What if I told you that nearly half of all older adults — not a small, extraordinary handful, but almost half — actually improve their cognitive and physical functioning as they age? Not maintain. Not slow the decline. Improve.

 

I know. That probably feels like it contradicts everything you’ve heard — from society, from healthcare providers, maybe even from your own inner voice. We live in a world that treats aging as synonymous with loss. Decline. Inevitability. But a landmark new study from Dr. Becca Levy’s lab at Yale challenges this narrative in the most powerful way.

 

And here’s what makes the findings even more remarkable: one of the strongest predictors of whether someone improves isn’t their genetics, their medications, or even their baseline health status. It’s how they think about growing older.

 

The Study: What Was Examined and Why It Matters

Published in March 2026 in the peer-reviewed journal Geriatrics, this study by Becca R. Levy, PhD, and Martin D. Slade, PhD, of Yale University is titled “Aging Redefined: Cognitive and Physical Improvement with Positive Age Beliefs” (Levy & Slade, 2026). It drew on one of the most rigorous aging datasets in the U.S.: the Health and Retirement Study (HRS), a nationally representative longitudinal study funded by the National Institute on Aging.

 

The researchers set out to answer two questions that science has largely failed to ask:

• Do a meaningful number of older adults actually improve — not just decline — in cognitive and physical functioning over time?
• And if so, do positive age beliefs predict that improvement?

 

 

To answer these questions, they needed a dataset large enough, long enough, and methodologically rigorous enough to detect improvement — not just decline.

 

Who Was in the Study

The study followed two overlapping groups of participants from the HRS:

Cognitive Improvement Group

• 11,314 participants
• Average age of 68 at the start of the study (ranging from 50 to 99)
• 83% had a high school education or greater
• 63% were married
• Followed for an average of 8 years, with most (76%) remaining in the study for 10 years or more

 

Physical Improvement Group (Walking Speed)

• 4,638 participants
• Average age of 74 at the start of the study (ranging from 65 to 99)
• 84% had a high school education or greater; 63% were married
• Followed for an average of 8.5 years

 

Both groups included people with a wide range of health conditions at baseline — cardiovascular disease, diabetes, hypertension, depressive symptoms — making the findings all the more meaningful.

 

What They Measured

 

Cognitive Health was assessed using a validated, widely used measure of global cognition that covers short-term memory, delayed recall, and mathematical skills. It’s been validated against gold-standard clinical assessments and is specifically designed to detect changes over time.

 

Physical Health was measured by walking speed — sometimes called the “sixth vital sign” because it predicts hospitalizations, disability, and mortality in older adults. Participants walked 2.5 meters at their normal pace (using any walking aids they needed), and the faster of two timed trials was recorded. This is considered a gold-standard performance measure.

 

Age Beliefs were assessed using a validated five-item scale, part of the Philadelphia Geriatric Center Morale Scale, with well-established validity for older adults (Liang & Bollen, 1983; Lawton, 1975). Sample items include: “The older I get, the more useless I feel” (reverse-scored) and “I am as happy now as I was when I was younger.” Higher scores reflect more positive age beliefs.

 

What They Found: The Numbers That Change Everything

 

Finding #1: Nearly Half of Older Adults Improved in Cognitive and Physical Health

 

In the group of participants whose cognitive and physical health were both tracked, 45.15% showed improvement in cognition and/or walking speed over up to 12 years.

 

Here’s how that number was calculated: looking at each group separately, 31.88% improved cognitively and 28.00% improved their walking speed. Because these were two different study cohorts — the cognitive group was larger and included adults from age 50, while the walking speed group was limited to adults 65 and older — the researchers carefully identified the subset of participants who appeared in both, counted those who improved in one or both domains, and made sure no one was counted twice. The resulting 45.15% reflects the combined picture of cognitive and/or physical improvement.

 

Why does the 45.15% matter so much? Because the U.S. Department of Health and Human Services’ Healthy People 2030 initiative uses 11.5% as its threshold for what counts as a “meaningful number” of older adults being reached by preventive services. The improvement rate in this study exceeded that benchmark by nearly four times. This was not a statistical blip.

