How overcoming negative attitudes to ageing can make you live longer

Ageism is pervasive, accepted and invisible. Stamping out this prejudice won’t just benefit society, it will also have huge payoffs for those people who hold it.

Last Christmas, my 4-year-old was worried that Santa might forget some presents on his list – “because Santa is old”. I was shocked. At that moment, I realised that he had already picked up negative stereotypes about older people. Perhaps I shouldn’t have been surprised given the way they are portrayed on TV and in film, books and ads, as well as the ways that we collectively talk about ageing. But given what I now know about such views, I was deeply concerned.

How we view ageing can change how we age ourselves
Robert Carter

Ageism is arguably the last acceptable prejudice. While other forms of discrimination are considered reprehensible, it is normalised. The World Health Organization reports that, globally, 1 in 2 people are ageist. Unfounded stereotypes about old age directly affect the lives of those in their later years – their financial opportunities and medical treatment, for example. Ageism is one of the biggest barriers faced by people everywhere, affecting all facets of life, says Nancy Morrow-Howell at Washington University in St. Louis, Missouri. “It’s so pervasive, it’s so accepted, it’s so invisible.”

But ageism isn’t just bad for society. My concern about my son’s developing ideas of old age also stems from the discovery that negative stereotypes of older people are bad for the individual who holds them too. Researchers have found that they affect how we age, both physically and mentally, with impacts on many aspects of our later lives, from memory function and hearing loss to the risk of depression and even how long we live. The scale of these effects can be enormous. However, knowing this also presents us with simple opportunities to change things.

Ageism begins in childhood

As my son’s comment indicated, this is a problem that starts early. Our stereotypes about older people are already mostly negative by the time we begin school. “Children learn from what they see,” says Anna Kornadt at the University of Luxembourg. And they see that some people look a certain way – they have grey hair and wrinkled skin and sometimes move differently. “This is a very obvious social category that helps children understand the world,” she says. That alone isn’t the issue. The problem is how their culture then defines people within this simplified category and continually reinforces a bleak narrative around what it means to be old.

Prejudice comes at children from all angles – not just the media, but also the language used by their family members. For example, a parent lamenting reaching a certain age may say they feel “over the hill” or some other entirely accepted trope about how awful it is to get old. Other sayings like “you can’t teach an old dog new tricks” reinforce the notion, often taken as fact, that when you are old, you are incapable of learning and changing.

While racial and gender-based stereotypes are widely understood to be rooted in structural inequalities that shape the world rather than any kind of inherent attribute of a group of people, our generalisations about older people are still considered true to life. Yet, largely, they aren’t. Older adults aren’t a monolith of dependent, frail and forgetful people, nor are they all wise and kind. They are an extremely varied social group that requires the same nuanced consideration we know is essential to understanding any socially constructed grouping. Yes, the risk of disability and certain illnesses increases as we age. But, in fact, good cognitive ability and health remain intact for the majority of older people, right into their final years.

Is dementia inevitable in old age?

When Kornadt explores conceptions of old age with her undergraduate students, she begins by asking them to guess how many of them will get dementia. “A lot of them think, ‘OK, if you’re old, you will get dementia no matter what’,” she says. “But in the end, for people over 90 years, it’s only 30 per cent.” And it is only 10 per cent of everyone over the age of 65. So, chances are, most people won’t get dementia in their old age. It is the same with loneliness, says Kornadt. There is an assumption that when you are old, you are lonely. But she points out that young people are just as likely to experience loneliness.

Kornadt notes that negative stereotypes of older people can benefit us when we are young: they elevate us in comparison. But eventually, if we are lucky, we get old too. “Then this turns into a stereotype about the group you yourself belong to,” she says. “We try to fend this off as long as we can.” Kornadt says that when people are asked at what point old age starts, they continually push it to beyond their own age. It isn’t until around 75 that people start to acknowledge that they are part of a group experiencing old age. This is when those negative stereotypes become how we think about ourselves, after being embedded in our thoughts decade after decade. And the consequences can be dire.

One of the first people to expose this was Becca Levy at Yale University. In 2009, she and her colleagues published a landmark paper showing that people who believed negative stereotypes about old age in their younger years had a much greater chance of having a cardiovascular event, such as a stroke or congestive heart failure, decades later. Another study led by Levy found that buying into pessimistic concepts of old age results in a 50 per cent greater chance of being hospitalised in later life compared with people who think positively about it. A third showed that those negative stereotypes were linked to being much less likely to recover from a disability from the age of 70 onwards. In 2019, research by Levy and Martin Slade, also at Yale University, even connected ageism to a greater likelihood of being obese in old age.

Memory loss and ageing

Then there is memory. As demonstrated by my son, it is widely assumed that being old inevitably means being forgetful. Memory is indeed affected by age: as the brain’s structure changes, working memory, which holds information temporarily as we are thinking, tends to decline. But it isn’t all downhill. Semantic memory, the ability to recall facts and concepts, often improves as we reach our later years. There are numerous factors at play in how sharp our memory remains, including genetics and illness. And we can add negative stereotypes about ageing to that list. Levy’s research shows that they account for a whopping 30 per cent of additional decline in memory in people aged over 60.

