What is Ageism & How Does it Affect Health

In 2020, researchers identified that ageism cost the US $63 billion dollars in one year and resulted in 17.04 million cases of 8 of the most expensive health and mental health conditions, including heart disease, dementia, cancer, diabetes, mental health conditions, among others (Levy et. al, 2020).

  1. What Is Ageism?
  2. How Does Ageism Affect Physical Health
  3. How Does Ageism Affect Mental Health
  4. What Can We Do About Ageism?
  5. Learn More About Ageism
  6. References

What Is Ageism?

Ageism, ahh ageism, the insidious harmful belief about aging. But what is it  exactly? 

What is Ageism?

According to the World Health Organization, Ageism includes three components: 

  • Stereotype: how we think about others (or ourselves) based on age. For instance, “Older adults are going to deplete us of our resources by using their social security and medicare.”  Or, “I think at a certain age, older people should stop driving.”
  • Prejudice: how we feel about others based (or ourselves) on age. Like, “I feel sad when I see older adults at the grocery store alone. I feel sorry for them”
  • Discrimination: how we act towards others based on age.  For example: “I try not to sit next to older folks in a work meeting” 

 

Ageism is not only directed at others, but also ourselves. Ever thought,  “I don’t like the way I look as I age”?

 

What are the types of ageism?

Ageism can take on many forms. Here are three strains of ageism described in a recent Columbia Mailman School of Public Health article:

 

Hostile ageism is the most overt type of ageism, which shows up in the form of physical, financial, and verbal abuse. It’s also implicated in the perception of older adults as a drain on societal resources. The term “Silver Tsunami” that is used to describe the baby boomer population “flooding” society and depleting all of its resources is one example. During COVID, the hashtag, “boomer remover” used across social media platforms is another harmful example.

 

Neglectful ageism is a variation of ageism that overlooks the contributions of older adults and makes them invisible. For example, under the initial perception of COVID-19 as a disease primarily affecting older and immunocompromised persons, many healthy younger adults initially ignored recommendations to socially isolate and protect their older relatives. The pendulum may have swung too far the other way, leading us to the third strain of ageism…

 

Benevolent ageism is a compassionate but paternalistic point of view, grouping older adults together as one uniformly frail and vulnerable population requiring protection. This type of ageism is harmful in that it degrades an individual’s sense of self-efficacy.

Ageism exists in society and within each of us

Structural ageism refers to the phenomenon of ageism being prevalent in systems and structures in society, like the healthcare system, work places, churches, etc. Structural ageism includes:

  • Denial of access to health care
  • Having resources including medical services rationed due to age
  • Exclusion from clinical trials
  • Limited work opportunities for older adults

 

Individual ageism is another type of ageism best described by the Stereotype Embodiment Theory (also called Stereotype Embodiment Threat). This theory suggests that we internalize stereotypes about older adults throughout our lifespan and that when we believe ageist stereotypes about ourselves, they can have a significant impact on our physical health and mental health as we age.

How Does Ageism Affect Physical Health

Ageism is linked to cardiovascular events. For example, in one study, people who held more negative age stereotypes at age 30 were significantly more likely to experience a cardiovascular event over the next 38 years. In a second study, Those with more negative age stereotypes were twice (2x) as likely to have a cardiovascular event after age 60.

 

Ageism is linked to Alzheimer’s Disease. In one study, people with negative age stereotypes had 3 times the rate of hippocampal-volume decline than people with positive age stereotypes. Additionally, people who held negative age stereotypes had significantly greater accumulation of amyloid plaques and neurofibrillary tangles (Levy et. al, 2016).

 

In yet another another study, among people with APOE ε4 gene (commonly known as the Alzheimer’s gene), those with positive age beliefs were 49.8% less likely to develop dementia than those with negative age beliefs (Levy et al., 2018).

 

Ageism affects longevity. Researchers found that those with a positive view of aging, live 7.5 years longer than those with a negative view of aging (Levy et al., 2002).

How Does Ageism Affect Mental Health

In a study looking at how ageist beliefs affected the mental health care of older Veterans, researchers found that when Veterans fully accepted ageist stereotypes, they were significantly significantly more likely to experience anxiety, post-traumatic stress disorder (PTSD), and suicidal thoughts. On the contrary when older Veterans fully resisted negative age stereotypes, they had significantly lower rates of anxiety, post-traumatic stress disorder (PTSD), and suicidal thoughts.

 

In a 2017 study looking at how older adults with suicidal ideation were treated in an Emergency Room, researchers found that older adults were significantly less likely to receive a mental health evaluation or be discharged with referral information for follow up mental health care compared to younger adults.

