10/2: What is Old?
Weekly recording
Miss the class? Or would you like to hear the lesson again? Join instructor Bridget Wright as she discussses, "What is Old".
What is Old?
What does “aging” mean? How is an older person defined? What is Agism? These are questions which we ask as we begin our lesson on What is Old. In this lesson, we learn what ageism is, how ageism affects us, types of ageism with a closed look at self-directed ageism, how self-directed ageism affects older adult’s health and their well-being, the ways to combat self-directed ageism, and having answered all the above questions.
Video campaign to say NO to ageist comments
What Does Aging Mean?
Aging is a natural and inevitable process. It is something that happens to all of us over time even without injuries, illnesses, environmental risks or unhealthy lifestyle.
What does aging really mean? What is “old enough” to be a licensed driver, to vote, and to drink alcohol? What is the reproductive age range? When is a woman too old to have a baby?
(on right) The World's oldest mother Rajo Devi Lohan (70) with father Ram Devi Lohan (72) and daughter Naveen at their home on December 17, 2008, in Badhu Patti village, Alewa, Hisar, Haryana. (Photo: Getty Images) Source: India Today
Types of aging
These questions suggest that there are many ways of looking at aging. In fact, age can be defined in different dimensions or perspectives including:
● Chronological age: the number of years you have been alive and is unchangeable.
● Biological age or functional age: how old your cells and tissues are, is based on physiological evidence. If you are especially healthy and fit for your age, your biological age may well be lower than your chronological age. But if you are sedentary, chronically ill, or in poor physical condition, your biological age may be higher.
● Psychological age: how your personality, mental functioning, and sense of self (self-esteem, self-confidence) change during your adult years. How you feel, act, and behave. It is not necessarily equal to chronological age. Your psychological age can be lower or exceed your chronological age.
● Social age: how your roles and relationships change within your family and friends or in formal organizations. Social aging includes the expectations and assumptions of those around us about how we should behave, what we are like, what we can do, and what we should be doing at different ages. (Morgan et al., 2015)
Three videos to make you think twice about aging and perceptions of aging
How is an Older Person Defined?
The United Nations defines an older person as over 60 years of age. In the U.S., a person who is over 65 is considered an older adult. However, families and communities often use other socio-cultural referents to define age, including family status (grandparents), physical appearance, or age-related health conditions. (UNHCR, 2020)
We reviewed different perspectives of aging and defined age in different dimensions. We continue to use age in so many aspects of social life. Like race and sex, age is one of the nine personal characteristics that we use to categorize people and it often leads to stereotypes, prejudice, and discrimination in terms of racism, sexism, and ageism. The image to the right shows the nine social characteristics. And yet, ageism remains an often socially accepted form of prejudice.
The United Nations (UNO) celebrates Older Persons Day on October 1st every year across the world to focus on older human rights. This year is the 75th anniversary of International Older Persons Day to eliminate age-based discrimination in institutions, attitudes, and practices.
Also, October 7th is nationally recognized as Ageism Awareness Day to draw attention to the existence and impact of ageism in our society and how we can reframe aging in our communities. (American Association on Aging, 2023)
What Is Ageism?
According to the World Health Organization (WHO), “Ageism refers to the stereotypes (how we think), prejudice (how we feel) and discrimination (how we act) towards others or oneself based on age.” Everyone experiences ageism, young and old. (WHO, 2021) We will discuss age discrimination against older adults.
Ageism can take root early in life. Even as children, we begin to pick up on the idea that aging is an unsatisfying process and older adults are incapable of taking care of themselves. These messages can show up in the media we consume. Just picture commercials that promise to reverse “unsightly” age lines or television shows that depict older adults as clueless and frail. Ageist messaging can also be passed along through jokes and casual comments from family members and friends. (Reid, 2023) The Figure below shows frequency of exposure to ageist messages in the United States in the form of environmental and social cues reflecting ageist prejudices and stereotypes (2 items); frequency of ageism in interpersonal interactions, specifically being targeted by discrimination rooted in others’ assumptions and stereotypes about older adults (5 items); and endorsement of internalized ageism, reflecting individually held beliefs linking aging and health (3 items)
Why Do We Worry About Ageism?
