How Positive Age Beliefs Improve Cognitive Function And Fitness in Seniors

If you’ve ever caught yourself thinking that aging automatically means pain, weakness, or losing your independence, this conversation is a reset. We dig into a Yale study published in *Geriatrics* showing that beliefs about aging are not just “nice ideas” but measurable predictors of how well we think and move as the years pass. When you treat mindset as part of health science, the story of getting older starts to look far more hopeful and far more actionable. 

We walk through the research design using the Health and Retirement Study (over 11,000 adults age 65+ followed for years), including how researchers measured attitudes toward aging, tested cognitive function, and used walking speed as a practical marker of physical function. The headline finding stopped us in our tracks: roughly 45% of participants improved in cognitive and or physical performance over time. Even more striking, more positive age beliefs strongly correlated with a higher likelihood of improvement, including for people who started below average. 

From there, we connect the dots to health span and compression of morbidity, the idea that we can live more years with high quality of life and fewer years of disability. We also talk epigenetics and why “don’t be a prisoner of your DNA” is more than a slogan, plus the everyday levers that make the biology real: movement, sleep, stress response, community, purpose, and setting new goals later in life. If this shifts your perspective, please subscribe, share with someone who needs hope about aging, and leave a review with your biggest takeaway.

For the video, reference study and slides go to www.thehealthedgepodcast.com

Transcript

Welcome And Why Aging Matters

SPEAKER_00 0:00

Welcome to the Health Edge, translating the science of self-care. I am Mark Pettis, and with my great friend and colleague, John Bagnulo. John, good morning, my friend.

SPEAKER_01 0:10

Hey, good morning, buddy. It's great to be with you today.

The Study On Age Beliefs

SPEAKER_00 0:13

Great to be with you. We have an interesting paper to review, which uh sort of takes us off the nutritional domain that we spend a lot of time thinking about and talking about. And uh this is a paper, John, that uh was recently published this year in a journal called Geriatrics that looked at the extent to which the mindset of an individual getting older strongly influenced the um cognitive capacity of that individual as they aged and strongly predicted their fitness level, their sort of functional capacity. And um I really like this study because I I think that uh certainly as I get older, and I, you know, I'm about to turn 69, that uh, you know, many people just assume that getting older inevitably means sort of slowing down and uh experiencing more pain and losing one's independence. And for many, that is a a uh sad and horrible trajectory. Uh but it's not the trajectory of many. And and I think it helps in in our uh model of health to be focusing on uh positive mindset and uh you know some might call it positive psychology. We tend to focus on that which is negative, right? The disease, the you know, the the adverse outcomes, and and we all want to avoid that, but but much less research goes into the understanding and the practice of how we can cultivate mindsets, uh perceptual landscapes that very much can alter the trajectory that we are on. And this was a good study to illustrate that, John.

SPEAKER_01 2:24

Yeah, it's awesome. You know, I've for years I've always looked at the process of aging as sort of an equation, right? And you have all these different variables, and some of them are I I I would look at, you know, it'd be my opinion that they'd be weighted a little more heavily. So they'd have a like maybe a larger coefficient. But if you picture you know this long equation with you know so many different variables, what I think are the most heavily weighted, right, that would have the greatest coefficients, would be like our outlook in life, and that's what I really like about this paper. I I think it's uh it shows you how much influence and how much power our mind has on the process of aging and whether it can it becomes you know, again, some people, as you just pointed out, you know, they they look at aging as being this inevitable steep downward decline, and then it becomes that as opposed to right, as opposed to looking at it as something that you know what I can still be an incredible contributor to my community, to you know, whatever it be, and then then that becomes the you know, the possibilities are great, I think, when you start to adopt that type of mindset. I I really, you know, I really think that we are so often prisoners of our minds. And I think aging is one of the best examples of that.

SPEAKER_00 3:58

Yeah, that's great. I I think it was Henry Ford that once said, whether you think you can or whether you think you can't, you are right.

SPEAKER_01 4:06

Exactly. Yeah.

