Yes, Ageism is Bad for Your Health

Re­search re­veals a link be­tween ageist at­ti­tudes and how you age

ZOOMER Magazine - - CONTENTS - By Bruce Gri­er­son

ONE OF FACE­BOOK’S core val­ues, ac­cord­ing to its founder Mark Zucker­berg, is to pro­mote “bet­ter un­der­stand­ing of the lives and per­spec­tives of oth­ers.” Not long ago, a group of psy­chol­o­gists from four Amer­i­can uni­ver­si­ties de­cided to test this lofty adage. They con­ducted the first-ever study of age stereo­types in so­cial net­works.

The psy­chol­o­gists looked for Face­book groups about older peo­ple — the kind of lily pads that seniors might land on as they surf so­cial me­dia. But the re­searchers were in­ter­ested a par­tic­u­lar kind of group: about older peo­ple but not by older peo­ple. They found 84. Th­ese sites were cre­ated and man­aged by peo­ple mostly in their 20s. They pre­sented a young per­son’s-eye view of what it’s like to be old. A fairly jaun­diced eye.

Three-quar­ters of the in­di­vid­ual posts “ex­co­ri­ated” older in­di­vid­u­als. One-quar­ter “in­fan­tilized” them. Nearly 40 per cent of the young posters thought older peo­ple should be banned from pub­lic ac­tiv­i­ties like shop­ping.

Some thought older folks should just hurry up and die al­ready. Of un­nat­u­ral causes if nec­es­sary: “Any­one over the age of 69 should im­me­di­ately face a fir­ing squad.”

Lead re­searcher Becca Levy, a pro­fes­sor of epi­demi­ol­ogy and psy­chol­ogy at Yale, had read­ied her­self for some vit­riol on th­ese sites. “But I didn’t ex­pect it to be this bad.”

Face­book says it does not toler- ate hate speech. “It is a se­ri­ous vi­o­la­tion of our terms to sin­gle out in­di­vid­u­als based on race, eth­nic­ity, na­tional ori­gin, re­li­gion, sex, gen­der, sex­ual ori­en­ta­tion, dis­abil­ity or dis­ease,” reads its Com­mu­nity Stan­dards pol­icy.

Levy no­ticed age wasn’t on the list. Ageism didn’t make the cut on a so­cial plat­form used by two bil­lion peo­ple. Even after the Yale study was pub­lished, Face­book didn’t bother to cor­rect the over­sight. Last time Levy checked, eight of the most of­fen­sive sites were still up and run­ning.

So this was ap­palling but il­lu­mi­nat­ing. The in­ter­net is the great mag­ni­fier of the hu­man id. Ugly truths waft out un­der cover of anonymity. This study re­vealed a few: ageism is ev­ery­where. And so­cial me­dia is a con­ve­nient plat­form for young peo­ple to den­i­grate older peo­ple. Some young peo­ple don’t like old peo­ple very much – or maybe they just don’t like the idea of grow­ing old.

But there is a bomb in the re­sults. Prej­u­dice, Levy has found, tends to boomerang back on the prej­u­diced.

Stud­ies show most peo­ple’s views of aging are a mix of pos­i­tive and neg­a­tive and neu­tral. But peo­ple who are too neg­a­tive – or have as­sim­i­lated more neg­a­tive age stereo­types from their cul­ture – pay for that bias on a phys­i­cal level. Whether we con­sider aging an op­por­tu­nity for growth or a ticket to frailty and in­com­pe­tence – our bod­ies reg­is­ter that im­pres­sion and deliver it as a wish, re­turn-to-sender.

In an irony wor­thy of Os­car Wilde’s Do­rian Gray, ageism makes peo­ple age more quickly.

Levy has built a dis­tin­guished ca­reer prov­ing it.

Her most fa­mous study lever­aged data col­lected in the mid-’70s from the town of Ox­ford, Ohio. Res­i­dents over age 50 were asked yes-or-no ques­tions about their thoughts on aging. For ex­am­ple: “As you get older, you are less use­ful” or “As I get older, things are (bet­ter, worse, or the same) as I thought they would be.”

Twenty-three years later, Levy en­tered the pic­ture. First she checked to see how many of those par­tic­i­pants were still alive. Then she matched the mor­tal­ity data with the sur­vey an­swers. She made a star­tling dis­cov­ery. The sub­jects with the most neg­a­tive views of aging died, on av­er­age, 7.6 years sooner than those with the most pos­i­tive views. Be­ing ageist in­flu­enced life­span more than gen­der. Or so­cioe­co­nomic sta­tus. Or lone­li­ness. Or ex­er­cise.

Be­cause it was a cor­re­la­tional study, there was no ob­vi­ous ex­pla­na­tion for the huge ef­fect. But Levy knew the No. 1 killer of peo­ple over 50 is car­dio­vas­cu­lar dis­ease. She won­dered: what if ageism stresses the heart? She de­cided to test that the­ory with a dou­ble­bar­relled tech­nique that has be­come her trade­mark.

