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Second Opinion: Aging Sterotypes

Hosted by Abigail Trafford
Washington Post columnist

Tuesday, July 18, 2:00 p.m. EDT

Abigail Trafford
Abigail Trafford

Welcome to Second Opinion, a weekly column and Live Online discussion with Abigail Trafford, former Washington Post Health Editor. She returns to the Health section as a full-time columnist and writer.

This week Abigail addresses the issues of aging and cultural stereotypes that are rampant here in the United States. In her column, she writes that individuals exposed to stereotypes of aging experience a direct effect on the quality of their health. "Ageism," she states, "can make you sick."

Joining Abigail in dicussing the issues of aging stereotypes is Becca Levy, an assistant professor at the Department of Epidemiology and Public Health at Yale University. She led a study on whether aging sterotypes has an impact on cardiovascular functioning.

You may read the discussion transcript below.

Abigail Trafford: Welcome everybody to Health Talk! Have you ever been dissed for being over a certain age? For being a "geezer?" For being forgetful? (Isn't everybody?) Do you know that this is unhealthy? Send us your questions and comments.

Abigail Trafford: Hello and welcome. Have you ever been dissed for being over a certain age? Ever been called an old "geezer?" Did you know this is bad for your health. Join us for a discussion on ageism. Send your questions and comments.

Abigail Trafford: Hello and welcome to Health Talk. This subject has generated a lot of buzz! Your research shows that aging stereotypes are hazardous to health. A lot of people may not know ageism even exists in this country. What kinds of stereotypes are negative to older people?

Becca Levy: Many of the negative stereotypes that exist in our country have to do with poor mental and physical functioning. Another common kind of negative stereotype of aging that appears on a lot of birthday cards concerns changing appearance.

Abigail Trafford: Becca--tell us about your study. What did you find?

Becca Levy: In our most recent study we found that aging self-stereotypes, or older individuals' beliefs about elderly people, can have an impact on their cardiovascular functioning. We found that when we activated negative age stereotypes in older individuals they showed a significant increase in blood pressure and heart rate. In contrast, when we activated positive age stereotypes in older individuals we found that they showed a significant decline in cardiovascular stress.

Abigail Trafford: What other studies show that ageism is hazardous to health?

Becca Levy: In previous studies we have found that when we activate negative age stereotypes, older individuals tend to show a decline in memory performance, self-confidence, will to live and handwriting. In contrast, we have found that when we activate positive age stereotypes we tend to find benefitial changes in these same areas.

Takoma Park, MD: Thank you for this discussion. Do you think aging stereotypes exist with doctors? My 81 year old mother in Minnesota has extremely high blood pressure and osteo and rheumatoid athritis. After getting minimal care from her doctors, the family talked her into joining a new "state of the art" geriatric center that just opened in St. Paul. Last week my mother woke up with chest pain, shortness of breath and swollen ankles. She didn't bother to tell anyone about this until two days later. One of my sisters then took her the next day to the geriatric center and expressed her concern to my mother's doctor. The doctor not only did not take an EKG of my mother, the doctor didn't even listen to my mother's heart or lungs and told my sister that "don't worry, your mother did not have a heart attack, if she did, she wouldn't be here!!" I was completely appalled when I heard. Do doctors discount seniors complaints as whining, or that they just make up the symptons to get attention?

Becca Levy: That is a terrible story. I think everybody is vulnerable to internalizing negative age stereotypes, even doctors.

Arlington, VA: I'm not sure if it's the research itself or merely a side-effect of the way it was summarized to fit into a newspaper article, but the study you wrote about, as described in today's column certainly seems to be drawing rather wild conclusions from some pretty ambiguous results. Apologies for the length, but it's very hard to do justice to the issues involved in just a few words (which I hope is the problem here, since this seems like pretty basic stuff they teach you in undergraduate research courses).

It's well established in psychological research that bombarding someone with negative stimulus can cause stress (which includes symptoms such as increased blood pressure and decreased performance on cognitive tests). This study shows that presenting someone with a list of age-related negative words ("Alzheimer's," "confused," "decline," etc.) causes stress and decreases performance vs. a group shown positive images. But does this really have anything to do with aging or is it an effect of negative imagery in general? Without seeing data to the contrary, I'd bet you could get the same effect with the same subjects using words like "inexperienced," "unworldly," "untrained," and "naive," "untested." Was this looked at? If not, it seems like you're making wild leaps of logic based on fairly mundane data. The question is not, do people receiving positive reinforcement perform better than people receiving negative reinforcement (duh, yes, this was news in 1950)? The question is, is the performance difference between people receiving negative age-related stimulus and people receiving positive age-related stimulus significantly greater than one would expect from general increases in stress?