How Researchers Measured Mindset

SPEAKER_00 4:08

And and so, well, let's look at this. Um, because it does, it does bring in a lot about the mind body. Uh, this even today, while we understand much more through neuroscience, uh, I think we the mind is still a black box. Consciousness from which our minds evolve is is very much a black box. And yet it may be one of the most powerful tools that we have, John, that is very much underappreciated, certainly in the in the traditional medical circles that I've been in. So here is this study. Uh, this is from Yale. And uh the study, as I said, was in geriatrics, uh, aging redefined, cognitive and physical improvement with positive age beliefs. And what, of course, one of the great uh uh patriarchs, uh, the late George Burns, right, say first you forget names, then you forget faces, next you forget to pull up your zipper, and finally you forget to pull it down. And uh, you know, I've seen examples of that uh throughout my life. Yeah, a lot of my uh medical work has been with the aging uh demographic, and um yeah, this is not an inevitable endpoint. Uh George Burns. So this was uh just a breakdown of the study, John. I'll go through this and and then uh feel free to comment. So these were 65 plus years of age, and the individuals were from uh uh the health and retirement study. This was an ongoing study. This was a cohort uh through the National Institute of Aging. Over 11,000 participants, average age 68, and they were followed for an average of eight and a half years. So pretty good follow-up. And they measured their attitude toward aging. Uh, there were many uh uh tools out there, validated tools. This was the Philadelphia geriatric center morale scale. And uh people would look at certain um uh perspectives and then comment on whether it was relevant to them a little bit, a lot, not at all. Um the older I get, the more useless I feel, for example. Uh you know, some people would feel strongly that that's that's where they're at. Um I am as happy now as I was when I was younger. Uh you know, there are some people that that is just that's their lens through which they look at every aspect of their life. And so this was a tool used to assess one's uh perceptions with respect to aging. Uh they measured uh cognitive uh testing. These are very um uh well-studied, validated tools to measure cognitive capacity that looks at um short-term memory, recall, mathematical skill, um, and a very good global assessment of where one's cognitive capacity is at. And certainly as people get older, there's great concern about, and that may be one of the greatest concerns that many people have. Uh and then they they measured physical improvement and um they looked simply at walking speed. This is again kind of a global measure of physical function, easy to do, valid. Um, and it it's a good predictor of rates of hospitalization, disability, mortality in the geriatric population. Anything uh you wanted to comment on there, John?

SPEAKER_01 8:06

Is no, I mean, I think these are you know easy, just easy metrics, so to speak, to understand. And I it's a good mix, right? Because, you know, we need to have the mind, body, spirit, I think, all represented here. Which you do, you get all three of them.

The 45 Percent Who Improved

SPEAKER_00 8:24

Yeah. And so over that period of follow-up, as we sort of get to the outcomes, the researchers discovered that 45%, uh, this this surprised me. I I thought this number might be lower. 45% of the participants who were 65 years and older showed improvement in cognitive and or physical function over a period up to 12 years was the maximum uh follow-up. And one of their conclusions, of course, is that this very much challenges the uh sort of cultural meme that getting older is uh just you know something to fear. Uh and so as they extrapolate this to the US population, and one of the things that I thought was really good about the study, John, is these these cohorts are just a cross-section of the American public. You know, it's um so the these participants are like you and I. Um, but it would suggest that as many as 26 million older people could experience improvement in their functioning. In addition, uh they found um for the first time, uh, this had not been published um prior, that you know, more positive age beliefs uh clearly were strongly correlated with the likelihood of improvement, both cognitively and physically. And um uh what they found, John, was that if you at the beginning of this study were functioning below a level that might have been considered um average for your age, you could improve to that level. So these weren't people who were just all healthy. Uh some had significant compromise, uh, and they improved as well as those who had a reasonable level of functioning at the beginning of the study. So no matter, I think the implication is no matter where one may uh be on that continuum, there's there's opportunity. And so this improvement pattern is picking up on a cognitive and physical reserve. I love that. I think you mentioned this to me before we got on this recording, that is available to the general population of older people. That's a pretty powerful statement.

SPEAKER_01 10:58

That is, and that the mind and the outlook on life and the outlook on the quality of their life and what's potential, that is what allows them to bridge that reserve that so many of us have, right? That we don't know we have. I think that's really the most beautiful statement that I found in this paper. So it's powerful stuff. You know, I you and I are lucky. I mean, and I think a lot of our listeners are lucky because we appreciate the influence that we have on quality of life, right? And and we understand that, you know, as you always describe it, you know, we have this incredible book of life that either you know is read now, right? The gene expression, so to speak, based on the inputs that we have. And I think everybody that appreciates that understands that we have this beautiful potential to live a high quality of life at older ages. And I think when you take that into account, but then have a greater appreciation for the outlook that you have or the role that you see yourself as having in any community or even within your family, um, I I think it's it's really powerful when you get to the synergy of those two things, right? The synergy of lifestyle with outlook has such a beautiful effect, and it can really raise the potential for that quality of life we want as we get older. Definitely.

