The notion that older people are forgetful is a widespread age-related stereotype. While aging is the greatest risk factor for dementia, memory loss is not an inevitable part of aging. Internalization of these negative aging stereotypes can have negative health consequences, and act as a self-fulling prophecy by impairing performance on cognitive tests.
Stereotype threat is the process by which an individual will underperform in ways that affirm a particular stereotype [1]. For example, an older adult may affirm the stereotype that older people are forgetful by performing worse on a memory test. These stereotype-associated impairments to cognitive performance can lead to underestimates of the cognitive abilities of older adults, which then further reinforces these stereotypes.
This effect may also interfere with the ability to accurately diagnose individuals with pathological cognitive decline, and a clinical trial is currently underway to determine whether this effect plays a clinically relevant role in the misdiagnosis of memory-related mild cognitive impairment [2]. It may explain why some people receive this diagnosis but never progress to dementia.
Meta-analyses of studies show that older adults primed with negative aging stereotypes perform worse on cognitive tests, particularly on measures of episodic memory [3;4]. A study examining brain activity showed that priming with negative stereotypes directed attention away from the task, so less brain resources are available to complete the test, which results in decreased performance [5]. Focusing on the age-related stereotypes may also shift the mindset from working to increase performance to one of avoiding errors [1]. This more cautious approach may lead to second-guessing, and this doubt may impair overall performance.
Those transitioning from middle-age to elderly are most susceptible to age-related stereotype threat, due to the disconnect between one’s actual age and how old someone feels. Starting around middle-age, people generally report feeling about 20% younger than their actual age [1]. While a more youthful mentality has been shown to be associated with a variety of health benefits, including increased life satisfaction, and lower rates of mortality [6; 7], these benefits can be offset by the internalization of negative aging stereotypes and a fear of aging [1]. Unlike other identity-related stereotype classes, such as race or gender, age changes over time, such that people become exposed to aging stereotypes while they are still young. As a result, individuals come to accept and internalize these stereotypes, leading them to view their own aging in a negative light [1]. While this suggests that broad societal changes in attitudes toward aging are needed to address the root cause, it doesn’t mean we are powerless against them. Rather, the key to overcoming these stereotypes is a personal change in mindset and expectations.
Poor physical and cognitive health are not inevitable parts of aging, but expectations that they are can lead us to become less health conscious as we age [8]. While some individuals can maintain extremely high levels of fitness into old age, a decline from the peak performance levels of one’s 20s is normal. Thus, comparing oneself to these ‘super-agers’ can lead to unrealistic expectations that exacerbate negative feelings about one’s own aging journey [9]. A healthy mindset toward aging is one that continues to prioritize personal growth and taking on new challenges, rather than just on avoiding risks, but which is rooted in self-compassion [10]. This mindset focuses on the learning process and broad goals related to overall health, rather than on specific performance-related goals.
One of the best ways to take on new challenges is to engage with others. Social engagement has emerged as one of the key factors in healthy aging and overcoming aging stereotypes. Individuals who participate in a wide variety of activities, which provides access to a broader array of social partners show lower levels of age-related declines in cognitive performance [11]. Similarly, the most socially active participants were found to be the least affected by negative aging stereotype priming on memory tests [12]. The negative effects on cognitive performance are also minimized when participants are tested in a familiar, supportive environment [13].
Rather than approach a momentary memory lapse with fear, take it as an opportunity for empowerment. Reflect on the efforts you are taking to prioritize your health, and consider new goals toward adopting a healthier diet, adding in more physical activity, increasing engagement in a social group, and/or learning a new skill.
Betsy Mills, PhD, is a member of the ADDF's Aging and Alzheimer's Prevention program. She critically evaluates the scientific evidence regarding prospective therapies to promote brain health and/or prevent Alzheimer's disease, and contributes to CognitiveVitality.org. Dr. Mills came to the ADDF from the University of Michigan, where she served as the grant writing manager for a clinical laboratory specializing in neuroautoimmune diseases. She also completed a Postdoctoral fellowship at the University of Michigan, where she worked to uncover genes that could promote retina regeneration. She earned her doctorate in neuroscience at Johns Hopkins University School of Medicine, where she studied the role of glial cells in the optic nerve, and their contribution to neurodegeneration in glaucoma. She obtained her bachelor's degree in biology from the College of the Holy Cross. Dr. Mills has a strong passion for community outreach, and has served as program presenter with the Michigan Great Lakes Chapter of the Alzheimer's Association to promote dementia awareness.
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