 

And when we expand to include people who simply held steady (rather than declined), the picture grows even more hopeful: 51.06% showed stable or improved cognition, and 37.56% showed stable or improved walking speed.

 

Finding #2: The Improvements Were Substantial, Not Marginal

You might wonder: did people actually improve, or could the numbers just be a fluke?

 

The team addressed this directly by requiring larger improvements to count — more than one point on the cognitive scale, or more than 5 cm/s in walking speed.

 

Even with that higher bar, 22.50% showed meaningful cognitive improvement and 26.71% showed meaningful physical improvement. And among those who improved, the vast majority improved by well more than the threshold — 71.98% for cognition and 77.38% for walking speed. These were real, clinically significant changes.

 

Finding #3: Positive Age Beliefs Predicted Improvement

This is where the findings become personally and clinically important. People who held more positive beliefs about aging were significantly more likely to show improvement in both cognitive and physical function — and this held up even after accounting for age, sex, race, depression, chronic illness, education, genetics (APOE-4 status), and other relevant factors.

 

The relationship between positive age beliefs and improvement was statistically significant for both cognitive and physical function, in every model the researchers tested, including the most conservative analyses that required larger improvements in a subsample who were already functioning at a healthy baseline. The finding was consistent and robust across all approaches.

 

In other words: this wasn’t a fluke, and it wasn’t explained away by other factors. What you believe about aging independently predicts whether you improve cognitively and physically.

 

 

 

“What you believe about aging independently predicts whether you improve cognitively and physically.”

 

Why Positive Age Beliefs Matter: Stereotype Embodiment Theory

To understand why age beliefs have such a powerful effect on health, it helps to understand the theoretical framework behind Dr. Levy’s decades of research: Stereotype Embodiment Theory (SET).

 

 

The core idea is this: we absorb beliefs about aging from our environment — from media, from family conversations, from healthcare interactions, from cultural narratives — starting in childhood, long before those beliefs feel personally relevant. We don’t choose them consciously. They accumulate unconsciously over a lifetime.

 

Then, as we enter older adulthood, something shifts. Those beliefs that we used to have about “other people” become self-relevant (“beliefs about ourself). And that self-relevance amplifies their power. The beliefs about aging that you’ve been carrying for decades start to shape your psychology, your physiology, and ultimately your health.

 

Here’s the way I often explain this to people: If you don’t  believe that life is going to be worth living as you get older, why would you do what it takes to live it well?

 

“The belief that ‘nothing will make a difference at my age’ is not only untrue — it is, according to this research, actively harmful.”

 

 

If you believe decline is inevitable and total — that nothing you do will matter — you’re less likely to take your medications consistently, stay physically active, maintain social connections, live your life with a sense of purpose, or reach out for mental health support when you need it. The belief becomes a self-fulfilling prophecy, not because of fate, but because of the decisions that this belief influences.

 

Think about it from the other direction. Imagine an older adult who  genuinely believes that her best years aren’t necessarily behind her, that growth is still possible, that her mind and body are worth investing in. She’s more likely to sign up for that yoga class, to challenge herself mentally, to seek treatment for her depression instead of dismissing it as “just part of getting old.” Her beliefs create a very different set of daily choices — and over months and years, those choices compound.

 

Dr. Levy’s previous research supports exactly this pattern. In one study, older adults exposed to positive age-belief messages showed improvements in physical function that continued to grow over the two-month follow-up — a snowball effect where positive beliefs led to better functioning, which reinforced more positive beliefs, which led to even greater functioning (Levy et al., 2014).

 

Negative age beliefs, meanwhile, have been associated with measurable changes in brain health. In previous research by Dr. Levy’s lab, negative age stereotypes predicted the accumulation of Alzheimer’s biomarkers — including plaques and tangles and lower hippocampal volume — even after controlling for other risk factors (Levy et al., 2016). The brain appears to be susceptible to the beliefs we carry about aging. The body follows.

