Aging is not a disease. It’s time we stop treating it that way
In honor of National HIV/AIDS and Aging Awareness Day, held this year on September 18, BETA invited HIV clinician and geriatrician Meredith Greene, MD, to share her perspective on HIV, health and ageism—and what we all can do to overcome the negative effects of age discrimination in our own lives.
Wrinkle cream. Hair dye to cover gray hair. We see all kinds of these—and other—anti-aging products advertised on TV, in print publications and online. It’s a big business (the global anti-aging market is estimated to be worth $191.7 billion in 2019), and it reflects the youth-oriented focus of our culture.
We don’t just experience ageism in the advertisement of beauty products. We also see ageism in how older adults are often portrayed in news stories, TV and movies—as fragile, forgetful, cranky or helpless. These portrayals can often lead many of us to assume that growing older is all doom and gloom. We start to think that chronic pain, dementia, depression and incontinence are common—or worse, a normal part of growing older. The reality? None of these conditions are a normal part of getting older.
In fact, some things, like creativity, can actually improve with age. We just don’t hear about it as often.
More and more as a society we are talking more openly about discrimination against race, sexual orientation and gender identity. Less often do we talk about or even recognize another “ism”: ageism.
Ageism is defined as “prejudice or discrimination on the basis of a person’s age.” Although the term can refer to discrimination of people at any age (including young people), the term has largely been applied to discrimination against older adults.
Like many other discriminations and stigmas, ageism can affect health—and researchers and clinicians are beginning to study ageism’s negative impact on health. This year at the International Association of Gerontology and Geriatrics (IAGG) World Congress, five separate symposia and poster sessions were held specifically related to ageism.
For example, ageism can impact stress levels, as measured by the release of the stress hormone cortisol. If cortisol is elevated for prolonged periods of time it can lead to health problems like digestive problems, anxiety, trouble concentrating and other cognitive problems. In one study, among 439 participants age 50 or older in the Baltimore Longitudinal Study of Aging, researchers found that participants who held more negative stereotypes of aging had significantly more cortisol release than people who held more positive views of aging.
Another national study with almost 2,000 adults over age 50 measured the extent to which participants experienced age discrimination in everyday life. (People most frequently reported experiencing ageism as being not treated with courtesy or being treated as less intelligent.) Age discrimination was significantly associated with life satisfaction: People who reported more age discrimination had lower life satisfaction than others who experienced less age discrimination.
Unfortunately, ageism can also extend into healthcare settings. Multiple studies have shown that people working across many healthcare professions—such as nursing, medicine and even rehab—can hold ageist views. And, like many biases, providers may not be aware of them. One example of how this manifests is by healthcare providers not routinely discussing sexual health with older adults. Providers may assume older adults don’t have sex, and are therefore not at risk for HIV, which could be one of the contributing factors for why new diagnoses of HIV among people over age 50 are delayed.
A few studies have also examined ageism in people living with HIV. A common theme is that people may be dealing with multiple stigmas. People may feel stigma related to living with HIV, and then on top of that may feel stigma related to their age. Despite all these challenges, many older adults living with HIV demonstrate resilience, including an increased self-awareness and optimism for the future.
How can we change our experience of ageism?
First, examine your own views about aging.
What have you gained as you have grown older? Have you gained wisdom from life experiences? Perspective on what’s really important in life?
While you cannot control how society may view older adults, you can change how you view the aging process. Your own outlook about aging may be just as important in influencing your life satisfaction as the experience of ageism in society. In other words, having a positive outlook on what you think about ageing, and your own experience of ageing, can help to combat any negative effects of age discrimination.
Studies have found that engagement in meaningful activities or volunteer work can also mediate the relationship between ageism and life satisfaction. Are you involved with a cause you feel passionate about? Is there a way you can give back to your community, or work towards a goal you find important?
Don’t be afraid to call out ageism if you see it or feel you have experienced it. Speak up if you feel like you’ve been mistreated, discounted or overlooked because of your age.
With regards to your health, don’t assume that a symptom such as pain especially if it persists is just a normal part of getting older. Feeling lonely, isolated or depressed are not normal parts of growing older—so don’t let others convince you they are. Talk to your healthcare provider about any health concerns you have, even if you feel like it’s something “normal” or expected. Every week I see someone who thinks it is normal to feel depressed, to have trouble walking, or have urinary symptoms just because they are now older. This is not the case.
Look around and you can readily find examples of older adults who don’t fit the media stereotypes. At AIDS Walk San Francisco last year, one of the walkers was wearing a sign on her back which read “97 years young and still walking.” She had over 20 years of AIDS Walk stickers on her sign, but also had her walker and a friend close by to help her if she needed help. She is the picture of resilience. Resilience doesn’t mean that you can do everything in the way you were able to when you were 20. But it means that you can still find a way to do something you love.
Aging is something we all experience from the day we are born. Every day, we are growing older, so we should embrace it. Aging is not a disease—it’s time we stop treating it that way.
Meredith Greene, MD, is an HIV clinician and geriatrician who specializes in caring for older adults. The views expressed here are her own. She is the associate director of the Golden Compass program at Zuckerberg San Francisco General Hospital’s Ward 86, a program for people over age 50 living with HIV. Monica Gandhi, MD (clinic director of Ward 86) directs the Golden Compass program with support from the Division Chief, Diane Havlir, MD.
Emlet, C.A. and colleagues. “I’m not going to die from the AIDS”: resilience in aging with HIV disease. Gerentologist, 2011.
Kim, H. & Kang, H. The influence of ageism on life satisfaction of older adults. Innovation in Aging, 2017.
Lindau, S.T. and colleagues. A study of sexuality and health among older adults in the United States. N Engl J Med, 2007.
Further reading and resources:
Lively, funny, and deeply researched, This Chair Rocks traces author and activist Ashton Applewhite’s journey from apprehensive boomer to pro-aging radical, and in the process debunks myth after myth about late life. Read Applewhites blog, Yo, is this Ageist?
#DisruptAging and find out why life after 50 can be as fulfilling and amazing as life before 50 with this campaign from AARP.
The Gray Panthers is a social justice organization working for a world where young people can look forward to growing older. Find out more about the San Francisco chapter.
The Elizabeth Taylor 50-Plus Network at San Francisco AIDS Foundation is a social support and engagement group for people both HIV-negative and people living with HIV over age 50. The group provides wellness coaching and social support and organizes social activities and events. Find more information and join the group.