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Why You May Truly Be Only as Old as You Feel

New research on "subjective age" and well-being.

The other day, I got on the elevator in my building with an endearingly eccentric older gentleman who lives on our floor. Over the years, we’ve had a few brief, largely one-sided conversations during which he shares deep proclamations in an incongruously mellifluous “radio voice”, but he generally keeps to himself and hardly leaves his apartment. In recent years, he’s started walking with a cane and appears less and less robust.

On this occasion, in keeping with his idiosyncratic style, as we got on the elevator he ponderously pivoted in my direction, intoning “My advice to you is ‘Don’t get old.’” He went on to explain that chronic pain has been a burden for him as he’s aged. As someone who has himself lived with chronic pain since a young age due to a childhood orthopedic problem, not to mention a few mid-life injuries related to living an active lifestyle, I found myself thinking about how to live most fully in spite of the trials and tribulations of aging, as I'm now in my early 50s.

Aging presents a variety of challenges, from changes in appearance, health, and energy levels to increasing awareness of time and the finitude of life, to changing roles and perceptions in and by society and those close to us, to gains in wisdom and peace if life has gone well. As the old saying goes, “You are only as old as you feel!” But, is it true? And how might perceived versus actual age affect decisions about how to approach getting older?

Subjective Age, Chronological Age, and Well-Being

A recent study in the Journal of Psychiatric Research (2022) takes a scientific view of this question. Researchers Aftab, Lam, Thomas, Daly, Lee, and Jeste analyzed data from the Successful AGing Evaluation Study (SAGE), with over 1,300 community-based participants comprising a real-world sample of everyday folks across the lifespan recruited in order to understand health and aging.

Participants completed a variety of measures: They were asked their subjective age (SA “How old/young do you feel?”); about how meaningful life is for them via subscales of the Presence of Meaning and Search for Meaning surveys; how successfully they felt they were aging using the Self-Rated Successful Aging Scale; their stance toward life via the Life Orientation Test; how much stress they experienced using the Perceived Stress Scale; how much they felt they had reached a state of comfort with themselves via the Personal Mastery Scale; measures of health and well-being including the Brief Symptom Inventory Anxiety Scale, the Patient Health Questionnaire, the CES-D Happiness Scale, and the Satisfaction with Life Scale; and other relevant measures including the Connor-Davidson Resilience Scale, the Brief Multidimensional Measure of Religiousness/Spirituality, the Santa Clara Brief Compassion Scale, and the Curiosity and Exploration Inventory.

Reflecting the perspective of “positive psychiatry”, the measures were selected to highlight key correlates of successful aging in relation to both subjective and chronological age.

Key Findings on Aging and Well-Being

First, perceived subjective age was consistently younger than chronological age (SA). This effect was stronger with increasing age: Participants on average rated their subjective age 7.3 percent younger than calendar age, but for those over 60, SA was 13 to 18 percent lower than CA.

Younger SA relative to CA was associated with better reported well-being, overall better health, and lower reported levels of mental and physical illness and impairment. This is consistent with prior studies, which have found the association bidirectional: Better health and well-being are correlated with feeling younger, and lower SA is associated with decreased risk for physical problems related to depression.

Further, the study found that younger SA was associated with a range of positive outcomes, including greater reported successful aging; enhanced sense of personal mastery; stronger resilience; hope, optimism, and curiosity; and greater perceived social support. People over 60 with younger SA reported greater meaning in life, but they did not report seeking meaning more actively, suggesting that the search for meaning may have taken place at an earlier stage of life.

Implications for Individuals and Healthcare

The study is part of a growing body of literature on successful aging. People on average are living longer, and younger people anticipate they will live longer than their parent’s generation did, creating open questions about how to construct a meaningful and satisfying life given changing expectations. For people in mid- to older adulthood, the question of how to live as one gets older becomes more pressing.

The study, along with related earlier work on aging, identifies a reciprocal relationship between subjective age and various measures of mental and physical health, life satisfaction and meaning, and psychosocial indicators related to well-being, including resilience, optimism, and social support. Individuals motivated to maximize chances of enjoying their older years can be intentional in efforts to identify and pull key levers, such as managing physical and psychological problems, maintaining fitness levels, engaging in meaningful activities, and actively cultivating social activities and new relationships, given inevitable losses.

From the point of view of healthcare, simply asking adults how old they feel and comparing that with calendar age is a useful screening question to identify both the need to dig deeper for problems as well as to identify areas of strength and resilience. Key research questions include asking whether cultivating a sense of younger subjective age is possible (presumably it is), and could doing so lead to enhanced health-promoting behaviors, and if so among what groups, via what means most effectively.

Moreover, subjective age is a key performance indicator correlated with the aforementioned factors associated with late-life flourishing and well-being. The younger we feel relative to our chronological age, the more likely we are to be doing well in other areas. On the other hand, starting to feel like our actual age may be related to wise acceptance, but it also may signify a need to look closely at why that is and what we can do to restore a sense of reasonable subjective youthfulness.

Being a Steward of Your Own Development Across the Lifespan

Understanding how self-concept changes with age given changes in health, cognition, and appearance is important for maintaining satisfaction throughout the life cycle. According to psychologist Erik Erikson’s foundational work, development proceeds from cradle to grave. The last two stages of adult development are middle adulthood, from about 40 to 65 years of age, and late adulthood, from 65 onward.

Middle adulthood is organized around generativity vs. stagnation, the sense of having lived a productive, successful personal and professional life. Late adulthood involves looking back on the totality of one’s existence, as death approaches, navigating ego integrity vs. despair. Feeling young at heart while accepting and coping with physical aging, making constructive choices without succumbing to excessive anxiety, and being resilient without undue struggle and suffering—perhaps easier said than done.

The older people get, the more the subjective age lags behind calendar age. Many people I've known report a sense of disbelief at being as old as they are, in a sense forgetting their age and feeling surprised when they remember. With a smile, my father often said, "What happened to that young guy I used to see in the mirror?"

It seems there is some truth to the old adage. Not only are we as young as we feel, feeling younger than we are may actually drive greater health, well-being, and purpose as we age.

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References

Aftab A, Lam JA, Thomas ML, Daly R, Lee EE, Jeste DV, Subjective age and its relationships with physical, mental, and cognitive functioning: A cross-sectional study of 1,004 community-dwelling adults across the lifespan, Journal of Psychiatric Research (2022), doi: https://doi.org/10.1016/j.jpsychires.2022.06.023.

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