Dr. Shahar Madjar, Journal columnist

With few exceptions, nobody wants to die, yet nobody wants to get old. On one hand, vivid images of physical decline and diminished minds linger in our collective memory. Who hasn’t witnessed an elderly relative lose their independence or struggle with the devastating effects of dementia? On the other hand, a different reality exists. I think of Pablo Picasso, Frank Lloyd Wright, and Benjamin Franklin, all of whom remained active, creative, and productive well into their eighties. I also think of my own cousin, who, in his eighties, still practices medicine to the delight of his patients. How extraordinary are these cases, really? One thing is certain: despite our best efforts, modern medicine, diet, exercise, and plastic surgery, staying young forever is a losing battle. The question, then, is whether declining in body and mind is truly inevitable. Is it possible to age gracefully, and can the right mindset not only alleviate some of the effects of aging but actually improve our mental and physical health?

In an attempt to answer these questions, Dr. Becca R. Levy and Martin D. Slade of the Yale School of Public Health conducted a study titled Aging Redefined: Cognitive and Physical Improvement with Positive Age Beliefs, published in the journal Geriatrics in March 2026.

The authors analyzed a large cohort of 11,314 community-dwelling adults aged 65 and older drawn from the Health and Retirement Study. Over a follow-up period spanning up to 12 years, the researchers assessed physical function through standardized walking speed tests and tracked cognitive performance using tests evaluating areas like memory, orientation, attention, language, and executive function.

Participants beliefs about age and aging were measured at the beginning of the study using a questionnaire that assessed how positively or negatively they viewed aging.

Unlike many previous studies that have focused primarily on age-related decline, this study specifically searched for evidence of cognitive and physical improvement and maintenance over time. By shifting the focus from deterioration to growth and examining how these trajectories were related to participants’ beliefs about aging, the authors were able to explore how a positive mindset can actually lead to better physical and mental health.

The results challenge the conventional narrative of inevitable late-life decline. Remarkably, 45.15% of participants experienced measurable improvement in either cognitive function, walking speed, or both over the course of the study. When examined separately, 31.88% demonstrated significant cognitive improvement, and when combined with those who maintained stable cognition, a total of 51.06% avoided the expected pattern of cognitive decline. Physically, 28% showed objective improvement in walking speed, while 37.6% either improved or maintained their baseline physical function. Most importantly, individuals with more positive beliefs about aging had significantly greater odds of experiencing these favorable outcomes. These associations remained statistically significant even after the researchers adjusted for potential confounding factors, including age, baseline health, chronic illnesses, education, depression and genetic risk for dementia (associated with the APOE ε4 allele).

It’s important to note that the study has several limitations. Because it is an observational study rather than a randomized controlled trial, it cannot definitively prove a cause-and-effect relationship between mindset and overall physical or cognitive health. While walking speed and global cognitive assessments are well-validated measures in geriatric research, they represent only specific aspects of physical and cognitive function. The findings therefore may not necessarily extend to other domains, such as fine motor performance or particular aspects of executive function.

Furthermore, because the study was conducted within the United States, its findings may not apply to cultures with different beliefs and attitudes toward aging.

The study presents a new definition of what it means to grow old. Rather than portraying aging as an unavoidable downward trajectory, the findings suggest that older adults retain considerable capacity for continued cognitive and physical adaptation. The study also raises the possibility that our cultural and personal beliefs about aging may influence the outcomes associated with it.

As I read this article on the Fourth of July, the 250th anniversary of the nation, Benjamin Franklin helped forge in his own brilliant elderhood, with the sounds of fireworks reverberating along my street, I came to an optimistic realization: decline associated with aging is not an absolute certainty. By reshaping how society views older adults and how older adults view themselves, we may unlock a remarkable human capacity for continued growth, resilience and vitality well into later life.

EDITOR’S NOTE: Dr. Shahar Madjar is a urologist and the author of “Is Life Too Long? Essays about Life, Death and Other Trivial Matters.” Contact him at smadjar@yahoo.com.