What Can We Do About Ageism?

Now that we can all agree that ageism is bad (don’t do it), what can we do about ageism?

 

Be self-aware. Ageism is pervasive and often difficult to detect. Developing awareness of your own ageist attitudes, language and behavior is a great place to start. Here are some ideas to get you started:

 

  • Engage in a self-reflective practice where you learn about yourself and what might contribute to your ageist thoughts and beliefs.
  • Take an assumptions test, like the Harvard Implicit Association Test, and discover your own unconscious bias as it relates to older adults.

 

Remember that older adults are diverse and have intersecting identities. As such, ageism interacts with other stigmatized identities like sex, race, gender, ability, and sexual orientation and can create a phenomenon of double jeopardy, triple jeopardy, and so on creating higher levels of risk and disenfranchisement and reduced levels of access to resources and care.

 

Speak out against ageism by providing feedback when you see ageism showing up. Ageism is so ingrained in us and our culture that many people are not aware of ways their language and behaviors negatively portray older adults.

 

Shift your focus — meaning, try to see things with a new lens. Shift away from the stereotype. For example:

  • Shift your focus from a stereotypical view of older adults to a “counter-stereotype.” This is where you put a picture in your mind of older adults that are the opposite of the stereotype. For example: Even though older adults were disproportionately impacted physically by the COVID-19 pandemic, they also demonstrated the highest coping and resilience rates and the lowest reports of mental health concerns compared to other age groups.
  • Shift how you interact with older adults. If you realize that you’re only around older adults who are sick or at the end of their life, then I encourage you to look for opportunities to interact with older adults who are in a healthier and more active season of their life.

 

Spread the facts. Make sure health workers, policymakers, and health care administrators are aware of diversity among older adults. Older adults experiencing double or triple jeopardy as a result of intersecting identities may be at particular risk for the negative consequences of ageism. If you work with these groups, you have an important role in advocating for their needs.

Learn More About Ageism

Want to dive deeper and learn more about ageism? Here you go:

 

References

References

  • Chang, E. S., Kannoth, S., Levy, S., Wang, S. Y., Lee, J. E., & Levy, B. R. (2020). Global reach of ageism on older persons’ health: A systematic review. PLOS One, 15(1), e0220857. https://doi.org/10.1371/journal.pone.0220857
  • Levy B. (2009). Stereotype Embodiment: A Psychosocial Approach to Aging. Current directions in psychological science, 18(6), 332–336. https://doi.org/10.1111/j.1467-8721.2009.01662.x
  • Levy, B. R., Slade, M. D., Kunkel, S. R., & Kasl, S. V. (2002). Longevity increased by positive self-perceptions of aging. Journal of personality and social psychology, 83(2), 261–270. https://doi.org/10.1037//0022-3514.83.2.261
  • Levy, B. R., Ferrucci, L., Zonderman, A. B., Slade, M. D., Troncoso, J., & Resnick, S. M. (2016). A culture–brain link: Negative age stereotypes predict Alzheimer’s disease biomarkers. Psychology & Aging, 31(1), 82-88. https://doi.org/10.1037/pag0000062
  • Levy, B. R., Pilver, C. E., & Pietrzak, R. H. (2014). Lower prevalence of psychiatric conditions when negative age stereotypes are resisted. Social Science & Medicine, 119, 170-174. https://doi.org/10.1016/j.socscimed.2014.06.046
  • Levy, B. R., Slade, M. D., Chang, E. S., Kannoth, S., & Wang, S. Y. (2020). Ageism amplifies cost and prevalence of health conditions. The Gerontologist, 60(1), 174-181.https://doi.org/10.1093/geront/gny131
  • Levy BR, Slade MD, Pietrzak RH, Ferrucci L. Positive age beliefs protect against dementia even among elders with high-risk gene. PLoS One. 2018 Feb 7;13(2):e0191004. doi: 10.1371/journal.pone.0191004. PMID: 29414991; PMCID: PMC5802444.
  • Levy BR, Zonderman A, Slade MD, Ferrucci L. (2009) Negative age stereotypes held earlier in life predict cardiovascular events in later life. Psychological Science, 20:296–298
  • Levy, B. R., Ferrucci, L., Zonderman, A. B., Slade, M. D., Troncoso, J., & Resnick, S. M. (2016). A culture–brain link: Negative age stereotypes predict Alzheimer’s disease biomarkers. Psychology & Aging, 31(1), 82-88. https://doi.org/10.1037/pag0000062

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