New research shows a positive attitude about getting older can significantly alter how long we live and even how young we look.
Ageing is often equated with loss of beauty, loss of function (slowing down, losing memory, increasing frailty and dependency), sometimes a sense of stagnation or disease (arthritis, Alzheimer’s) and social isolation or loneliness. Our negative stereotypes of old age are also reflected in the language we use: over the hill, out to pasture, twilight years, even comparing it to death, for example: ‘Old age isn’t so bad when you consider the alternative.’
Generally, these stereotypes result in feelings of fear or at least resistance to ageing – one reason for the progressive rise of appearance medicine. I think of my mother saying she still feels 18 but when she looks in the mirror she is shocked to see a 60-something-year-old looking back at her. The thought of a young person trapped in an old body is terrifying.
Ageing has been defined as “a side-effect of staying alive” by Aubrey de Grey, Cambridge University geneticist and author of Ending Aging (St Martins Press, 2008). He believes that ageing is a curable disease, stating that the basic processes by which we age can be averted. He provocatively suggests that humans could live to be hundreds of years old; a notion that may seem unappealing, depending on our perceptions of ageing.
Interestingly, negative stereotypes about ageing have been shown to affect life expectancy. In a 2002 Yale University study, older people who had more positive self-perceptions of ageing were shown to live 7.6 years longer than those with less positive self-perceptions of ageing. Information was gathered from 660 participants aged 50 and older, from a town in Ohio, which included whether they agreed or disagreed with statements including, ‘as you get older, you are less useful’. When other factors – including age, gender, socioeconomic status, loneliness and overall health – were taken into account, the effect remained. Surprisingly, the effect on survival of positive self-perceptions of ageing was greater than factors such as low systolic blood pressure, cholesterol, lower body mass index, history of smoking, and regular exercise.
The experiences of older members of my family bring a different perspective to ageing. Having just completed her Bachelor of Arts at the age of 66, my aunt Marie announced on her graduation day: “I’m going to write a book about being a mature student at university.” After being asked to babysit for friends and family she then embarked on further university courses learning about early childhood development. Similarly, when her mother Alice was looking for a new challenge in her mid-50s after her children had left home, she joined St John Ambulance. Her daughters recall her tending to the sick in the middle of the night for years to come. These two women embody recent findings on positive ageing, which show increasing involvement and engagement as factors important to ageing well.
Erik Eriksson, a famous 20th-century developmental psychologist, delineated eight stages of life development and defined each one in terms of an issue or conflict that must be resolved. He believed that you could only move on to the next stage having mastered the previous one. His seventh stage, middle adulthood, was seen as a conflict between generativity and self-absorption or stagnation. Generativity is the ability to do creative and productive work, especially as it relates to the betterment of society. Increased generativity has been associated with feelings of wellbeing. In a 1993 study reported in the journal Psychology and Aging, 520 people aged 55-84 found that generativity accounted for approximately 80 per cent of their feelings of wellbeing. Most of us will be familiar with older people who are focused on working within the family and community through forms of volunteer work, civic engagement and interpersonal relations involving caring for non-family members. Marie and Alice demonstrate this.
Gene Cohen of the US National Center for Creative Aging identifies four phases of development in adulthood, in his book The Mature Mind: The Positive Power of the Aging Brain (Basic Books, 2006). Phase one, he terms midlife re-evaluation; occurring from the 30s to mid-60s when people confront a sense of mortality for the first time.
Phase two, liberation and innovation, occurs from the mid-50s to mid-70s, when people have a sense of ‘If not now, when?’ plus a sense of personal freedom. Phase three, resolution and contribution, occurs from the late-60s into the 90s, when people are motivated to share their wisdom. Phase four, reflection and celebration, occurs in the late-70s to the end of life, when the desire to restate major themes and explore new variations on the themes positively impacts on family and community.
As with much of psychology, attention is now focused on the positive aspects of ageing, and surprising facts are emerging from neuroscience and psychology research that tend to turn our received wisdom about ageing on its head. The research is being disseminated through newsletters, such as healthandage.com, which promote ‘growth-enhancing’ activities and research, rather than focusing on minimising decline; thus redefining ageing as encompassing both limits and possibilities.