SPEAKER_00 12:34

And I I have found in my in the work that I've done as a nephrologist through the years, and you know, caring for older people with just extraordinary physical, mental, emotional challenges, that the all other things being equal, that individual who perceives their glass to be half full on the worst of days versus that person who might perceive their glass to be half empty, I have found in this laboratory of life to be one of the strongest predictors of quality of life. Again, which is not to say that they don't have extraordinary issues and challenges. Um my parents manifested this. Both my parents were on dialysis, uh, my mother had a stroke, she was depressed, you know, it it there were some days I would look at them and think that the suffering was really hard for me to witness. And yet they they found um uh glades of light uh that you know maybe took the form of love, um, love for me, love for my sister, love love for each other as they did throughout their lives, um, love of a higher purpose, right? We'll we'll look at this in a second, the extent to which having meaning in our work, love and play, is one of those things that does seem to shape our beliefs. Um uh so it it is it is uh an extraordinary um connection. Uh and and it I think people who um uh and there's a risk of sounding judgmental. I don't mean I don't mean to come across this way. There are people who perceive what happens in their lives to to be happening to them, right? Right. You're this person, uh, and uh uh your health is all the stuff happening inside of you. Uh, but really what impacts that is what's what's out there, and what's out there happens to you. And it's this sort of random, you either have good luck or bad luck, or genes, or bad genes, and and if the genes you inherited, you perceive as bad, um, and the stuff out there happening to you, you you believe you have no influence or control over.

SPEAKER_01 15:09

You're totally uh unempowered, right? And that's and that is really where the slope gets the steepest with respect to aging, yeah, loss of empowerment.

Mindset As A Non-Drug Intervention

SPEAKER_00 15:20

Absolutely. Yeah. And let's uh so I'm gonna just come back to sharing my screen. Uh John, and we'll um just get a few more slides here. So um this is uh a graphic of their results, and this looks at the percentage of people in the cohort that either stay the same or improved physically. Um and again, these are very different um trajectories of those with positive uh beliefs as opposed to those that that perceive their lives in a more negative way. Um the asterisk just refers to statistical significance, uh, and the same can be said with with cognitive functioning. Now, let's say, John, that uh if this wasn't so much a study of mindset, but it was a study of a drug that uh one of Big Pharma produced. Yeah. Uh and uh the negative group was the control group, and the positive group got the drug.

unknown 16:29

Right?

SPEAKER_00 16:30

Would this not be front page news? And in the US, uh every doctor would be uh getting their prescription pad out, and um it would be the uh it would explode. It would explode at every scientific uh forum.

SPEAKER_01 16:48

And um every patient would be demanding it.

