People tend to see aging as a downward spiral of physical and cognitive decline. This is not the whole story, however. In fact, many people do improve with age — if they have the right attitude — a Yale University study finds.

“We found improvement in later life is not rare, it's common, and it should be included in our understanding of the aging process,” Becca Levy, lead author on the study, told TheDoctor.

Beliefs about aging become more powerful as they become more relevant.

Negative beliefs about aging are reinforced over time in movies, social media and advertising. This happens without most of us being aware of it, particularly if we are not yet feeling the effects of age. Beliefs about aging become more powerful as they become more relevant. “When people start to think of themselves as getting older, those beliefs have more of an impact,” she said.

Attitudes about aging can affect how a person ages through psychological, behavioral and physiological pathways, Levy, a professor of epidemiology and social and behavioral sciences at Yale, explained.

People with more positive beliefs about aging are more likely to start with a psychological advantage and more independence than those with more negative attitudes.

They are more likely to have behavioral advantages such as being active, eating well and taking prescribed medications.

Those who have fewer negative beliefs about aging also tend to have lower levels of stress biomarkers and fewer Alzheimer's biomarkers like amyloid plaques and tau protein tangles.

The study analyzed the responses from more than 11,300 participants in a survey of American adults ages 50 and older — the Health and Retirement Study. Participants completed an Attitudes About Aging questionnaire which explored their beliefs about aging at the start of the study. They responded to statements such as, “The older I get, the more useless I feel” and “I am as happy now as when I was younger,” with answers ranging from “strongly agree” to “strongly disagree”.

Then, over the 12-year follow-up period, the researchers tracked changes in cognitive function in participants using a global measure of cognition. They also followed changes in physical function in participants 65 years old or older using walking speed, which healthcare professionals consider an important sign of aging because it is strongly associated with disability, hospitalization and mortality.

More than 45 percent of participants improved cognitively or physically.

Encouragingly, more than 45 percent of participants showed improvement in at least one of these domains: about 32 percent improved cognitively and about 28 percent improved physically.

When the researchers added data from participants whose scores seemed to plateau during follow-up, they found that more than 51 percent of participants stayed the same or improved cognitively and almost 38 percent stayed the same or improved physically. Forty-four percent of those who showed improvement in cognitive function also showed improvement in physical function.

Levy emphasizes that because age beliefs can change, effective interventions at both the individual and population level are possible. Join a group that interests you. Do a little more moving. It's never too late to start.

The study is published in Geriatrics.