A classic experiment was performed in nursing homes in America in the 1970s. Residents were divided into two groups, one group received extra control in their daily lives, choosing when they watched videos, watered plants and had specific items for dinner. The other group received all the benefits the first group had but had no control over their schedules. A year and a half later, the members of the first group were more cheerful, active and alert, and – surprisingly – more were alive than in the control group. The impact of perceived control on our lives has been shown in many studies since.
In her book Counterclockwise: Mindful Health and the Power of Possibility (Ballantine Books, 2009), Ellen J. Langer describes a week-long experiment she conducted with elderly individuals in which one group of participants had to live as if it was 1959 (complete with magazines, newspapers and talking about current affairs from 1959) while the other group spent the week reminiscing about 1959. Both groups experienced improved hearing and memory, weight gain and a significant increase in the strength of their grips. They found on many of the measures the participants got ‘younger’, but the experimental group showed great improvements on joint flexibility and manual dexterity. On intelligence tests, 63 per cent of the experimental group improved their scores, compared with only 44 per cent of the control group. Objective observers judged that all of the experimental participants looked noticeably younger at the end of the study.
The notion that it is not chronological age but perceived age that is correlated with longevity was confirmed by Kaare Christensen, head of research from the University of Southern Denmark. His team examined whether perceived age was linked with survival in 387 twin pairs. All participants were aged 70 to 99 at the time their photographs were taken. The results of the study, completed in 2005 and published in the British Medical Journal (BMJ), showed that a person’s perceived age – how old people think they look – was linked to how long they lived. The researchers concluded: “Perceived age, which is widely used by clinicians as a general indication of a patient’s health, is a robust biomarker of ageing that predicts survival among those over 70.”
It was once thought that we were born with all the brain cells we need in life and that during our lives these brain cells remained static or declined. Exciting research in the late 1990s confirmed that the adult brain could form new brain cells through a process called neurogenesis. This finding provided hope for sufferers of brain diseases – such as Alzheimer’s and Parkinson’s disease – and resulted in certain beliefs being challenged, including the ability of adult brains to learn and grow. Results from brain imaging studies by scientists at University College London show that London cab drivers’ brains change as a result of their experiences navigating the complex London streets, enlarging the area of the brain responsible for memory. Studies of professional musicians’ brains have also shown changes, this time in areas responsible for discriminating pitch.
As people age there is more coordination, integration and transmission of information across both hemispheres of the brain. While it is true that as we age there is a decrease in reaction time, decrease in speed of processing and – from age 30 years on – nominal aphasia (the ability to remember names and words) worsens, this does not foreshadow sinister events. It is increasingly recognised that abilities related to maturity, wisdom and creativity (while more difficult to measure) are greatly enhanced. A majority of facets of intelligence do not decline with age. Indeed, a Seattle longitudinal study conducted by Sherry Willis and K. Warner Schaie, which has followed participants since 1956, found that subjects at midlife scored higher on almost every measure of cognitive functioning, including verbal and numerical ability and verbal memory than they did when they were 25.
There is also evidence that as people age they become more mellow. Specifically, older adults generally experience less intense negative emotions, they pay less attention to negative emotional stimuli and are less likely to remember negative than positive emotional materials.
Gene Cohen summarises the literature on positive changes with ageing as follows:
1 Because people have learned from their life experiences, they typically have a bigger repertoire in terms of human relationships, bringing a mature psychological perspective to their experiences (this may include an acceptance of life’s realities and a more long-term perspective).
2 Emotions are likely to be in balance, and a degree of equanimity is possible.
3 Advanced, dialectical thinking is possible, for example being able to reconcile opposing views: “I cycle quickly between loving him and wanting to leave him. But I’ve come to realise I need to work on both feelings at the same time. By looking at why I love him I can better understand what is good in the relationship. By looking at why I want to leave him, I can identify what’s wrong and work with that.”
The small American town of Albert Lea in Minnesota was chosen as an experimental site for improving people’s health and longevity by engaging most of the population in activities to test their benefits. People were encouraged to eat better, become more active, connect socially and find a greater sense of purpose, with experts brought in to help develop these new behaviours. When the project ended in October 2009, a total of 3464 residents had participated. The life expectancy of the 786 people who were evaluated rose by almost three years, and all of them said they felt healthier than before they had entered the project.