Health Span And Compressing Morbidity

SPEAKER_00 16:51

You you you know, you you this is the bandwagon you'd want to be on, right? Um so this is a these are these are beautifully non-pharmacologic. Uh the the pharmacology is your mindset, essentially. That's it. And so I wanted to share this, John. Um, you know, I've one of my professional roles before retiring uh was to oversee population health in western Massachusetts, where I live. Population health, looking at health outcomes, the drivers of those outcomes, and how, as communities, you can create healthier communities that not only improve the health and quality of life of the individuals you serve, particularly those at higher risk from poverty, from violence, drug addiction. Um and in improving quality of life and creating healthier communities, you not surprisingly reduce the cost of care for those individuals. So not only are you improving outcomes, but you're you're saving a lot of money. Uh something we still struggle with with our modern medical industrial complex. This was published only in the New England Journal of Medicine, James uh Freese, who the late James Freeze, who when he published this, was at Stanford, and he made the observation, as others were uh aware of, that the typical quality of life here in America, as you get older, was not very good. And um so common is this trajectory that it would be normal and natural to perceive that this is an inevitable outcome. And uh as long as I live longer, I can anticipate um just going downhill. And his uh sort of radical observation is that this is a completely uh, maybe not completely, but largely avoidable trajectory. And he brought into the uh vernacular this concept of health span that today we talk about all the time. Um Fries was well ahead of his time, in my view, um, in understanding that our medical industrial complex just was not well designed to take you from here to here. Um, a lot of the drugs that people may find themselves taking may change this slope a little bit, but not a lot. Uh so Free suggested that we could compress morbidity, compress the extent to which we are losing quality of life, and the term he used was rectangularize this relationship, create better quality of life. I mean, we're all going to die of something, uh, but wouldn't it be better to have an amazing area under the curve of quality of life right up until that something happened? And that is not the experience for probably the majority of humans on the planet. Yeah. Um, unlike the rest of the mammalian world, right, John, I think humans are the only mammals that sort of follow. I mean, most other mammals will pretty good quality of life until, you know, they maybe they're killed by a predator um and uh or they're traumatized, something happens, um, and you know, so this is an unusually uh uh negative trajectory that is very much where you tend to find people. And that's really what Freeze defined in this amazing article that um no matter where one may find themselves, there's opportunity uh to enhance that trajectory. And I think that's sort of what this article uh is suggesting. And um this is what you know, in in my experience, John, I've met so many people through the years. I've I've entered the free fall of those individuals, no matter where they were at, in an effort to share in that experience. And uh, you know, most people that I cared for, and many confronting their mortality, were less afraid of death and more afraid of suffering. And um uh I I think so much suffering can could be mitigated, uh prevented. Um so this I I just want to just want to bring this to people's attention because so much of what we talk about, John, and the health. Health edge is just that. It's getting off this trajectory if you find yourself on it and realizing that you have much more influence over your health span than what you may have ever considered.

unknown 22:15

Yeah.

SPEAKER_00 22:16

And this is I I find, John, I'm I really love epigenetics. Um as a sort of a biologist, to me, this was a bit of a game changer in the field of human biology. Uh this um I was taught, as I know you were, John, that you know, you're you you're born with this book of life. Yeah, you get half from mom, half from dad, and you have very little influence over what you get from mom and dad. And if mom did not live long, and if mom was not healthy, if dad had health issues, um there was nothing you can do about what you ultimately inherited from them. Uh what the field of epigenetics began to show was that this book of life could be translated in an infinite number of ways. In physics, in quantum physics, you would call that probability. Ours is a trajectory of an infinite number of trajectories. And the the one that uh compresses, that becomes the reality that we're experiencing, is one that is largely a byproduct of these relationships, uh, from mindset to how we move, how we eat. Uh it's either compatible with the book of life we inherited from thousands of generations before us, more recently, mom and dad, uh, or it is completely uh incompatible. Uh, and that's not a trivial difference. And what the research is currently suggesting is that you can literally reprogram your DNA, if you will, by shifting from a less compatible in set of environmental circumstances, or in perhaps a less compatible mindset. Um, my glass is half empty, I inherited these diseases, and there's nothing I can do. I'm stuck, I'm unlucky, uh, you know, life sucks, then you die. Um or not. Um and that is such a powerful biologic revelation, uh, which is not to say that gene, you know, genetics do have a lot to say about that trajectory, but it's much more uh plastic, malleable, probabilistic uh than it is fixed and deterministic. I think that would be my interpretation of it.

SPEAKER_01 24:53

Yeah. Yeah, and that the you know, the the power of the mind on this process, you know, is is maybe second to none.

SPEAKER_00 25:03

Definitely. And this is part of that epigenetic work. I I I didn't want to, I know our tongue doesn't allow us to dive too deep into this, John, but um, you know, I'm at an age where I, you know, I think a lot about this. Uh, but you know, it in our 20s and teens, 30s, you know, we're not often thinking about, you know, what's life going to be like here? Uh and is it possible that I have an ability to influence? I'd much rather be here than than you know, walking and being able to walk that mile, two miles and you know, in 15 minutes than uh in a wheelchair, unable to play with my grandkids, unable to maybe do the things that I I love to do. And so these this epigenetic, the extent to which how we eat and how and and how we move and how we interpret and respond to stress and how we sleep and how much meaning we cultivate in our work, love, and play, how much love and purpose our lives are filled with, creates a different human, our you know, same book of life, different human being. And I think this is much more within the realm of um influence um than uh we've we've been given credit for. And uh, you know, certainly one aspect is identifying those things that you love and are passionate about, right? I and and I love you know, dancing and motion is the lotion, as we like to say, John. These are just examples of joy and and the ability, the capacity to thrive that might otherwise feel very, very elusive. And that's our biology and the and the science would suggest now that that is we need to think differently about this. And this study definitely uh I think reinforces the importance of thinking differently.