Ageism Is a Global Challenge
Every second a person in the world is believed to hold ageist attitudes. Prevalence figures based on a survey of 83,034 people in 57 countries found one in every two people held moderately or highly ageist attitudes. (Office et al., 2020) The Prevalence of everyday ageism among 2035 US adults ages 50 to 80 years, was 93.4%. Internalized ageism was reported by 1664 adults (81.2%), ageist messages by 1394 adults (65.2%), and interpersonal ageism by 941 adults (44.9%). (Allen et al., 2022)
The figure to the right shows 64% of women and 59% of men have experienced age discrimination in the workplace, according to a study by AARP.
The key findings of ageism from the report in the United Kingdom shows that:
● Over 3 in 10, 50–64-year-olds have felt invisible because of their age.
● Only 2 in 10 people over 50 feel national newspapers represent their age positively.
● Almost 3 in 10 men over 50 have felt they could not apply for jobs because of their age.
● Almost 1 in 3 women over 50 feel their age is not well-represented in society.
Ageism Is Costly
Ageism costs our societies billions of dollars. Results of a recent study (2020) in the U.S showed that the annual health cost of ageism was $63 billion for a broad range of health conditions including overtreatment or undertreatment. (Greenwood, 2018) AARP and The Economist Intelligence Unit reported that the economic contribution of people aged 50-plus was worth $8.3 trillion in 2018, and it is forecast to more than triple to $28.2 trillion by 2050. They estimated that the U.S. missed out on an 11% increase in the 50-plus population in 2018 and could miss out on a 15% increase in the 50-plus population’s economic contribution in 2050 because of age discrimination. The figure below shows the current contribution of the 50-plus population to U.S. GDP versus the potential contribution under a no-age discrimination scenario ($ trillion). (AARP, 2019)
Ageism is a Serious Health Problem
Ageism has serious and wide-ranging consequences for people’s health and well-being. It can change how we view ourselves, can destroy solidarity between generations. Among older people, ageism is associated with poor physical and mental health, increased social isolation and loneliness, greater financial insecurity, decreased quality of life and premature death. An estimated 6.3 million cases of depression globally are estimated to be attributable to ageism. (WHO, 2021)
The figure below shows the impact of ageism on older persons’ health in 11 health domains:
Three Types of Ageism
Institutional Ageism
Institutional ageism is when social norms, practices, and rules are unfair to older adults. A workplace that insists workers retire at a specific age is an example of institutional ageism. In some cases, ageism is so embedded in institutions that it may be hard to spot. For example, in the medical field, older adults are often underrepresented in health research and clinical trials. In the mental health field, professionals may receive less training on how to work with older patients. (Reid, 2023)
Interpersonal Ageism
Interpersonal ageism is when ageism occurs in the interactions between individuals. This can include parent-child relationships. It can involve ignoring someone’s point of view in decision making, or the way of speaking to someone who is older. (RTOERO, 2023) This kind of dismissive language can make older adults feel humiliated, frustrated, and undervalued. It can also give way to self-directed ageism. (Reid, 2023)
Self-directed Ageism
Self-directed ageism is when a person internalizes a negative attitude toward aging or his/her own age group. This creates a deep sense of self-doubt and an overall negative perception of aging. (Reid, 2023)
Self-directed ageism limits our potential. For example, we may think we are too old to learn new skills or try an activity. We may assume health or mobility declines are a natural part of aging rather than something we can influence or receive treatment for. This only reinforces our self-directed ageism and gives other people more reason to believe the stereotypes. (RTOERO, 2023)
Understanding Self-directed Ageism
Self-directed ageism can happen in two ways:
● Behavioral – where people come to believe the messages they hear about aging, such as that cognitive and physical decline are inevitable with age. As a result, they don’t engage in certain behaviors, for example, activities that would maintain or improve their health.
