A new Yale University study challenges a common assumption that later life means inevitable cognitive and physical decline. An analysis of 12 years of data from more than 11,000 older Americans found that 45% of adults ages 65 and older showed measurable improvement in cognitive function, physical function, or in some cases, both.
What journalists should take away from this study is that the assumption of universal, inevitable decline is wrong for a large share of older adults — and that beliefs about aging have measurable, real-world health consequences.
Study findings
Researchers Becca Levy, Ph.D., and Martin Slade, Ph.D., MPH, found that participants who held more positive beliefs about aging at the outset were significantly more likely to improve in cognitive and physical function, even after controlling for age, sex, education, depression, and chronic disease burden.
“Many people equate aging with an inevitable and continuous loss of physical and cognitive abilities,” Levy, a professor of social and behavioral sciences at the Yale School of Public Health and the study’s lead author, said in a statement. “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.”
About 32% of participants improved cognitively and 28% improved physically over the follow-up period. A global survey by Alzheimer’s Disease International cited in the paper found that 65% of health care professionals and 80% of the general public falsely believe all older adults develop dementia. A separate U.S. survey from AARP found 77% of Americans ages 40 and older expect their cognition to decline.
Why this matters
For this study, Levy and Slade used an approach that examined individual trajectories rather than averages. When they applied the usual method of averaging all participants together, they found decline. Telephone Interview for Cognitive Status scores, a common measure, dropped by an average of 1.39 points; walking speed decreased by an average of 11.69 cm/s. However, when they examined individual trajectories and specifically looked for improvement, the results varied.
“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,” Levy said in a Newsweek story.
This approach has direct implications for how health journalists should think about aging research. Aggregates or averages in longitudinal studies of older adults often fail to account for diverse characteristics within a population. A study that reports group-level decline is not necessarily saying that all, or even most, individuals declined. Reporters should be asking researchers about what happened at the individual level. Were there meaningful subgroups that improved?
Positive beliefs play a role
One of the most interesting findings involves predicted improvement. Among those who had internalized more positive beliefs about aging — measured at baseline with a validated five-item scale — the odds of improving in both cognition and walking speed were significantly higher, even after controlling for age, sex, education, depression, chronic disease, and other factors.
This finding builds on Levy’s Stereotype Embodiment Theory, which says that cultural messages about aging are absorbed through social media, advertising, and institutional attitudes, often starting in childhood. These messages eventually become more relevant as people enter older age and can directly shape health outcomes. Prior research by Levy found negative age beliefs linked to poorer memory, slower walking speed, higher cardiovascular risk, and biological markers associated with Alzheimer’s disease. This study shows the reverse: positive age beliefs predict measurable functional gains.
Reconsider the aging narrative
The authors estimate that, if extrapolated to the U.S. population, more than 26 million older Americans may be experiencing improvement in functioning.
“The current study demonstrated that the predominant narrative of aging as a time of inevitable and universal decline needs to be reconsidered,” they wrote.
The study also noted a counterintuitive finding about the relationship between physical and cognitive improvement. Most participants (66%) improved in only one domain. That challenges the popular assumption that cognitive and physical health necessarily track together in later life, and could have implications for how care and rehabilitation programs are designed.
In addition to the TICS, the researchers also used walking speed to validate their findings. Participants walked a measured course, timed twice, and the faster result was used. Walking speed has a strong predictive relationship with disability, hospitalization, and mortality
Potential story angles
This study offers several clear avenues for reporters covering aging, health policy and health disparities. Here are a few story angles to consider.
Ageism by default
The World Health Organization’s primary tool for assessing cognitive and physical capacity in older adults classifies outcomes as either declining or not.
The study authors call explicitly for revising that framework. What would it take to change clinical guidance and screening tools? Who in your local health system is thinking about this?
Intervention differences
The authors note that ageist assumptions, the belief that older patients “won’t get better anyway,” can discourage clinicians from offering preventive care and rehabilitation services to older adults.
What does that look like at your local hospital, rehab facility, or primary care practice? Are patients being offered the same options as younger adults?
Shift age beliefs
Since age beliefs are modifiable, they can be shifted through education, exposure, and intentional practice.
Levy has developed a technique called the ABC method: Awareness of negative age messaging, Blame-shifting (attributing difficulties to ageism rather than aging), and Challenging negative beliefs. What programs in your community are building on this kind of approach?
Equity
The Health and Retirement Study sample, while nationally representative, underrepresents certain ethnic minority populations. The authors acknowledge this limitation directly. Is the relationship between age beliefs and health outcomes different across racial, ethnic or socioeconomic groups?
Policy implications
If functional improvement is common in later life, it has direct implications for how Medicare structures preventive benefits, how policymakers invest in rehabilitation and how public health campaigns talk about aging.
The bigger picture
This longitudinal study followed more than 11,000 participants for up to 12 years. The effects are statistically significant but modest, and age beliefs are just one of many factors — including chronic disease, socioeconomic status and social connection — that shape outcomes in later life.
For journalists, this study underscores the importance of looking beyond averages, asking about variation within populations and examining how beliefs about aging may shape real-world health outcomes.
Resources
- National Center to Reframe Aging
- Old School, anti-ageism advocacy group with resources and articles
- Global Campaign to Combat Ageism Toolkit, World Health Organization
- Ageism is one of the last socially acceptable prejudices. Psychologists are working to change that, American Psychological Association, 2023
- 10 tips for eliminating ageist language from your stories AHCJ tipsheet (2023)
