Yes, Ageism is Bad For Your Health

from ZOOMER magazine, June 18, 2018

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 tolerate 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 think of aging is 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 number one killer of people over fifty is cardiovascular disease. She wondered: what if ageism stresses the heart? She decided to test that theory with a double-barreled 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 the participants out further, 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 1500 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 a 2016, she and colleagues 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 tangles of amyloid plaques, 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 percent.

““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 behavior. This was likely a factor in Levy’s studies of stereotypes and long-term heart-health. “If people hold more negative views of aging, they may be less likely to walk the extra block or engage in healthy behaviors 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.

“People under forty don’t think of themselves as eventually getting older,” says the Harvard psychologist Ellen Langer, whose pioneering work on age primes paved 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 behavioral 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 tow-headed 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 eighties. Ageism is rampant among older people.”

This curious, common phenomenon of prejudice against one’s own group makes ageism different from the other ‘ism’s 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 public-health 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 re-creation of the ‘50s and emerged, one week later, measurably more spry. It has inspired the re-design of some seniors facilities and the re-thinking 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.