● Psychological – where a person believes they will perform badly on a task because of their age (because this is what all external messages tell them). This leads to anxiety and a lack of confidence causing them to underperform on the task thereby confirming the stereotype. (Center for Ageing Better, 2023)
Source: Don't let your age stop you from learning a new skill!
Negative Effects of Self-directed Ageism
Self-directed ageism occurs when a person internalizes ageism due to repeated exposure to ageist messages and, as a result, they can become self-ageist causing them to modify their own thinking and behavior. Self-directed ageism can have detrimental effects on mental and physical health and negatively impacts financial well-being and social well-being. (Center for Ageing Better, 2023)
Mental Health Effects of Self-directed Agism
Self-directed ageism leads to poor body image or increased pessimism or anxiety about getting older, reduced self-esteem, older adults who have negative self-perceptions of aging might experience an actual drop in cognitive abilities, such as memory, due to fear of confirming those stereotypes. (Center for Ageing Better, 2023.), (Reid, 2023)
Physical Health Effects of Self-directed Agism
Self-directed ageism leads to engaging in unhealthy behaviors like eating a poor diet, smoking, drinking, or skipping prescribed medications. Older adults with negative self-perceptions of aging, might also have lower levels of resilience and social support, which are two factors that affect longevity. (Reid, 2023)
Negative effects of self-directed ageism on health behaviors:
● Lower levels of exercise
● Unhealthy eating
● Alcohol consumption
● Tendency to smoke
● Less likely to use seat belt
● Less likely to visit doctor regularly
● Less likely to seek help for chronic back pain
● Less likely to seek treatment for urinary incontinence
● Less likely to use of preventive health services including cholesterol tests, mammogram, x-ray, pap smear or prostate exams
● Less likely to seek medical care for worrying symptoms
● Lower adherence to medications (including in patients with osteoporosis) (Center for Ageing Better, 2023)
Negative Effects of Self-Directed Ageism on Health Status
● Increased risk of mortality
● Reduced physical function such as the ability to do things like housework and working full-time
● Increased reporting of poor health (as opposed to good or very good health) to have coronary heart disease, chronic lung disease, arthritis, limiting long-standing illness, and depressive symptoms. (Center for Ageing Better, 2023)
Effects of Self-Directed Ageism on Social well-being
Older adults with negative self-perception of aging internalize that old age is a period of loneliness and isolation. That means self-directed ageism can result in social isolation and loneliness. Loneliness can then lead to all sorts of additional problems, such as:
● Higher stress levels
● Reduced sleep quality
● Impaired immune system
● Increased risk of physical illness
● Increased cognitive decline (Reid, 2023)
Effects of Self-Directed Ageism on Financial Well being
The mental and physical health issues due to self-directed ageism are costly. Also, falling out of work prematurely due to health issues and ageism in the workplace leads to financial insecurity. (Center for Ageing Better, 2023)
A study in the U.S. showed that negative self-perceptions of aging are associated with a higher prevalence for all the eight most expensive health conditions among Americans, which include heart disease, lung disease, diabetes, musculoskeletal disorders, and injuries. Researchers reported that the health care cost of negative self-perceptions of aging was more than the health care cost of age discrimination and negative age-stereotypes. The graph below shows that the excess cost was $11.1 billion for age discrimination, $28.5 billion for negative age stereotypes, and $33.7 billion for negative self-perceptions of aging. (Levy et al., 2020)
Research on Self-Directed Ageism
We all have the right to live free from discrimination. Ageism and self-directed ageism have harmful impacts on both physical and mental health. As the population of older adults increases, it is important to understand what may assist every older person to live well and longer.
