Many of the things we associate with getting older-aches and pains and memory lapses-are hard to accept and have become stereotypical of what it means to get older. However, as we’re living longer and often healthier lives, we recognize that in many areas we improve as we age.
Greater sense of acceptance of self and of others; desire for connection and the means to create it; life experiences that help us make smart decisions; wisdom and empathy-all are available to us as we grow older. And don’t forget gratitude. Being grateful for our families and our physical, mental and financial health can increase as we grow older and allow us to simply be glad to be alive.
Chronological vs. physiological age
Davangere P. Devanand, MD, is the director of geriatric psychiatry and a professor of psychiatry and neurology at Columbia University Vagelos College of Physicians and Surgeons. He stresses that age-our chronological age-really is just a number. It’s our physiological age, such as cardiac function for example, that really identifies individuals as middle aged or older.
“Some people in their 30s to 50s may have poor health for various reasons, and by biological markers, they are old,” Devanand explains. “Others of the same chronological age maintain very good health and fitness, and they are not really aging in the same way.”
Improvements with age
Some of the benefits we associate with aging may be due to the survival effect. “Those who become older are the survivors and are more resilient,” says Devanand. Others may die from diseases, accidents, suicide, substance abuse, or other reasons beyond their control. Those older survivors are less likely to be depressed or have substance abuse problems than many of their younger counterparts.
That said, as we age, our minds can get sharper. “We measure raw intelligence with the traditional IQ test, and older people may have a slight decline because of memory loss,” says Devanand. “We lose some connections-how we remember and place things in context-with age.”
But it is possible to learn new information. It happens all the time as older people learn to use new technology such as computers and smart phones. It just seems easier for younger people who “have more space on their mental hard drives,” he says.
Emotional intelligence and social intelligence generally do improve with age, he says. “Older people have less emotional volatility and a better understanding of relationships and have figured out strategies for different situations-what we call wisdom.”
Certain nerve cells in the brain are required for the fight or flight response that helps humans survive. But as we age, the number of these cells in the sympathetic nervous system and a region in the brain called the locus ceruleus may drop to half, causing the ability to generate anxiety to decrease. “Younger people often experience panic, for example, but after age 60 or 65, new onset panic disorder is rare and almost unknown because those neurons are just not there,” Devanand says.
A longer response time gives an older person more time to think through the problem and give a considered response.
In general, it takes longer to respond as we get older, which can be a disadvantage in situations like traffic. On the other hand, a longer response time gives an older person more time to think through the problem and give a considered response. “This extra time decreases impulsivity, which can be a huge problem among many younger people,” he says. Recognizing cause and effect of different situations is gained from life experience. “And as we get older, we get more adept at handling a variety of problems, which also may allow for more tolerance overall.”
Options for social interaction and community involvement may increase with age as people utilize senior centers or live in retirement villages where social activities are endless. “Older individuals view social relationships from a broad perspective and like to have a wider circle,” he says. “They know that having a narrow circle may make them more depressed.” And during the pandemic, many of those older, more isolated people held onto their positive outlook through Zoom and other virtual means. “They found ways to stay connected and remain more resilient.”
Normal aging or disease?
If advances in medicine and public health continue, Devanand says, the average person might live to be over 100 years old. “It may be difficult to imagine now,” he says, “but it’s theoretically possible.”
The difference between normal aging and disease is often difficult to determine. For example, blood pressure rises for almost everyone as they get older, so is that normal aging or disease? The same is true with memory loss. Most people have trouble remembering names, places, and so on, but is it normal or Alzheimer’s disease?
“It’s an ongoing medical debate, but if the average person lived to 100 or more, most people would have high blood pressure and many would have Alzheimer’s disease,” he says. “The severity of one’s functional impairment would just be different.”
Maintaining quality of life with increasing age will require effort in a person’s younger years, Devanand adds. Regular exercise and a healthy diet are known to decrease the risk for heart disease and stroke and maintain cognitive functioning. And social activities are important for physical and mental well-being.
“Health is not automatic, and the effort we put into our exercise and diet will determine how we age. Physical health often requires one to take extra steps.”
Davangere P. Devanand, MD, is director of the Memory Disorders Clinic and an attending psychiatrist at the New York State Psychiatric Institute and NewYork-Presbyterian. An expert in age-related cognitive decline, he has been recognized for his research, books, and articles published in leading medical journals about dementia, depression, ECT, and Alzheimer’s disease.