Why do we get better with age? Yale study finds nearly half of older adults improve over time
A long-running study from Yale University finds that older adults do not undergo as one-directional a decline as is often assumed. About 47 percent of participants showed measurable improvement in at least one health domain over the course of the study compared with their baseline. The findings, reported by Science Daily, were published in advance alongside an early journal release on Friday.
The study followed more than 2,500 participants aged 60 and over for six years. Outcomes measured included activities of daily living (ADL), cognitive tests, depressive symptoms, chronic disease burden and social engagement. Just under half the participants showed measurable improvement in at least one of these measures.
Lead author Dr Becca Levy said "our perception of aging is generally built around a decline narrative, but the reality is much more complex." Levy, a professor of epidemiology at Yale School of Public Health, has worked for more than a decade on aging and health beliefs.
The domains of improvement clustered into different groups. Some participants improved on physical fitness measures (exercise, muscle mass, balance), while others gained in psychological resilience. A third group reported improvements in social connection and a sense of meaning. The study suggests these dimensions can improve independently of one another.
The strongest contributors to improvement included regular physical activity, social engagement, quitting smoking and improved sleep quality. The study also found that positive beliefs about aging, the view that aging is not only loss, made an independent contribution to the measured improvements.
Dr Levy's earlier work had shown that individuals with positive beliefs about aging lived approximately 7.5 years longer. The new analysis supports a similar effect for quality of life: participants with positive beliefs experienced improvements in specific health markers at roughly twice the rate of those without.
The study has clinical implications. Primary-care physicians and geriatricians could design brief interventions about patients' beliefs around health. These could resemble small interventions used in depression care, such as short educational sessions, informational handouts or daily reminders.
In the full paper, due for publication in Nature Aging next month, the researchers broke the data down by demographic subgroups. Socioeconomically disadvantaged populations in the United States and the United Kingdom showed lower rates of improvement, highlighting the importance of access to health resources. The researchers called for greater public-health investment on this front.
A limitation of the study is reliance on self-reported data. The researchers said future studies should integrate objective biological markers, such as epigenetic aging clocks. Nevertheless, the existing findings carry a meaningful message for how geriatric care policy is designed.
The US National Institute on Aging (NIA) was one of the study's funders. NIA director Richard Hodes called the findings "an important contribution to the growing evidence base on the multidirectional nature of aging." NIA announced that its fiscal-year 2026 budget includes specific funding for research on resilient aging.
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