Also, you're showing that a short-term bombardment of intense negative stimuli has a negative effect within a few minutes of exposure, then generalizing that to say that low-level exposure over a long period of time has a long-term negative effect. That may be true, but there's no data mentioned in the column that supports that leap. I'm pretty sure, for example, that immediately after my computer crashes twice in a row for no good reason, my blood pressure will be higher and I'll do worse on cognitive tests than I would otherwise. But that doesn't necessarily mean that using a computer is causing me brain damage. Doesn't mean it's not, either. There's not enough information to judge either way.

Abigail Trafford: Interesting question, Becca. How do you know if a stereotype has a lasting effect on a person?

Becca Levy: You are right that positive and negative words alone would probably have an impact on some of the same outcomes that we have looked at in our research. However, in several studies we have included young people and they do not seem to show the same trends in response to the age stereotypes, perhaps because the stereotypes are not as relevant to them. Also, in this study and others, we have found that the older participants in the studies do not seem to show change on any of the mood measures included. In addition, the stereotype words are presented subliminally so most participants are not aware of the content of the words that flash before them.

Also, you are right that in the present research we only followed the effects for about half an hour. Significant differences between the age stereotype groups still exist at half an hour. Other research suggests that heightened response to stress over time may contribute to the development and progression of cardiovascular disease. Our research does not follow people over long periods of time but rather hints at a possible stress-inducing process that may occur in everyday life.

Philadelphia, PA: Thank you for your wonderful work in combatting ageism.

Do you believe it is possible to reverse the effects of negative beliefs once they have set in and their detrimental effects begin to manifest themselves? Can people think themselves healthier by changing their core beliefs?

Becca Levy: Thank you for your kind comment.

I think it is quite challenging to reverse negative beliefs once they have "set in" however research suggests that most people can report both positive and negative stereotypes of aging (although the negative stereotypes may be more prevalent in our culture). Also, our research suggests that when the positive age stereotypes are activated it can lead to some beneficial changes, such as a reduction in cardiovascular stress.

Abigail Trafford: In China there's much more respect for older people. What does your research show about the physical and mental agility of older people in China?

Becca Levy: In a cross-cultural study I conducted with Ellen Langer we found that the Chinese participants reported more postive views of aging than the American participants and the older Chinese participants tended to perform better on memory tasks than the older American participants. We also found that older Deaf Americans, who tend to have more positive views of aging than hearing Americans, also perform better on memory tasks than their same age hearing American peers.

Silver Spring, MD: Becca,
Here's a posting from an earlier WP discussion today - I find this to be excellent timing for your discussion:

washington, dc: amy,
i'm a recent college grad with a terrific job, however one aspect of my job is making me completely unhappy. There are no young people working with me. I work in a small firm with 15 others who are all between the ages of 30-50. It makes me feel even worse when most of my friends are in positions in which the average age is 25. My job pays well and will help with obtaining better jobs in the future or attending grad school. However, I can't shake this sadness about my undesirable work environment. While i think it's a bit rash to find a new job so soon (i started this one about a month ago), i've considered giving it a test period of about 6 months. (edited for length) My job-happy friends can offer little advice.

Nice, huh? I guess anyone over 30 is just supposed to disappear so that 20 somethings can have a work place that is a version of Friends. These youngsters have the idea that the workplace is their own personal playground for the young, fun and hip, and anyone over 30 is deemed undesireable! Forget the fact that we have mortgages, retirements to fund, kids' college to pay and basic expenses. These whiners should grow up, get over themselves and realize that there are all kinds of people in the world, even those with experience who are actually full fledged adults.

Abigail Trafford: Right on! What a good example of ageism in the workplace. Maybe this is how the sterotype gets started of stupid kids. . . .

Becca Levy: Yes, a good response Abigail. I suppose there is nothing wrong with liking to hang out with same age peers but most of us can learn a lot from a workplace with older people.

Rockville, MD: "presented subliminally" what? Can you further explain the execution of this research. (a pet peeve of mine, is when the media cite numerous studies w/out giving full disclosure to the method of research)

A parallel is the recent reporting that spermicide increases risk of HIV transmission - sure if you're having sex of the same nature and frequency of a prositiute.

Becca Levy: In our intervention older individuals were randomly assigned to a positive or negative age stereotype group. Then the participants sat in front of a computer screen. We told them to report whether they saw something flash above or below a bull's-eye.

We presented the words at speeds that psychologists like to say allow "perception without awareness." The words were presented to most of the older participants on a computer screen at 55 ms and then the words were covered over with a mask. This intervention is fast enough that the participants are unable to report what has flashed on the screen.

