The research was supported by funding from the National Institute on Aging.
Drawing on more than a decade of data from a large, nationally representative study of older Americans, researchers discovered that nearly half of adults age 65 and older experienced measurable improvements in cognitive function, physical function, or both.
The findings suggest that improvement in later life is far more common than many people realize.
“Many people equate aging with an inevitable and continuous loss of physical and cognitive abilities,” said Becca R. Levy, lead author of the study and professor of social and behavioral sciences at the Yale School of Public Health (YSPH). “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 aging process.”
The study was published in the journal Geriatrics.
Aging and Improvement Over Time
The research team analyzed data from more than 11,000 participants in the Health and Retirement Study, a federally funded long-term survey of older Americans.
To measure changes in mental abilities, the researchers used a global cognitive assessment. Physical function was evaluated through walking speed, a measure often considered by geriatricians to be a key indicator of overall health because it is closely linked to disability, hospitalization, and mortality.
Participants were followed for as long as 12 years. During that period, 45% showed improvement in at least one of the two areas examined.
Approximately 32% improved cognitively, while 28% improved physically. Many participants experienced gains large enough to be considered clinically meaningful. When researchers also counted individuals whose cognitive abilities remained stable rather than declining, more than half of participants avoided the commonly held expectation of cognitive deterioration.
“What’s striking is that these gains disappear when you only look at averages,” said Levy, author of the book Breaking the Age Code: How Your Beliefs About Aging Determine How Long & How Well You Live. “If you average everyone together, you see decline. But when you look at individual trajectories, you uncover a very different story. A meaningful percentage of the older participants that we studied got better.”
The Role of Positive Age Beliefs
The researchers also explored why some older adults improved while others did not.
One possibility, they proposed, was the influence of age beliefs held at the beginning of the study. Specifically, they examined whether participants had adopted more positive or more negative views about aging.
Their analysis supported that idea. Older adults with more positive beliefs about aging were significantly more likely to improve in both cognitive performance and walking speed. The relationship remained strong even after adjusting for factors including age, sex, education, chronic disease, depression, and length of follow-up.
The findings build on Levy’s stereotype embodiment theory. The theory proposes that age-related stereotypes absorbed from society through sources such as social media and advertising can eventually become personally meaningful and have measurable biological effects.
Previous studies led by Levy found that negative beliefs about aging are associated with poorer memory, slower walking speed, increased cardiovascular risk, and biomarkers linked to Alzheimer’s disease.
According to Levy, the new findings show the opposite pattern can also occur.
The current study shows that those who have assimilated more positive age beliefs often show improvement, Levy said.
“Our findings suggest there is often a reserve capacity for improvement in later life,” she said. “And because age beliefs are modifiable, this opens the door to interventions at both the individual and societal level.”
Challenging Assumptions About Aging
The improvements were not limited to people who began the study with physical or cognitive impairments.
Researchers found that even participants who started with normal levels of cognitive and physical function frequently improved over time. This finding challenges the idea that later-life gains simply reflect recovery from illness or a return to previous levels after a setback.
The authors hope the results will help shift public perceptions about aging and reduce the belief that continuous decline is inevitable. They also suggest the findings support greater investment in preventive care, rehabilitation programs, and other health-promoting services that help older adults build on their capacity for resilience and improvement.
Martin Slade, a lecturer in occupational medicine at Yale School of Medicine and in the Department of Environmental Health Sciences at YSPH, co-authored the study.
The research was supported by funding from the National Institute on Aging.
The research team analyzed data from more than 11,000 participants in the Health and Retirement Study, a federally funded long-term survey of older Americans.
To measure changes in mental abilities, the researchers used a global cognitive assessment. Physical function was evaluated through walking speed, a measure often considered by geriatricians to be a key indicator of overall health because it is closely linked to disability, hospitalization, and mortality.
Participants were followed for as long as 12 years. During that period, 45% showed improvement in at least one of the two areas examined.
Approximately 32% improved cognitively, while 28% improved physically. Many participants experienced gains large enough to be considered clinically meaningful. When researchers also counted individuals whose cognitive abilities remained stable rather than declining, more than half of participants avoided the commonly held expectation of cognitive deterioration.
“What’s striking is that these gains disappear when you only look at averages,” said Levy, author of the book Breaking the Age Code: How Your Beliefs About Aging Determine How Long & How Well You Live. “If you average everyone together, you see decline. But when you look at individual trajectories, you uncover a very different story. A meaningful percentage of the older participants that we studied got better.”
The researchers also explored why some older adults improved while others did not.
One possibility, they proposed, was the influence of age beliefs held at the beginning of the study. Specifically, they examined whether participants had adopted more positive or more negative views about aging.
Their analysis supported that idea. Older adults with more positive beliefs about aging were significantly more likely to improve in both cognitive performance and walking speed. The relationship remained strong even after adjusting for factors including age, sex, education, chronic disease, depression, and length of follow-up.
The findings build on Levy’s stereotype embodiment theory. The theory proposes that age-related stereotypes absorbed from society through sources such as social media and advertising can eventually become personally meaningful and have measurable biological effects.
Previous studies led by Levy found that negative beliefs about aging are associated with poorer memory, slower walking speed, increased cardiovascular risk, and biomarkers linked to Alzheimer’s disease.
According to Levy, the new findings show the opposite pattern can also occur.
The current study shows that those who have assimilated more positive age beliefs often show improvement, Levy said.
“Our findings suggest there is often a reserve capacity for improvement in later life,” she said. “And because age beliefs are modifiable, this opens the door to interventions at both the individual and societal level.”
The improvements were not limited to people who began the study with physical or cognitive impairments.
Researchers found that even participants who started with normal levels of cognitive and physical function frequently improved over time. This finding challenges the idea that later-life gains simply reflect recovery from illness or a return to previous levels after a setback.
The authors hope the results will help shift public perceptions about aging and reduce the belief that continuous decline is inevitable. They also suggest the findings support greater investment in preventive care, rehabilitation programs, and other health-promoting services that help older adults build on their capacity for resilience and improvement.
Martin Slade, a lecturer in occupational medicine at Yale School of Medicine and in the Department of Environmental Health Sciences at YSPH, co-authored the study.
The research was supported by funding from the National Institute on Aging.
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