Myths & Facts: Aging

ACCORDING TO estimates from the Census Bureau’s National Demographic Analysis, the 2020 census highlights the sharp growth divide between the old and the young in America. Between 2010 and 2020, the number of people over age 55 grew by 27 percent, which is 20 times larger than the growth rate of the collective population under 55 (1.3 percent). And, the largest driver of this divide is the baby boomer generation that passed the age of 65 during the past decade, increasing the size of the 65- to 74-year-old age group by a half (Figure 1).¹ By 2060, the number of Americans aged 65 and older is projected to double to more than 987 million, and it will be the first time in history the number of older adults outnumbers children under age 5 years. What’s more, older adults are expected to live longer than ever before, with one out of every four 65-year-olds today living past 90 years old.²

Interestingly, how healthfully people age depends a lot on how they perceive the effects of aging. Becca Levy, PhD, a public health and psychology researcher for more than 20 years, found that having positive perceptions about aging (e.g., wisdom, self-realization, satisfaction, generally being vital and robust) instead of negative perceptions (e.g., useless, helpless, devalued) is associated with a nearly eight-year increase in average lifespan. In her study, she analyzed longitudinal data from a group of 660 adults collected between 1975 and 1995 and mortality data obtained through 1998. At the beginning of the study, participants completed a survey designed to detect personally held stereotypes about aging, answering positively or negatively to statements such as “things keep getting worse as I get older” and “as you get older, you get less useful.” Participants with positive scores outlived those with negative scores, and those with a positive bias were more likely to exercise, eat well, limit alcohol, be nonsmokers and have had preventive healthcare — all characteristics consistent with taking control of one’s life.

Another of Dr. Levy’s studies published in the Journal of the American Medical Association suggests seniors with positive age stereotypes are 44 percent more likely to fully recover from a severe disability.³ So, with all the myths surrounding aging, it stands to reason that by dispelling them, people might have a more positive outlook about their expectations for growing old.

Separating Myth from Fact

Myth: Physical deterioration is inevitable as individuals age.

Fact: While this isn’t entirely untrue due to the wear and tear on bodies after decades of use, not all older adults’ physical health is the same. In fact, many older adults are active and healthy, whereas others are frail with multiple health conditions.⁴ Yes, stem cells do lose some of their potential and other cells weaken, but healthful habits can curb the physical aging process.³ According to the World Health Organization, “increased physical activity and improving diet can effectively tackle many of the problems frequently associated with old age,” including reduced strength, increased body fat, high blood pressure and reduced bone density.

Again, expectations play a role. Some studies show that merely expecting physical deterioration increases the likelihood that someone will physically deteriorate. In one study in which scientists surveyed 148 older adults about their aging, lifestyles and general health expectations, they found expectations regarding aging “play an important role in the adoption of physically active lifestyles in older adults and may influence health outcomes such as physical function.” So, although some deterioration is likely, managing expectations will help individuals make better life choices to maintain physical health and fitness later in life.⁴

Myth: It’s inevitable that older adults will experience cognitive decline.

Fact: While some changes in cognition are normal with age such as slower reaction times, reduced problem-solving abilities, and a slower speed of processing information, many older adults outperform their younger counterparts on intelligence tests that draw on accumulated knowledge and experience.² And, it’s known that cognitive development continues through life. According to a 2014 National Institutes of Health study, pursuing new interests that stimulate the brain help improve memory, and keeping the mind active and learning new skills help to build a cognitive reserve that allows the brain to become more adaptable and compensate for any age-related memory challenges.⁴ What’s more, wisdom and creativity often continue to the very end of life, and personality traits remain relatively stable over time.²

Myth: Cognitive decline leads to dementia.

Fact: While people who develop dementia tend to experience cognitive decline first, it does not necessarily signal the start of dementia. In fact, one study estimated 22.2 percent of people in the U.S. 71 years and older experience cognitive decline, of which only 11.7 percent to 20 percent develop dementia.

In 2015, the Alzheimer’s Association evaluated the evidence of modifiable risk factors for both dementia and cognitive decline and found “there is sufficient evidence to support the link between several modifiable risk factors and a reduced risk of cognitive decline.” These factors include maintaining regular physical activity; managing classic cardiovascular risk factors such as diabetes, obesity, smoking and high blood pressure; a healthful diet; and lifelong learning.⁵

In addition, dementia is not a normal part of aging despite the growing risk of dementia as people age. Many people live into their 90s and beyond without significant declines in thinking and behavior that characterize dementia.⁶

Myth: Older adults need less (or more) sleep.

Fact: A common misconception is that a person’s sleep needs increase or decline with age. An increase can often be attributed to older people enjoying a nap, whereas a decline is often attributed to rising earlier in the morning. The fact is older adults’ sleep patterns are more fragmented because as the body changes with age, it can disrupt the circadian (daily) rhythms, which impacts sleep. There are also certain diseases that occur more commonly in older adults such as osteoarthritis and osteoporosis that can cause discomfort and influence an individual’s ability to get to sleep or stay asleep.