Intriguingly, gloomy old-age stereotypes affect sensory perception too. Becoming hard of hearing is considered just a reality of reaching our later years, but again, ageing is only one of many factors that can cause it. Levy found that ageist generalisations are another noteworthy cause.

Perhaps more obviously, there is also an impact on mental health. Negative beliefs about ageing are associated with an increased risk of depression, anxiety and suicidal ideation as we age. They can affect a person’s will to live and, by extension, their choices about whether or not to take life-prolonging medications. And all this adds up. “Individuals who have taken in more positive age beliefs from their culture tend to show an average survival advantage of seven-and-a-half years over those who have taken in more negative age beliefs,” says Levy. That extraordinary result has been found again and again in numerous countries, including Germany, China, the US and Australia.

Ageist views affect your health

How exactly do negative age stereotypes have such drastic repercussions? Levy posits three pathways. One is physiological. “People who have taken in more negative age beliefs tend to have higher cortisol levels, which is the main stress biomarker, and that has been found to have adverse impacts on a number of different outcomes,” she says. Indeed, numerous studies show that being exposed to negative age stereotypes, even subliminally, increases people’s blood pressure and heart rate. When this happens again and again, your health can be seriously harmed.

Levy’s second pathway is psychological. Once internalised, old-age stereotyping ends up becoming a self-fulfilling prophecy, shaping our thoughts about what we are capable of doing and what we see as the inevitable outcomes of reaching our later years. “People who take in more positive beliefs tend to have higher self-efficacy or a higher sense of mastery in different aspects of their life,” says Levy. “So they’re more likely to feel like they can accomplish certain goals, and that may encourage them to do better on cognitive tasks.” Believing negative stereotypes has the opposite effect. It can also block the psychological resources that could allow us to act in ways that would keep us in good health for longer. It might, for instance, interfere with the sophisticated cognitive skills that can compensate for hearing loss, such as drawing on context, memory and comprehension to fill in missed bits of conversations.

Levy’s third pathway is rooted in behaviour. “Those who take in more positive age beliefs tend to engage in more beneficial health behaviours, like being physically active and taking prescribed medications,” she says. Conversely, ageist stereotypes can result in people behaving as if they are unable to do certain things, such as continuing to work, exercising or taking up a new hobby. It also fosters dependent behaviours. One study, for example, showed that after being exposed to ageist ideas, older people were more likely to ask for help to complete a puzzle. So an older person may stop doing things for themselves, with no physical or cognitive reason other than those beliefs.

How all this plays out differs depending on an individual’s gender and culture (see “A multifaceted prejudice“, below). But with many countries now having an increasingly older population, issues like real or imagined intergenerational competition over social and economic resources could be exacerbating the problem. “I think, with time, there has been an increase in negativity of age stereotypes,” says Levy. The covid-19 pandemic laid bare some of these prejudices in the way that older people were treated in the healthcare system. But systemic ageism is ingrained throughout many societies, from the media and education to housing and the workplace.

How do we reduce ageism?

Pushing back against ageist stereotypes will require structural changes, which is difficult. But it is never too early, or too late, to change your own thinking about old age. Morrow-Howell says that unlearning internalised ageist stereotypes can take a lot of one-on-one work with someone very knowledgeable about the topic. But simply increasing awareness about ageism also goes a long way, she adds. Morrow-Howell encourages older people she works with at the National Center to Reframe Ageing in the US to understand what is really behind the belief that they are “too old” for something. Is it a health issue? Is it desire or preference? Is it because of social factors? “We just have to keep separating age as the primary driver,” she says.

Levy also says that recognising and understanding our prejudices is key to dismantling them. “If you aren’t aware that these negative age stereotypes are having an impact, it’s hard to fight them, it’s hard to challenge them and prevent their impact.” In her book, Breaking the Age Code, she lists common beliefs about old age – including that older people can’t use or invent new technology, that they should avoid exercise because they are frail, that they don’t have sex – and then counters each myth with the facts.

Another way to reduce ageism is through meaningful interactions between younger and older generations, as a study that brought teenagers together with older people to share wisdom revealed. It also highlighted the need for these interactions to be based on reciprocity, not a younger person feeling like they are doing some act of charity for an older person. “It’s meaningful intergenerational contact, not just meeting people but really working towards a common goal,” says Kornadt. For many of us, these are rare. But there are some cultures where multiple generations are more likely to still live together, promoting positive age beliefs. This might help explain why, in the UK, Black people and those of Asian ethnicity generally outlive white people, for example.

For myself, having this knowledge has made me much more aware of the language I use when talking about age. It has made me see how ubiquitous ageism is – and I don’t let these stereotypes go unchallenged. It has shifted my thinking about how much I will be able to do in the decades to come, too. And as for Santa, he didn’t forget anything on my son’s list.

(Clem De Pressigny is a freelance writer and editor. )

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