Ageism affects the health of the elderly and can shorten their life years

Each fall, Becca Levy asks students in her health and aging class at the Yale School of Public Health to imagine an elderly person and share the first five words that come to mind. Don’t think too much, she tells them.

Levy writes the answers on the board. They include words of admiration like “wisdom” and “creative” and roles like “grandmother.” But “‘senility’ shows up a lot,” Levy said recently, “and a lot of physical illness and decline: ‘bent’, ‘sick,’ ‘decrepit’.”

The Doctor. Robert N. Butler, psychiatrist, gerontologist and founding director of the National Institute on Aging, coined the term “ageism” half a century ago, which echoes “sexism” and “racism,” to describe stereotypes and discrimination against the elderly.

Among the mementos in Levy’s small office at Yale is a treasured photo of her with Butler, who died in 2010. It could be argued that she is his heiress.

A psychologist and public health researcher, Levy has demonstrated — in more than 140 articles published over 30 years and in a new book, “Breaking the Age Code” — that ageism results in more than hurt feelings or even discriminatory behavior. Measurably affects physical and cognitive health and well-being, and can reduce years of life.

“Just as we’ve learned over the past few decades that there are biased structures against women and people of color that lead to worse health outcomes, she showed that negative feelings about old age lead to poor outcomes in older people,” said Dr. Louise Aronson, geriatrician. at the University of California at San Francisco and author of the bestselling book “Elderhood”.

Another memento in Levy’s office is a card on his bulletin board that reads, “Ask me about 7.5.” The memory came from an anti-aging campaign in Wisconsin and refers to his 2002 longevity study, which for two decades followed hundreds of residents over 50 in a small Ohio town.

The study found that median survival was 7.5 years longer for those who had the most positive ideas about aging compared to those who had the most negative attitudes.

“I use it in pretty much every lecture I give, because it’s shocking,” said Tracey Gendron, who chairs the gerontology department at Virginia Commonwealth University and cites Levy’s work in her recent book “Ageism Unmasked.” ). “She was really a pioneer.”

Levy and his team measure attitudes towards aging in several ways. They use quizzes or the same five-word exercise she gives students, as well as test subliminal biases using computer programs that display negative or positive words about aging so quickly that participants absorb them without noticing.

They also used small experimental samples from a few dozen people and tracked the health records of thousands through large national surveys. Thanks to your efforts, we know that in addition to reduced longevity, ageism is also associated with:

• Cardiovascular events, including heart failure, strokes and heart attacks. Using health records from nearly 400 participants under age 50 in the Baltimore Longitudinal Study on Aging, “we were able to track people for 40 years,” Levy said. about aging.” Their cardiovascular problems also occurred at earlier ages.
• Physical function. Among 100 older adults (mean age 81 years), those exposed weekly to implicit positive age stereotypes for one month scored better on tests of posture, strength, and balance than control groups. In fact, those who received positive exposure improved more than an age-matched experimental group that exercised for six months. In a study of New Haven residents over 70, those with positive ideas about age were also more likely to fully recover from severe disabilities than those with negative beliefs.
• Alzheimer’s disease. Some participants in the Baltimore study underwent regular brain scans and some donated their brains for autopsies. Those who held more negative age beliefs at younger ages exhibited a more pronounced decline in the volume of the hippocampus, the brain region associated with memory. They also exhibited, after their deaths, more plaques and brain tangles that are biomarkers of Alzheimer’s.

Another study used data from the National Health and Retirement Survey that included whether participants had the APOE4 gene, which increases the risk of Alzheimer’s. Those with the gene and positive ideas about age “had as low a risk as people without the gene,” Levy said.

The list goes on. Older people with positive views of aging perform better on tests of hearing and memory tasks. They are less likely to develop psychiatric illnesses such as anxiety, depression, PTSD (post-traumatic stress disorder) and suicidal thoughts.

Indeed, Levy and his colleagues estimate that age discrimination, negative age stereotypes, and negative self-perceptions of aging lead to $63 billion in excess annual spending on common health conditions such as cardiovascular and respiratory disease, diabetes, and injuries.

We absorb these stereotypes from a young age, through derogatory portrayals in the media and fairy tales about bad old witches. But institutions — employers, health organizations, housing policies — express a similar bias, reinforcing what is called “structural ageism,” Levy said. Reversing this will require radical changes, an “age release movement”, she added.

But Levy found reason for optimism: Harmful ideas about age can change. Using the same subliminal techniques that measure stereotyped attitudes, his team was able to increase the sense of competence and worth among the elderly. Researchers in many other countries have replicated their results.

“You can’t create beliefs, but you can activate them,” Levy said, exposing people to words like “active” and “full of life” rather than “grumpy” or “helpless” to describe older adults. .

Translated by Luiz Roberto M. Gonçalves