A 12-year national study reveals that aging does not necessarily mean decline. Researchers have shown that many older adults maintain or improve their cognitive and physical abilities, and that positive beliefs about aging are linked to improved long-term health outcomes.
Research: Redefining aging: Cognitive and physical improvements through positive age beliefs. Image credit: Finist4 / Shutterstock
In a recent study published in the journal geriatricsA group of researchers determined whether older adults can experience improvements in cognitive and physical function over time, and whether positive beliefs about aging predict such improvements.
Background: Reconsidering assumptions about declining aging
Many people think that getting older inevitably means that your memory declines, your movements become slower, and your independence decreases. According to recent research, approximately 80% of people believe that cognitive decline is a natural phenomenon of aging. Medical professionals often share similar assumptions about their patients’ aging trajectories. This affects how older people are viewed by society and how they themselves are viewed.
Growing evidence suggests that some aspects of age-related decline may be less inevitable than previously thought. An individual’s cultural attitudes toward aging, combined with personal beliefs about aging, can shape physical and mental functioning as one ages. Understanding these influences is essential to promoting healthier aging worldwide. Further research is needed to clarify how beliefs about aging shape long-term health trajectories.
Study population and longitudinal data sources
Participants were drawn from the Health and Retirement Study (HRS), a nationally representative longitudinal survey of U.S. adults aged 50 and older conducted by the University of Michigan Institute for Social Research. The study is funded by the National Institute on Aging (NIA) and collects health, social, and economic data every two years. Individuals included in the analyzes had a baseline measure of age beliefs and at least one follow-up assessment of cognitive or physical function.
Measurement of cognitive ability and physical function
Cognitive ability was assessed using the Telephone Interview for Cognitive Status (TICS), and physical function was assessed using gait speed measured during a 2.5-meter walk test. Faster walking speeds indicated better physical function, and participants were followed up for up to 12 years.
Assessing beliefs about age
Beliefs about age were measured using the Attitudes toward Aging subscale of the Philadelphia Geriatric Center Morality Scale, with higher scores indicating more positive beliefs about aging.
Cognitive performance was measured in participants aged 50 to 99 years, whereas gait speed was assessed at baseline and final follow-up in participants aged 65 years and older. Statistical analyzes examined whether participants’ cognition and walking speed improved from baseline to final follow-up. Logistic regression analysis was used to determine whether positive attitudes toward aging predicted improvements in both cognition and gait speed while controlling for demographic, health status, and psychosocial factors.
Results: Improved cognitive and physical function
The findings cast doubt on the widely held belief that aging inevitably leads to decline. A significant proportion of participants showed improvement in cognitive or physical function during the follow-up period. Overall, 45.15% of participants experienced improvements in cognition and walking speed over time, indicating that positive changes in health are not uncommon in later life.
When tested individually, 31.88% of participants improved their cognitive abilities and 28% improved their walking speed. These rates were significantly higher than benchmarks established by the Healthy America 2030 initiative. In this study, it was used as a reference threshold to define a “meaningful” rate of improvement, which was set at at least 11.5% in older adults.
Positive age beliefs predict physical and cognitive improvement and stagnation. Note: *p < 0.05. In the physical improvement and stagnation group, 58% improved, and in the cognitive improvement and stagnation group, 40% improved.
Stability and variation of aging trajectories
The results also showed that stability itself is common. Adding those with stable function to those with improved function, 51.06% of participants showed stable or improved cognitive function, and 37.56% showed stable or improved gait speed. These findings highlight that many older adults maintain or improve their abilities rather than experiencing continued decline.
Some people improved their memory but not their motor skills, and others walked faster without significantly improving their cognitive function. Of the participants who improved in cognition, about 44% also improved in walking speed. This indicates that these health domains may develop somewhat independently.
Effects of positive age beliefs on health status
Further analysis investigated whether beliefs about aging influenced these improvements. Positive age beliefs significantly predicted better outcomes in both domains. People with more optimistic attitudes toward aging were more likely to experience improvements in cognitive function and walking speed, even after accounting for age, education, health status, sleep problems, depressive symptoms, and other factors.
For example, statistical models showed that participants with stronger positive beliefs about age were more likely to have better cognitive function and faster walking speed during the follow-up period. These relationships remained significant even when more stringent improvement criteria were applied, such as requiring significant increases in cognitive test scores or walking speed.
Additional analyzes tested participants who already had normal baseline levels of cognitive or physical function. Even among these people, positive beliefs about age predicted future improvement. This suggests that the relationship between beliefs and health is not limited to people recovering from a disability, but also applies to people who begin to function relatively well.
Overall, the results show that improvements in later life are possible and common. It also shows that psychological and cultural factors, such as beliefs about aging, can influence an individual’s physical and cognitive aging. This study builds on the framework of stereotype embodiment theory, which proposes that people internalize social beliefs about aging throughout their lives, which can influence health outcomes when these beliefs later become relevant to themselves.
Conclusion: Positive beliefs and healthy aging
The results of this study show that aging does not necessarily lead to decline. Contrary to common beliefs about aging, many adults have experienced improvements in their physical and cognitive abilities over time. More positive beliefs about aging were associated with greater likelihood of improvement, suggesting that attitudes and cultural attitudes toward aging can influence later health trajectories.
Promoting more positive attitudes toward aging may therefore influence medical practice, policy, and individual behavior with the aim of helping maintain or improve the health and functioning of aging populations. The authors also note that many aging studies average changes in health across participants, which can mask improvements occurring within subgroups of older adults.
Reference magazines:
- Levy, B. R., & Slade, M. D. (2026). Redefining aging: Cognitive and physical improvements through positive age beliefs. Geriatric medicine. 11(2). DOI: 10.3390/geriatrics11020028, https://www.mdpi.com/2308-3417/11/2/28
