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Getting Older Doesn’t Have to Mean Getting Worse
Updated: Oct 6
New research challenges one of our most persistent assumptions about aging: that physical and cognitive decline is inevitably a one-way street
We tend to talk about healthy aging as a defensive exercise.
Keep exercising so you don't lose strength. Keep your mind active so your memory doesn't deteriorate. Eat well to ward off disease. Stay socially connected to avoid isolation.
The underlying assumption is almost always the same: Aging means decline, and the best we can do is slow it down.
But an intriguing study highlighted recently by The Washington Post suggests that assumption is incomplete. Many older people don't simply maintain their abilities as they age. They actually
improve.
The study, described by Post columnist and physician Leana S. Wen, analyzed information from more than 11,000 older Americans participating in a long-running National Institutes of Health-funded survey. Participants were followed for up to 12 years and generally entered the research in their late 60s or early 70s.
Researchers looked at two measures: cognitive ability and walking speed. When the researchers considered all participants together, the expected pattern emerged: Average function declined with age. But those averages concealed a much more interesting story.
About 32% of participants improved cognitively, while approximately 28% improved their walking speed. Altogether, more than 45% improved in at least one of the two areas.
That's a potentially powerful message for anyone entering life's second half.
Improvement isn't limited to people recovering from illness
An obvious explanation would be that some participants began the study while recovering from an injury or illness and simply returned to their previous level of functioning. The researchers considered that possibility and separately examined older adults who began with normal functioning and still found meaningful numbers who subsequently improved. That suggests later-life gains weren't simply the statistical result of people recovering from temporary setbacks.
The study also challenges the tendency to view physical and cognitive health as moving together.
According to The Post, roughly two-thirds of the people who improved did so in only one of the two areas studied. Someone experiencing physical limitations, in other words, might still make cognitive gains. Someone struggling with memory might nevertheless become physically stronger or more mobile. That's important because a diagnosis or limitation in one area can easily become a verdict on an entire life. The research suggests it shouldn't.
Your attitude toward aging may matter
Perhaps the study's most provocative finding involved something researchers call “age beliefs” — the expectations people hold about getting older.
Participants with more positive views of aging were more likely to improve both cognitively and physically, even after researchers accounted for factors such as education, chronic disease, depression and chronological age.
That doesn't mean positive thinking is some kind of anti-aging medicine. No one is going to cure arthritis or reverse dementia simply by deciding that 75 is the new 55. But expectations can influence behavior.
If you believe physical decline is unavoidable, why start strength training at 62? If you assume memory inevitably disappears with age, why learn something difficult at 70? If you think new friendships are primarily for younger people, why join a club or volunteer organization in retirement?
Expecting the possibility of improvement creates a reason to keep trying. That distinction matters because negative stereotypes about aging remain widespread. Wen noted that a 2024 Alzheimer's Disease International survey found 80% of respondents incorrectly believed dementia is a normal part of aging.
There are things you can do
The new study doesn't provide a formula guaranteed to make someone sharper or faster at 75 than at 70. But other research offers useful guidance about behaviors associated with healthier aging.
The National Institute on Aging says physical activity can help older adults maintain strength, improve balance, increase energy and help prevent or delay some chronic diseases. Research also suggests physical activity may support aspects of cognitive health, although scientists are still studying how much exercise can prevent cognitive decline.
Current federal guidelines recommend that adults 65 and older get at least 150 minutes of moderate-intensity aerobic activity each week, or 75 minutes of vigorous activity, or an equivalent combination. Older adults should also include muscle-strengthening activities at least two days a week and activities that improve balance.
That last part is worth emphasizing. Walking is excellent exercise, but healthy aging isn't only about accumulating steps. Strength and balance can help preserve the physical abilities required to climb stairs, carry groceries, get out of a chair and remain independent.
The brain needs its own exercise
The National Institute on Aging points to evidence that certain kinds of structured cognitive training can help maintain specific cognitive abilities. It also says meaningful activities such as music, dance, photography and creative writing show promise, although evidence that such activities produce lasting cognitive improvements isn't yet definitive.
And don't overlook the importance of hanging out with other people. Analysis from the NIH-supported Health and Retirement Study involving more than 7,000 adults 65 and older found that higher levels of social engagement — including visiting neighbors and volunteering — were associated with better cognitive health later in life.
Implications for medical care
The research also carries a message for doctors and families. If everyone assumes decline is simply “what happens when you get old,” treatable problems may be overlooked. Changes in mobility might benefit from physical therapy. Hearing problems can be addressed. Depression can be treated. Medications can be reviewed. New exercise and social routines can be started.
Age shouldn't automatically be the diagnosis.
A different way to think about the next 30 years
Perhaps the most valuable thing about this research isn't the percentages. It's the change in perspective.
Healthy aging doesn't have to mean desperately trying to preserve the person you were at 60 for as long as possible. There may still be things you can improve. You might become stronger. You might learn something complicated. You might become more socially connected. You might recover an ability you thought was disappearing. And even when one aspect of your health declines, another may improve.
Aging certainly brings real physical and cognitive risks, and no study eliminates them.
But decline isn't the only possible trajectory. Getting older and getting better can happen at the same time.
This article was inspired by reporting and commentary by physician Leana S. Wen in The Washington Post on research examining improvements in physical and cognitive function among older Americans.
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