Aging successfully

In a recent news report, I talked about a study of older adults that found that their sense of control over their lives fluctuates significantly over the course of a day, and that this impacts on their cognitive abilities, including reasoning and memory. ‘Sense of control’ — a person’s feeling that they are (or are not) in control of their life — is an attribute that includes perceived competence, as well as locus of control (you can take a Locus of Control Test here, if you’re interested), and in general it tends to decline in older adults. But obviously it is an attribute that, across the board, varies dramatically between individuals.

In older adults, a stronger sense of control is associated with more successful aging, and among people in general, with better cognitive performance. This isn’t surprising, as it is entirely consistent with related associations we have found: between strategy use and cognitive performance; between the belief that intelligence is malleable rather than fixed and cognitive performance.

My point here, however, is the connection between these findings and other aspects of successful aging that impact mental performance.

For example, I have spoken before about the association between age-related hearing loss and cognitive impairment (see this recent New York Times blog post for a very nice report on this), and poor vision and cognitive impairment.

Similarly, high blood pressure, diabetes, and depression have all been implicated in age-related cognitive decline and dementia. (For more on these, see the topic collection on diabetes, the topic collection on depression, and the new topic collection on hypertension.)

Depression, and poorer hearing and vision, are aspects of health and well-being that many seniors ignore, regarding them as no more than can be expected in old age. But their occurrence, however inevitable that may be, should not be regarded as untreatable, and seniors and their loved ones (and any with a duty of care) should be aware that by letting them go untreated, the consequences may well be more serious than they imagine.

Hypertension and diabetes, too, are medical problems that often go untreated. These problems often begin in middle age, and again, people are often unaware that their procrastination or denial may have serious implications further down the line. There is growing evidence that the roots of cognitive decline and dementia lie in your lifestyle over your lifetime, and in middle age especially.

Similarly, chronic stress may not only impair your mental performance at the time, but have long-term implications for your mental health in later old age. It is therefore an important problem to recognize and do something about for long-term health as well as present happiness. Scientific American has a self-assessment tool to help you recognize how much stress you are experiencing.

What does all this have to do with the sense of control association? Well, it seems to me that people who feel in control of their lives will be more likely to take action to deal with any of these problems; those who don’t feel in control of their lives will tend not to take such action. Thus giving up their control, and making their beliefs about the perils of aging a self-fulfilling prophecy.

A final note: my talk of treatment should not be taken as advocating a medicalized view of aging. Another aspect of aging and cognition is the widespread use of drugs among older adults. In the U.S., it’s reported that over 40% of those over 65 take five or more medications, and each year about one-third of them experience a serious adverse effect. You can read more about this in this New York Times blog article, and see the list of 53 potentially inappropriate medications or classes of medication on page 3 of this American Geriatrics journal article (pdf) on the new guidelines.

Hypertension, diabetes, depression, and stress are all problems that are amenable to a range of treatments, of which I personally would put drugs last.

But my point here is not to advocate specific treatments! I am a cognitive psychologist, not a medical doctor. All I wish to do in this post is provide a warning and some resources.

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