By Aïna Chalabaev, Grenoble Alpes University, France
As outlined in a previous post, the health benefits of regular physical activity are well established for people aged 65 and over. Clear guidelines have been set by the World Health Organization on the amount and type of activity associated with health gains. However, older people remain among the most inactive segment of the population worldwide.
The limits of one-size-fits-all interventions
This highlights that raising awareness about physical activity benefits is not sufficient; bridging the intention–behavior gap is necessary. Health psychology researchers have developed a range of theory-based techniques to promote healthy behaviors. However, some techniques effective in younger adults may be ineffective, or even harmful, for older adults, stressing the need for tailored approaches.
Ageism: A hidden barrier to physical activity
Ageism is a barrier specific to older adults. It includes stereotypes (beliefs), prejudice (affects) and/or discrimination (behaviors). Although stereotypes can be positive, they tend to be predominantly negative, a trend that has intensified during the 20th century. Such stereotypes contribute to discrimination. About 35% of adults aged 65+ report facing discrimination in daily-life, and one in 17 adults aged 50+ in healthcare.
Healthcare professionals are often educated about aging through a lens of disease and decline. This, coupled with daily exposure to frail older adults, can reinforce ageist attitudes. To counteract this, interventional studies present counter-stereotypical data (for example about the proportion of seniors who volunteer, work or develop new skills). They also foster intergenerational contact to change perceptions, i.e., meaningful interactions between people of different generations, especially between younger and older age groups.
In addition to being discriminated, older adults may internalize age stereotypes. Becca Levy’s team proposed a model in which stereotypes learned earlier in life shape older adults’ self-perceptions, health and longevity. For example, young adults with negative age stereotypes are more likely to experience a cardiovascular event 30 years later. This key role of views on aging may notably be explained by their influence on health behaviors, those with a positive attitude toward their own aging are more likely to stay active and adopt healthy habits.
Interventions to tackle ageism and its impacts
Several studies have tested ways to promote positive self-perceptions of aging, especially in relation to physical activity. For example, Beyer et al. (2019) conducted a randomized trial with 84 frail, inactive older adults (mean age ~77). One group received standard adapted physical activity (APA); the other received APA plus a self-perception module. This module included four sessions over 12 weeks focused on challenging stereotypes, learning about aging, and modifying negative self-perceptions. The intervention group reported more positive aging perceptions and improved mental health.
An even subtler consequence of stereotypes has been identified in experimental studies. They show that exposing older adults to negative stereotypes during clinical tests impairs performance on tasks involving memory or grip strength. One study found that activating an ‘older adult’ identity reduced grip strength by nearly 50%. This activation can happen subtly–through interactions with younger healthcare professionals, indicating their age on forms just before clinical testing, or being told they are being tested on age-sensitive abilities. The challenge for healthcare professionals is therefore to guarantee a clinical environment that is free of ageism cues, for example by avoiding asking older adults to indicate their age before they perform a clinical test.
Overall, combating ageism requires combined efforts: raising awareness and transforming societal views, while empowering seniors to reshape their own perceptions of aging. To reach this objective, interventions based on rigorous scientific knowledge are key.
Practical recommendations
- Actively reflect on your assumptions about older adults and keep up to date with scientific knowledge to form unbiased impressions.
- Think how you might integrate positive aging messages into consultations, highlighting that older adults can still gain strength and learn new skills.
- Mention how positive views on aging support long-term activity and health.
- Avoid negative age cues like describing a test as “age-sensitive” or comparing them with younger adults.
- Encourage older patients to intergenerational programs where younger and older adults collaborate on the same tasks.