Levy is both an ex­per­i­men­tal so­cial psy­chol­o­gist and an epi­demi­ol­o­gist, which makes her uniquely qual­i­fied to see both the fine

grain and the big pic­ture of so­cial sci­ence. She goes back and forth. “I like to ob­serve things in a con­trolled set­ting, and then see if that ap­plies in a real world set­ting over time.”

In her lab at Yale, Levy had a num­ber of test sub­jects, all over 65, take math and ver­bal tests un­der tight time pres­sure. But be­fore they did, the sub­jects were “primed” with ei­ther pos­i­tive or neg­a­tive aging stereo­types. Essen­tially, a rosy or gloomy view of aging was planted in the test-tak­ers’ minds be­fore the start­ing gun sounded.

The neg­a­tive-stereo­type-primed group tight­ened right up. Their heart rate and blood pres­sure soared. The test – which in­volved talk­ing about a stress­ful ex­pe­ri­ence – was hairy for both groups. But the neg­a­tive stereo­types stressed par­tic­i­pants out more, while the pos­i­tive stereo­types calmed them down.

“So then we won­dered how that might op­er­ate in the com­mu­nity over time,” Levy says.

The Bal­ti­more Lon­gi­tu­di­nal Study of Aging, started in 1958, tracked health data of around 1,500 vol­un­teer sub­jects in to­tal aged 17 to 49 over the course of six decades. Hand­ily, the re­searchers also asked those sub­jects what they thought about aging and older peo­ple.

It turned out, sub­jects who had bought into the neg­a­tive stereo­types of aging suf­fered twice as many heart events – from mini-strokes to con­ges­tive heart fail­ure – as those who had ab­sorbed more pos­i­tive stereo­types. Levy had con­trolled for ev­ery fac­tor she could think of, from diet to smok­ing to fam­ily his­tory to depression. The only dif­fer­ence was the sub­jects’ thoughts about aging.

“Young healthy peo­ple who hold ageist at­ti­tudes may put them­selves at risk of heart dis­ease up to 40 years later,” Levy con­cluded in the study, pub­lished in Psy­cho­log­i­cal Sci­ence in March of 2009.

Ageism is a util­ity knife of wicked ver­sa­til­ity. It af­fects even things you wouldn’t ex­pect to have a psy­cho­log­i­cal di­men­sion. Things such as bal­ance, hand­writ­ing, mem­ory. Even hear­ing loss.

In one study, Levy asked sep­tu­a­ge­nar­ian test sub­jects to think of words that de­scribed older peo­ple. Those who came up with words like “frail” more than words like “wise” saw their hear­ing de­grade more quickly – three years later, this group’s hear­ing was sig­nif­i­cantly worse than the group that had held more pos­i­tive views of aging.

Just a few weeks ago, Levy, in col­lab­o­ra­tion with the sci­en­tific di­rec­tor of the Na­tional In­sti­tute on Aging, pub­lished per­haps her most au­da­cious study yet – and her most per­sonal. Levy had a beloved grand­fa­ther who suf­fered from Alzheimer’s. Could the course of that kind of af­flic­tion, too, be steered by our thoughts?

Levy had al­ready pro­duced one block­buster study sug­gest­ing the an­swer is yes. In 2016, she and col- leagues com­pared the ageism scores from that Bal­ti­more Lon­gi­tu­di­nal study to the au­top­sied brains of the study sub­jects who had died. The brains of sub­jects who had held the most neg­a­tive age stereo­types bloomed with plaques of amy­loid and showed sig­nif­i­cant hip­pocam­pal shrink­age.

In the new study, within a dif­fer­ent data set of older sub­jects, Levy ze­roed in on a par­tic­u­lar type of de­men­tia can­di­date. Peo­ple who carry the ε4 vari­ant on the APOE gene are more likely to de­velop early-on­set Alzheimer’s and other de­men­tias. The chance is around 50 per cent.

““So half of this is en­vi­ron­men­tal,” says Levy. “We thought the pos­i­tive be­liefs might be one of the en­vi­ron­men­tal fac­tors that ex­plain why some peo­ple with APOE4 de­velop de­men­tia and oth­ers do not.”

Around a quar­ter of the sub­jects car­ried APOE4 – as re­vealed by ge­netic test­ing at the be­gin­ning of the study. All the sub­jects were de­men­tia-free at that point. Levy com­pared the at­ti­tude data to the health out­comes. Turned out, the APOE4 car­ri­ers who held rosier views of aging were less than half as likely to show signs of de­men­tia four years later.

So what is ac­tu­ally go­ing on here? What might ex­plain the dra­matic phys­i­o­log­i­cal ef­fects of some­thing as in­ef­fa­ble as mere “thoughts”?

For one thing, our at­ti­tudes, con­scious or not, drive our be­hav­iour. This was likely a fac­tor in Levy’s stud­ies of stereo­types and longterm heart health. “If peo­ple hold more neg­a­tive views of aging, they may be less likely to walk the ex­tra block or en­gage in healthy be­hav­iours as they get older,” Levy said. “Be­cause they tend to think of poor health as in­evitable later in life.”