Bethesda, Maryland: I am in my mid-sixties and have great difficulty standing up, standing erect, walking without stiffness, and walking up and down stairs. I commute by metro to my office and find that the morning commute can be very painful to get through. What exercises can I take to relieve my situation and make me less stiff and walking easier?

Abigail Trafford: Have you been to a doctor to determine why you are having so much pain? That's what I would do first. Becca, what do you think?

Becca Levy: Yes, I agree with Abigail. It would be great if you could get advice from a doctor as soon as possible to find out how you can reduce your pain.

New York, NY: Shouldn't we just accept our fate instead of kicking and screaming about getting old. Shouldn't we just get ready to go gracefully? I mean that, of course, for anyone 75 or older, not for us young things in our 60s.

Abigail Trafford: It's one thing to achieve grace at a certain age. Another thing to be a doormat! People should kick and scream--at injustice and discrimination. And 75 is not so old--expecially if you're in good health. Isn't this one of the myths about aging, Becca. Decline is not inevitable and diseases can--and should--be treated. What do you think Becca?

Becca Levy: I think that the person in New York, NY is right that accepting aging (and even "getting ready to go" or one's mortality) is a good thing. But ageism, on the other hand, should be met with kicks and screams.

Seattle, WA: Thank you Abigail for tackling the tough issues and for always having such interesting and knowledgable guests.

Ms. Levy, how do the findings of your research compare with health statistics from cultures who claim to have a higher level of reverence and respect for the elders in their populations? Are the elderly of Japan, China or Hawaii healthier in general?

Abigail Trafford: I think the U.S. enjoys the longest life expectancy after age 85--but I don't know if older Americans are healthier. Becca?

Becca Levy: Thank you reader/internet member from Seattle, WA.

I think the most recent statistics from the World Health Organization found that Japan has the highest average lifespan in the world. However, I have not seen statistics to support that the elderly of Japan, China or Hawaii are healthier in general. They may be healthier in respect to different diseases. But this gets complicated because they also tend to have different diets and patterns of exercise. Part of this cross-cultural variability is the reason we followed up our cross-culural research with experimental studies when people are brought into more controlled environments.

To Silver Spring, MD: We younger people do not think that the workplace is our personal playground. Nor do we feel that anyone over 30 should disappear. I am under 30 and enjoy working with older people and feel that I can learn a lot from them. However, it is nice when you are able to work with those who share your interests and goals. When I worked in a department with mostly older people, all they ever talked about were their kids (who are my age) or their grandkids. I had nothing in common with them outside of work. That is NOT ageism.

Abigail Trafford: Good comment. It's true we enjoy people with whom we have something in common. Your thoughts, Becca?

Becca Levy: Yes, perhaps the ideal is to have a mix of same age peers and older (and younger) workplace peers.

Alex: Dr. Levy,

Are you familiar with the work of anthropologist Jennie Keith of Swarthmore College? She and five or six others did an amazing study of five or six cultures over the world (from the !Kung tribe to the Scandinavian countries) and the way those cultures treat their old and very old and the effects arising out of that treatment. The study should be in print by now and if not, Dr. Keith is easily reachable (she is now the Provost of Swarthmore). Anyway, her work dovetails beautifully with yours and I think both of you would benefit from connecting.

Becca Levy: Thank you for mentioning her work. Yes, I am familiar with some of her work and have enjoyed it very much.

Westland MI: Like so many others,in my foolish youth I equated a bronze tan as sexy & healthy. Now I wonder whether skin discolorations might be early stages of skin cancer. The likelihood of my HMO allowing me to see a Dermatologist is roughly equivalent to peace in the mideast. In layman's terms, what do I look for to detect a potential problem vs. plain old age spots?

Abigail Trafford: You've hit on the key issue of gerontoloty. What effects are due to disease and what are attributed to "aging?" In the past decades medical science has made great strides in treating diseases of older people--heart disease, for example. Now the new scientific arena is to stall, mitigate or prevents unwanted effects associated with aging in the absence of disease. Doctors can help people both in the treatment of disease and in the treatment of aging effects. For an individual, the line gets blurred between disease and aging effects. That's why you need to go to a doctor--in your case a dermatologist--to check out your spots. I have very sensitive skin and go every year for a checkup. Becca, your thoughts on this?

Becca Levy: Yes, I agree with your response Abigail.

Abigail Trafford: Alas, our time is up. Thank you Becca Levy. This was so interesting. And thank you all for participating. Join us same time, same place next week for a discussion on buying alternative remedies. Cheers.

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