A systematic review from 32 observational studies in 15 countries across the globe aimed to synthesize findings on the association between Self-Perception of Aging (SPA) and Quality of Life (QoL) among older adults aged 60 and above. Results indicated a strong association between positive perception of aging and quality of life (QoL), including key domains of QoL, physical health and functioning, psychological health, mental health, and general well-being. Results also showed that positive SPA is associated with a better Myocardial Infarction (MI) recovery rate, increased physical activity, better aging knowledge, better self-image, better memory self-efficacy, feeling younger, and better life satisfaction. In contrast, negative SPA, and negative age stereotypes were related to lower life satisfaction, QoL, and lower self-esteem. Researchers concluded that promoting a positive perception of aging would help to enhance older adults’ quality of life. (Velaithan et al., 2023)
A study using two independent subsamples from the U.S. Health and Retirement Study to examine the association between SPA and health care delay over the next 12 months among 5340 adults aged 51 and older. Results showed that more negative aging self-perceptions were associated with a higher likelihood of health care delay and more perceived barriers to care. In conclusion, negative SPA affects decision-making processes regarding whether to seek care for worrisome symptoms. Researchers suggested efforts to promote more positive SPA to encourage older adults to be more proactive in addressing their healthcare needs. (Sun & Smith, 2017)
A systematic review of 21 studies from the United States, Germany, Australia, Israel, and Switzerland examined the longitudinal consequences of self-perceptions of aging (SPA) in participants 50 years or older. Analyze indicated that more positive SPA was consistently associated with healthier longitudinal outcomes, including better self-rated health and less obesity, greater longevity, better performance of the activities of daily living, less depression, and better cognitive functioning (including reductions in cognitive decline and incidence of dementia). (Tully-Wilson et al., 2021)
Results of a micro longitudinal study for 100 days among 103 men and women aged 52 years and older showed that more positive SPA significantly reduced the impact of perceived stress. (Witzel et al., 2022)
The objective of a systematic review was to determine the relationship between ageism and psychological well-being of older adults. All the reviewed studies showed that ageism is negatively associated with older adults’ psychological health, causing mental health issues such as depression and anxiety and well-being in a negative way. Results showed that psychological well-being of older adults who (1) who were proud to be a member of their age group, (2) who experienced less negative emotions (i.e., feeling hurt, angry, sad, frustrated, humiliated, discouraged, terrified, foolish, or ashamed), (3) who considered aging process positively and held a positive view of their future, (4) who had greater body esteem, and (5) who had high levels of flexible goal adjustment were less negatively influenced by ageism. (Kang et al., 2022)
Summary of research:
What Can Be Done to Combat Self-Directed Ageism?
Change your own thoughts:
Self-directed ageism acts as a barrier to behavior, not allowing us to fully engage. Thus, when addressing self-directed ageism take these steps:
● Recognize that we are all growing older, no matter our age. Be aware that the process of normal changes that come with age is slow and there are many things you can do to offset negative effects. They range from exercise and food to medicine and technology. (Yearwood, 2023)
● Explore yourself and find what makes you afraid. Age related changes may lead to uncertainty about your abilities. Try to think about your fears in a wise and reasonable way, keep everything in perspective.
● Acknowledge the role that you play. You have much to offer those around you, like support, wisdom, and love.
● Change your thoughts, language/word choice and actions. As, language/word is a powerful indicator of your underlying beliefs and shapes your thoughts. (Gullette, 2023)
Strengthening intergenerational bonds:
● Consider spending more time with children, grandchildren, younger coworkers, or younger people in your local community. Get to know their views, priorities, and values. Try to be open-minded and willing to learn from them.
● Consider what you have to offer. You can act as a mentor to pass on skills and knowledge such as playing an instrument. In fact, when you help others, you will find purpose and meaning in your life, and this is the best way to build resilience.
Source: Intergenerational solidarity
Push back on ageist messaging:
Language/word affects your thinking and changes your perception. If you hear ageist language/word, gently remind misconceptions on aging to push back on. So, understanding misconceptions on aging will help you to push back on ageist messaging.
On the right: A collection of messages which might be considered ageist. What do you think of them? Would you consider them to be ageist? Why or why not?
Separate the Myths from the Facts:
● Myth: Aging is a disease.
● Fact: Aging is a normal part of life.
● Myth: Older adults are set in their ways and can't learn new things.