But older adults still need between seven and nine hours of sleep per night, the same as all adults. In fact, the Centers for Disease Control and Prevention states adults aged 61 to 64 need seven to nine hours per night, whereas those aged 65 and older need seven to eight hours of sleep.

A silver lining to this sleep miscon-ception is research suggests older adults handle sleep deprivation better than young adults, with older adults scoring better following a sleep-deprivation intervention in a range of measures, including negative affect, depression, confusion, tension, anger, fatigue and irritability.⁵

Myth: Older adults should not exercise to avoid injury.

Fact: It is often believed that exercise can do more harm than good for older adults, especially for those with a chronic condition. And, since bone density decreases with age, a fear of overexertion leading to injury is common. However, research proves there is a lot more to gain by being active and a lot to lose from being sedentary, which is more to blame than age when older adults lose their ability to do things on their own.^4,6

Not only can exercise increase muscle strength and reduce fat, it can improve mental health. In one study, researchers put 142 adults aged 60 years to 80 years through a 42-week weight-lifting regimen and found it increased dynamic muscle strength, muscle size and functional capacity. Another study that involved 1,740 older adults found regular exercise was associated with a delay in onset of dementia and Alzheimer’s disease.⁵

Most older adults can engage in some form of physical activity. Tai chi and similar mind and body movement practices have been shown to improve balance and stability to help maintain independence and prevent future falls. Other useful activities include walking, golfing, swimming and biking. However, it is recommended that those with certain conditions associated with age such as osteoporosis avoid high-impact exercise.^5,6

Myth: Only older women get osteoporosis.

Fact: Both women and men are affected by osteoporosis, and by age 65 or 70, men and women lose bone mass at the same rate. While women naturally have smaller, thinner bones than men, putting them at higher risk of osteoporosis, 20 percent of those affected are men. One in every four men and one in every two women older than 50 will experience an osteoporosis-related fracture in their lifetime.⁷ Causes of osteoporosis for both men and women include family history, a lack of calcium or vitamin D and too little exercise.⁶

Myth: Most older adults will have to give up driving.

Fact: Changes that occur with aging can affect a person’s ability to drive such as slower response speed, diminished vision or hearing, and reduced strength or mobility. However, it’s not age that determines older adults’ ability to drive but rather their ability to drive safely. Surprisingly, as the U.S. population ages, the number of licensed older adults continues to increase. According to the Federal Highway Administration, there were a record-high 221.7 million licensed drivers in the U.S. in 2016, including 41.7 million (almost one in five) who are 65 years and older.⁶

Myth: Older adults are often lonely and don’t contribute much to society.

Fact: It is true that more older people live alone, but they are not necessarily lonely. In fact, their relationships may grow more intense in old age.⁸ In addition, older adults are highly valued employees, colleagues and volunteers. According to researchers at the Stanford Graduate School of Education and the San Francisco-based nonprofit Encore.org, the majority of older adults want to contribute to society, and about a third actively do.⁹ Also, a Pew Research Center study found 67 percent of seniors over age 65 use the Internet, and more than 100,000 individuals over age 50 participate in the nonprofit Road Scholar experiential learning program each year to better understand other cultures around the world.¹⁰

Myth: Older adults are not interested in sex.

Fact: A 2017 University of Michigan National Poll on Healthy Aging showed 65 percent of respondents aged 50 years to 80 years were interested in sex. Seventy-six percent agreed sex is an important part of a romantic relationship at any age, and 40 percent indicated they were still sexually active.¹⁰

While it’s true that older age increases the risk of erectile dysfunction (ED) and vaginal dryness, these are not insurmountable issues for most people. An article in the International Journal of Clinical Practice indicates approximately 0.4 percent of men aged 18 years to 29 years experience ED compared with 11.5 percent of men aged 60 years to 69 years, which means nine out of 10 men in their 60s do not have ED. It’s also true that as people grow older, some don’t have the same sexual drive or desire, but this is not the case for everyone. In fact, researchers who conducted a study that involved 158 older adults wrote: “A remarkably robust sex life was evidenced by both the men and women, even until advanced old age.”⁵

Myth: Most older adults live in nursing homes.

Fact: Actually, a very small percentage of older Americans resides in nursing homes, and only approximately 5 percent live in them at any given time. However, the percentage does increase with age, ranging from 1.1 percent for persons 65 years to 74 years to 3.5 percent for people 75 years to 84 years and 13.2 percent for people aged 85-plus.²

Dispelling the Myths Now

The common theme to most myths surrounding growing old seems to center on inevitability or the perception that older age is associated with negative outcomes. But, as Dr. Levy stressed, being optimistic, diligent and having the will to live are important to living more healthfully as people age. While growing older does present challenges that differ for each person, aging by no means automatically results in a diminished quality of life, especially with today’s scientific advances. The good news is getting to the truth surrounding these myths may help individuals make smart choices to keep their minds and bodies healthy.