SPEAKER_01 27:16

Yeah, yeah, and you know, I think earlier in life, I think a lot of people are much better at setting goals. I think as people get older, they have this in a way it's like a death sentence when they start thinking, well, I've arrived. You know, I've arrived, I've met the end point now. They don't set goals, they don't try to learn anything new in life. And I think we have to, you know, I think to to really um to really find that quality of life, I think we have to think about even in our later years, how we can grow, how we can learn, how we what what new experiences you know we can have. I think that's a really big part of it that is sorely missing. And the other the other part of it is finding a mission, you know, something you're really passionate about that gives you a feeling that you're contributing, that you're you know, you're really trying to make a difference still in the world. Those things I think are incredibly powerful, and they give a lot of people a reason to put all of those different lifestyle components in place that have such favorable epigenetic effects. So, but it all starts with uh, I think how people look at themselves at any given age. And you have to always try to you have to always try to you know reach for something. I think that's that's important, right? Reach for something that's part of your own evolution as a human. And once you once you don't have that, then yeah, you people start wondering why they're why they're here.

Mark’s Personal Health Turnaround

SPEAKER_00 28:54

Yeah, and to to um none of this is to say that you can prevent really bad and adverse things from happening, right? But but how we interpret and respond to those things is so important. And um, you know, we all we all need help along the way. You know, as I like to say, ours is a journey meant to be shared. Yeah, it's about communities. So, and and I think also in my own life, John, uh, because you know, 30 years ago, um I had early signs of diabetes, I had hypertension, my lipids were off the chart. I had all the things that my parents had, and and my my perspective was well, here you go. I, you know, these are these book of life is now uh expressing itself. Um, I'm at that age where you expect the expression to occur, and so aren't aren't I lucky to be alive at a time where I've got all these great meds I can take? Um and what a limited mindset that was, as I a mindset that would have reinforced those diseases. Um for me, it was a wake-up call. And as I got more into the mind-body work, a lot of which we've shared through the years and our teaching and being on the faculty of the Center for Mind-Body Medicine with Dr. Jim Gordon, and um uh a lot of the work that we've done at Kropalo, you know, the importance of meditation, you know, yoga, many of these ancient traditions that just inherently saw the the uh belief system as critical and the the physical as uh uh more of a of a manifestation of you know spirit, and then them being primal, a lot began to shift for me. So I um my experience, you know, I my blood pressure rarely runs over 110 now. Uh and I you know I don't take any medicine for it. Uh I think I would have been one of the 45% in this study, John. I think I, if anything, I think I'm healthier now than I was 20 years ago, for sure.

SPEAKER_01 31:18

Um, that's awesome.

SPEAKER_00 31:20

And so you, you know, you it experiencing is believing. Yeah. And uh um so it's a hopeful message. I think a really interesting study, and uh so much of what we talk about um uh feeds into this issue of a holistic lifestyle and mindset is very much at the top of that pyramid.

SPEAKER_01 31:46

Yeah, it's a great time to you know to offer hope to people, right? At a time when, you know, globally there's it's sometimes hard to find that. Um, but it's it's beautiful. And I think you know what you've experienced and what we've you know, what we've seen in so many patients and and individuals we've worked with would really, you know, would really support and affirm this.

SPEAKER_00 32:13

Yeah, so we don't be a prisoner of your DNA. All right. Uh don't ever underestimate how powerful you are, how beautiful and perfect you are. And um negative things that happen as they will, I think, sometimes challenge us to step back in our lives and and how can we interpret and respond in a way that can that can serve us with love and compassion and with reservation of judgment. And that's obviously in this ecosystem we're in, uh, easier said than done. This is our ecosystem is perfectly designed to produce the curves that that Dr. Free shared with us in the New England Journal back in 1980. That is not a normal natural trajectory. So um be well, right, John?

SPEAKER_01 33:14

Absolutely. Great stuff. Thank you so much, Mark.

SPEAKER_00 33:17

Yes, thank you, John. Great to be with you as always. Uh, we'll get we'll get the um uh the slide deck up on our website, the healthedgepodcast.com, for those who are interested. And we look forward to uh being with you uh all next week. And uh spring is in the air and uh the the uh uh getting closer. So looking forward to that.

SPEAKER_01 33:42

Me as well. Take care.

SPEAKER_00 33:43

You as well.