Pro-Aging, Anti-Ageism

By: Jessica Novello, MS, BSN, RN, CDP

 

What is Ageism?

• Negative stereotypes within a culture that guide feelings and behaviors surrounding aging and based on the age of persons.
• The term was coined in 1969 by Robert Butler (an American Gerontologist). Not all languages have a term equivalent to “ageism”.
• Ageism can exist at any point in the aging process and beliefs can be held against the young and/or the old.
• Negative manifestations can affect our sense of self, our interpersonal relationships, and institutional practices (healthcare and work policies). This creates layers of individual and widespread disadvantages- at personal, social, and organizational levels.
• Disadvantages can be compounded by race, sex, or other stereotypes. Stereotypes may exist in healthcare, workplaces, legal systems, or housing/public benefits and are prominent in business and media (anti-aging culture).
• The COVID-19 pandemic and the effect on nursing homes recently illuminated ageism disadvantage.
• Professor Becca Levy, Yale School of Public Health, is a prominent ageism researcher in the US.

 

What are the Costs of Ageism?

 

Economic

• • $63 billion on ageism related excess health costs (measured in a group of adults 60 years and older over 1 year as an aggregate of excess spending for 8 common health conditions) (B. Levy, et al., 2020-Yale Medicine, see link). Health costs of ageism calculated at $63 billion annually, study finds < Yale School of Medicine
  • $4 trillion (in lost Gross Domestic Product (GDP) by 2050) correlating to lost economic activity among older workers from systematic bias and ousting from the workforce (AARP, 2021- see link). Cost of Inequity: Age Discrimination Could Cost the Economy Trillions (businessinsider.com)

 

Health

Note: some of these studies are from the Baltimore Longitudinal Study of Aging.

 

• • • Heart attacks/Stroke risk– correlation shows that cardiovascular risk doubles when negative age stereotypes are internalized.
      • Age Stereotypes Held Earlier in Life Predict Cardiovascular Events in Later Life – PMC (nih.gov)
    • Better gait, balance, and strength measures were observed– when well older adults were exposed to positive age stereotypes
      • Subliminal Strengthening: Improving Elders’ Physical Function over Time through an Implicit-Age-Stereotype Intervention – PMC (nih.gov)
    • Improved recovery– older adults were 44% more likely to recover from an Activity of Daily Living performance disability when exposed to positive age stereotypes
      • Association Between Positive Age Stereotypes and Recovery From Disability in Older Persons – PMC (nih.gov)
    • Alzheimer’s Disease and Dementias– adults with negative age stereotypes had greater volume decline in the hippocampus region of the brain and poorer memory performance over time, while positive age beliefs served as a protective factor to lower Alzheimer’s risk, even in people without the APOE4 gene (a gene that carries an increased risk of Alzheimer’s Disease).
      • A Culture-Brain Link: Negative Age Stereotypes Predict Alzheimer’s-disease Biomarkers – PMC (nih.gov)
      • Memory Shaped by Age Stereotypes over Time | The Journals of Gerontology: Series B | Oxford Academic (oup.com)
      • Positive age beliefs protect against dementia even among elders with high-risk gene | PLOS ONE.
    • Better mental health was observed– among veterans exposed to positive age stereotypes (increased coping and reduced stress) made participants less likely to develop mental health conditions.
      • Active coping shields against negative aging self-stereotypes contributing to psychiatric conditions – PubMed (nih.gov)
    • A metanalysis showed that negative age stereotypes lend themselves to negative behavior and beliefs that impact health and function, there is also a small, but notable correlation inferring that positive beliefs lead to positive aging outcomes.
      • Meta-Analysis of Positive and Negative Age Stereotype Priming Effects on Behavior Among Older Adults | The Journals of Gerontology: Series B | Oxford Academic (oup.com)
      • The stereotype-matching effect: Greater influence on functioning when age stereotypes correspond to outcomes. (apa.org)
      • The influence of subjective aging on health and longevity: A meta-analysis of longitudinal data. (apa.org)

 

I didn’t intend for this blog to become a literature review, but there is a growing volume of studies among smaller groups showing discrete measurable health improvement and tracking, long term, health risk among populations depending on exposure to aging stereotypes. Personal and social beliefs matter (and science is mounting in support)!

 

How do we Reduce Ageism?

 

Policy and Law

At all levels-from fair local business practices to international policies protecting persons of all ages, especially the young and old.

• • • The National Council on Aging is active in policy-focuses on equity in public programs for older adults- https://www.ncoa.org/advocates/public-policy
    • Equal Employment Opportunity Commission, focuses on Anti-age discrimination in the workplace- https://www.eeoc.gov/age-discrimination#:~:text=The%20Age%20Discrimination%20in%20Employment,younger%20workers%20from%20age%20discrimination
    • American Society on Aging, focuses on tackling ageism in healthcare culture, and law https://www.asaging.org/ageism

 

Meaningful Interventions

It is important that we have interventions that invoke people of all ages (commonly called intergenerational programming)- when older and younger adults work together both groups are better informed and able to combat age-related stereotypes.

• • Generations United has a great search engine to find mixed-age programming near you https://www.gu.org/ig-program-database/page/61/ (Baltimore hosts a community prom, art groups, and school mentorship programs).
  • The AARP Experience Corps are active nationally and in Baltimore! https://www.aarp.org/experience-corps/experience-corps-volunteer/experience-corps-cities-baltimore.html

 

Education

Education should start with young children and be worked into college and professional-level training; we also need to consider academic research and social campaigns to combat harmful cultural beliefs.

• • • The Gerontological Society of America’s Ageism First Aid is wonderful (there is a cost for the course, but this is a worthy investment for organizations), https://www.geron.org/programs-services/education-center/ageism-first-aid
    • Old School runs a free anti-ageism clearing house with lots of education options, https://oldschool.info/
    • Our friends at LeadingAge offer educational resources from presentations to discussion guides, https://leadingage.org/topic/ageism/
    • I like to think of living examples as important social learning opportunities:
      • The oldest performer on SNL (she was 88) and worked into her late 90s before passing away at 99 years of age- Betty White, https://www.cnn.com/2021/12/31/entertainment/betty-white-obituary/index.html
      • She models and is a design phenomenon, she is still working at 100- Iris Apfel, https://www.today.com/style/style/iris-apfel-interview-hm-collection-rcna24327

 

There is power in people and their stories and Betty and Iris’ show that meaningful engagement, work, and respect go a long way. Their longevity is likely not by chance, but was earned by their action. I hope that by creating awareness and sharing education that we can work to break age-bound barriers, like Betty and Iris have done, to create a mutual benefit across all ages in society. When practice and policy support an overall educational and cultural shift against ageism both people and organizations stand to make large gains to stay well and active.

 

Learn More:

A short read (global): Ageing: Ageism (who.int)

A long read (global): Global report on ageism (who.int)

Listen to a summary of Dr. Levy’s research (NY Times) here: Exploring the Health Effects of Ageism – The New York Times (nytimes.com)