● Fact: Seniors are capable of adapting and learning new things, and doing so can have health benefits such as improving memory.
● Myth: Depression is a normal part of aging.
● Fact: Depression isn't a natural or inevitable part of aging. In fact, younger adults tend to have higher rates of depression than their seniors.
● Myth: Older adults should be more sedentary to avoid accidents.
● Fact: People can continue to be physically active as they age. In fact, it's never too late to start being more active. Exercise can improve physical and mental health as well as help you manage chronic conditions. Just be sure to choose exercises that you enjoy and can stick with.
● Myth: All older people require geriatric services.
● Fact: Older people may be in excellent health status and require no geriatric services.
Defy stereotypes:
Represent your message to challenge ageist comments. Here are some ways to resist age-related stereotypes.
● Participate in social events to resist that older people are isolated.
● Stay physically active to resist that older people are sitting on their rocking chairs.
● Keep up to date on things that interest you, learn new things about subjects you care about to resist that older people are stuck in the past and don't understand the present.
Seniors defying their age
Manage stress:
Doing exercise regularly, using relaxation techniques, practicing good sleep hygiene, and sticking to healthy eating habits are stress management techniques which help you to stay confident and build self- esteem, resist negative physical and mental effects of self-direct ageism, such as increased risk of depression and chronic health conditions. (Reid, 2023)
Conclusion
The negative view of late life is not just false, it is also dangerous. Self-directed ageism occurs when a person internalizes ageism due to repeated exposure to ageist messages and, as a result, modifies their own thinking and behavior. Internalized ageism is associated with negative outcomes, including physical and mental issues, cognitive and functional impairment, lower life satisfaction and quality of life. Thus, reducing negative attitudes to aging is crucial to our individual for combating self- directed ageism and being well with age.
Yes to Aging. No to Ageism!
References
AARP. (2019). The economic impact of age discrimination. AARP. Retrieved September 25, 2023, from https://www.aarp.org/content/dam/aarp/research/surveys_statistics/econ/2020/impact-of-age-discrimination.doi.10.26419-2Fint.00042.003.pdf.
Allen, J. O., Solway, E., & Kirch, M. (2022). Experiences of Everyday Ageism and the Health of Older US Adults. JAMA Netw Open, 5(6). 10.1001/jamanetworkopen.2022.17240
American Association on Aging. (2023). Ageism Awareness Day. American Society on Aging. Retrieved September 20, 2023, from https://www.asaging.org/ageism-awareness
Center for Ageing Better. (2023). Ageism: What's the harm? Centre for Ageing Better. Retrieved September 20, 2023, from https://ageing-better.org.uk/sites/default/files/2023-02/Ageism-harms.pdf
Greenwood, M. (2018, November 13). Health costs of ageism calculated at $63 billion annually, study finds. YaleNews. https://news.yale.edu/2018/11/13/health-costs-ageism-calculated-63-billion-annually-study-finds
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Office, A., Thiyagarajan, J. A., Schneiders, M. L., Nash, P., & Fuente-Núñez, V. d. l. (2020, May 1). Ageism, Healthy Life Expectancy and Population Ageing: How Are They Related? Int. J. Environ. Res. Public Health, 17(9). https://doi.org/10.3390/ijerph17093159
Reid, S. (2023, June 21). Ageism and Age Discrimination. HelpGuide.org. Retrieved September 20, 2023, from https://www.helpguide.org/articles/aging-issues/ageism-and-age-discrimination.htm
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Tully-Wilson, C., Bojack, R., Millear, P.M., Stallman, H.M., Allen, A., & Mason, J. (2021). Self-perceptions of aging: A systematic review of longitudinal studies. Psychology and Aging, 36(7), 773-789. https://doi.org/10.1037/pag0000638
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Yearwood, D. (2023). The Folly of Self-directed Ageism. Top Sixty Over Sixty. Retrieved September 20, 2023, from https://www.topsixtyoversixty.com/resources/policy-research/the-folly-of-self-directed-ageism/