But a more po­tent fac­tor – in some ways the ele­phant in the room in all aging stereo­type stud­ies – is this: there’s of­ten a dis­con­nect be­tween young peo­ple and their fu­ture selves.

“Young, healthy peo­ple who hold ageist at­ti­tudes may put them­selves at risk of heart dis­ease down the road”

“Peo­ple un­der 40 don’t think of them­selves as even­tu­ally get­ting older,” says the Har­vard psy­chol­o­gist Ellen Langer, whose pi­o­neer­ing work on age primed the way for Levy’s. That dis­con­nect is a prob­lem. It pre­vents young peo­ple from, for in­stance, de­vel­op­ing habits that would profit their older selves down the line. (Like sav­ing for re­tire­ment, as the be­havioural econ­o­mist Dan Ariely has shown.) Just think­ing about grow­ing old is heart-con­strict­ingly stress­ful – if, that is, you ex­pect older age to be a time of pain and lone­li­ness and con­fine­ment, rather than a time of leisure and dis­count travel and free play with adorable grand­kids. Ageism, at root, is about fear. Robert But­ler, the psy­chi­a­trist who coined the term “ageism,” thought ageism and el­der abuse stem from “deeply hu­man con­cerns and fears about the vul­ner­a­bil­ity in­her­ent in the later years of life.” The idea of shuf­fling in­ex­orably to­ward the grave scares the hell out of us. So we hold the shuf­flers at a con­temptible dis­tance – even as we our­selves, bit by in­vis­i­ble bit, be­come them.

“One time I picked up my fa­ther at the air­port,” re­calls Langer, “and I said, ‘Dad, how was the flight?’ He said, ‘It was fine, but there were all th­ese old peo­ple on the plane.’ My fa­ther was in his 80s. Ageism is ram­pant among older peo­ple.”

This cu­ri­ous, com­mon phe­nom­e­non of prej­u­dice against one’s own group makes ageism dif­fer­ent from the other -isms that Face­book ac­tu­ally cares about, like sex­ism and racism. Peo­ple don’t typ­i­cally diss their own gen­der or race. If oth­ers diss our gen­der or race, well, we can de­velop an­ti­bod­ies against those at­tacks from an early age, and ward off those poi­sonous judg­ments. Age is dif­fer­ent. To the young, “old peo­ple” can seem al­most like a dif­fer­ent species – crotch­ety and frail and out to lunch. Un­til one day the young ac­tu­ally are old and find

them­selves un­de­fended against the very stereo­types they so deeply ab­sorbed. And they sink to their low es­ti­ma­tion of them­selves.

This is all bad news for those ageist 20-some­thing Face­book posters. They don’t know what flight plan they just filed.

But here’s the rub. Levy be­lieves it’s pos­si­ble to change that flight plan.

In fact, al­most all her stud­ies can be flipped to re­veal not the destructive ef­fects of neg­a­tive aging stereo­types but the health­ful ef­fects of pos­i­tive ones. Her whole body of work, in a way, is a call for a pub­lichealth cam­paign against ageism.

“We know that chil­dren as young as three or four have taken in those neg­a­tive stereo­types of our cul­ture, and we know that those stereo­types are re­in­forced in young adult­hood and mid­dle age,” she says. “So by the time in­di­vid­u­als reach older age the stereo­types can be pretty en­grained.

“But we also have re­search that sug­gests that thoughts are mal­leable. If you prompt them, most peo­ple can come up with pos­i­tive im­ages. Some of those strate­gies we can learn. Peo­ple can be taught to ques­tion neg­a­tive be­liefs.

“Be­cause we know this starts at a young age, the ear­lier the in­ter­ven­tions hap­pen, the bet­ter. For ex­am­ple, you can make cur­ricu­lum changes” in schools. “There are pro­grams where older in­di­vid­u­als come into class­rooms and be­come re­sources.”

Langer’s work car­ries a sim­i­lar mes­sage.

Many of her age-prim­ing stud­ies are about trick­ing the old to re­mem­ber what it was like to be young – the bet­ter to tap the youth­ful­ness that is still in them. (In her fa­mous Coun­ter­clock­wise study from 1979, older sub­jects were dropped into an elab­o­rate re­cre­ation of the ’50s and emerged one week later mea­sur­ably more spry. It has in­spired the re­design of some seniors fa­cil­i­ties and the re­think­ing of el­der care.)

But the rest of them are about nudg­ing the young to think about what it’ll be like to be old.

“Let me tell you some­thing I wanted to do years ago but couldn’t get fund­ing,” Langer says. “I wanted to cre­ate a build­ing that sim­u­lated life at age 70. As you get older, your body changes. You feel tem­per­a­tures more in­tensely. Your field of vi­sion nar­rows. By hav­ing a 40-year-old live in such a place – and I don’t think it’d take more than about three weeks – they’d prob­a­bly de­velop the skill to be able to over­come or at least adapt to th­ese deficits.”

For the in­ter­net hate-mon­gers, it would be a pow­er­ful intervention. It might just keep them alive.

Becca Levy

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