 

This theoretical and empirical framework, supported by at least nine meta-analyses to date (Meisner, 2012; Westerhof et al., 2023), is why the current study’s findings make so much sense. Age beliefs are not just attitudes. They influence biology, physiology, cognitive function, and behavior – essentially everything.

 

Frequently Asked Questions About This Research

 

Can you change your age beliefs if they’ve been negative for a long time?

Yes. Beliefs about aging are “modifiable” on both the individual and societal level. Prior studies have shown that even brief, implicit exposure to positive age-related messages can shift beliefs and improve outcomes.

 

On a clinical level, this is work that can happen in therapy, through psychoeducation, and through intentional reframing — it’s not a fixed trait.

 

Does this mean everyone will improve if they just think positively about aging?

No — and this is an important nuance. Positive age beliefs are one significant predictor of improvement; they don’t override genetics, chronic illness, or other health determinants.

 

What the research tells us is that beliefs add meaningful, independent predictive value — that they matter above and beyond the other factors we typically measure. Believing aging can include growth doesn’t guarantee improvement, but it meaningfully increases the odds.

 

 

Why haven’t we heard this before? Why do we still talk about aging as decline?

 

Partly because most aging research is designed to measure decline. Standard assessment tools used by the World Health Organization, for example, classify cognitive and physical health as either “declining” or “not declining” — they don’t include categories for improvement (Levy & Slade, 2026). When your measurement tool can’t detect growth, you’re going to find a lot of decline. This study used a method that could detect upward trajectories, which is part of why it found them. The people who were improving have always been there. We just weren’t looking.

 

 

What This Means for Older Adults

If you are an older adult — or if you’re supporting one — please hear this: the story that aging is nothing but loss is empirically incomplete. It has been written in a way that makes it easy to miss the people who are improving. You may be one of them. You could be.

 

This doesn’t mean aging is effortless or that real struggles aren’t real. They are. But the picture is far more nuanced, and far more hopeful, than the dominant cultural narrative suggests. What you believe about aging can shape your health trajectory.

 

When older adults understand that improvement is possible, it may increase self-efficacy, encourage engagement in health behaviors, and reduce the fatalism that so often keeps people from even trying. The belief that “nothing will make a difference at my age” is not only untrue — it is, according to this research, actively harmful.

 

This isn’t about toxic positivity or pretending aging is easy. It’s about noticing when resignation has replaced reality — when “I’m just getting old” has become a reason to stop trying rather than an honest assessment of where you are. The antidote to negative age beliefs isn’t pretending everything is fine. It’s giving yourself permission to expect more than decline — because the evidence says you can (and should).

 

“The antidote to negative age beliefs isn’t pretending everything is fine. It’s giving yourself permission to expect more than decline — because the evidence says you can (and should).”

 

 

What This Means for Mental Health Clinicians

 

For those of us who work with older adults, this study has direct clinical relevance.

 

First, it invites us to examine our own age beliefs. Research has shown that healthcare providers — including mental health clinicians — often hold ageist assumptions that affect the care they provide and the expectations they communicate (Inouye, 2021). If we unconsciously believe that improvement isn’t realistic for older clients, we may be less likely to offer evidence-based interventions, set recovery-oriented goals, or communicate the genuine possibility of change.

 

Second, it underscores the clinical value of explicitly addressing age beliefs with older adult clients. Age beliefs are modifiable through psychoeducation, cognitive reframing, and dismantling stereotypes. This is real clinical work with real health consequences.

 

Third, this study invites us to reframe how we set therapeutic goals with older adults. Improvement-focused goals are not only clinically appropriate — they are empirically supported.

 

 

The Bottom Line

 

Nearly half of older adults in a nationally representative study improved their cognitive and/or physical functioning over up to twelve years. That improvement was predicted by something modifiable: how positively they viewed aging.

 

This is not a story about exceptional people. It’s a story about the general older population — people with chronic illness, people with depressive symptoms, people at all levels of baseline functioning. Improvement was not rare. It was not unusual. It was, in many ways, the norm.

 

If aging can include growth — and this study tells us it often does — then what we believe about growing older is one of the most important health investments we can make. And unlike genetics, it’s something we can actually change.