capacity in later life, which, they noted, does not allow for the possibility of improvement in these domains.

The study argued that this framing has practical consequences. It stated that awareness of improvement findings “might overcome the unwillingness of some healthcare providers to offer older persons preventive and rehabilitation services, due to the assumption that they are unlikely to get better.”

It noted that the finding that positive age beliefs predicted improvement was significant because such beliefs, unlike genetic factors, are modifiable, both at the individual level and through broader societal and policy interventions.

The study acknowledged several limitations. The Health and Retirement Study did not include measures of muscle plasticity or brain neuron plasticity, which could have helped identify the biological mechanisms behind the improvements observed. 

It also noted that the sample, while nationally representative, had limited representation of certain ethnic minority groups and called for future research with more diverse cohorts. They added that improvement patterns in other types of cognition, such as spatial memory, remained unexplored.

Doctors find similarities among the elderly

Dr Prashanth Rao, director of surgical gastroenterology and minimal access surgery at Gleneagles Hospital Parel, said the study’s findings broadly matched what he observed in clinical practice. He noted that many older adults were able to maintain or even improve their physical and cognitive function when they stayed physically active, socially connected, and managed chronic health conditions with timely medical attention.

Dr Rao said a positive outlook encouraged older adults to stay active and engaged in healthy behaviours, which contributed to better physical and cognitive health.

He also pointed to several barriers that prevented older adults in India from accessing adequate rehabilitation and preventive care. Most Indians did not get insured early, and it was very difficult for the elderly to get insured due to pre-existing diseases or high premiums. He added that older adults were often dependent on their children or grandchildren to take them to healthcare facilities and pay for their treatment, which was not always easy.

“Make sure to encourage healthy ageing by promoting regular exercise, lifelong learning, social engagement, and preventive health check-ups. So, the adults should be motivated to lead a healthy life,” Dr Rao said.  “Activities such as solving crossword puzzles or playing sudoku are believed to help keep the mind active.”

Also read: Born after 1965? Study suggests your body may be ageing faster