December 18, 2018
Senior woman smiles while kayaking with her husband

Positive Attitudes About Aging May Protect Cognition

by Wellness Letter  

We are bombarded with negative stereotypes about aging. In TV shows, ads, health news, and daily conversation, being old is often equated with being frail, helpless, and incompetent. Studies have linked increased exposure to such stereotypes and negative attitudes about aging to poorer health and worse cognitive and physical function in older people. That is, the messages can become self-fulfilling prophecies.

In an analysis of 22 studies of older people, published in Psychology and Aging in 2015, English researchers found that situations evoking negative age-related stereotypes can impair memory and cognition in older people, at least in the short term. For instance, even “subtle differences” in the way older people are treated—such as being spoken to very slowly or being patronized—can lead to underperformance on cognitive testing.

Now a study from Yale University has looked at the topic from another angle: how having positive attitudes about aging may help protect cognition in older people and even reduce the risk of dementia. Published in PLOS ONE, the study involved 4,765 people, average age 72, who were free of dementia at the start; about one-quarter of them carried the APOE4 genotype, which increases the risk of dementia. Their attitudes and beliefs about aging were assessed by a standard test.

Over the next four years, participants with positive attitudes about aging had a lower risk (2.6 percent) of developing dementia than those with negative attitudes (4.6 percent). Among APOE4 carriers, positive attitudes were associated with an even greater reduction in dementia risk compared to negative attitudes. Interestingly, when they had positive age beliefs, people who carried APOE4 were not at higher risk for dementia than those without the genotype.

Attitudes about aging are largely shaped by our culture and life experiences. Fortunately, clinical trials involving older people have shown that “positive age beliefs can be bolstered and negative age beliefs can be mitigated with corresponding changes in cognitive and physical performance,” according to the researchers.

How might positive age beliefs help reduce the risk of cognitive decline? They may buffer against the deleterious effects of stress, the researchers suggested. And positive attitudes may actually affect the causal pathway by which APOE4 increases dementia risk or may alter the gene’s expression, they further hypothesized.

It’s possible, of course, that dementia could affect beliefs about aging, instead of the other way around, but the researchers said this was less likely because beliefs were measured at least two years before participants developed dementia, and the findings were adjusted for baseline level of cognition.

These findings should encourage health care providers to identify people with negative age beliefs in order to personalize strategies to improve cognitive health by bolstering more positive attitudes, the researchers concluded.

A version of this article first appeared in the UC Berkeley Wellness Letter.

Also see Countering Negative Images of Aging.