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Aging is often associated with inevitable physical and cognitive decline, but emerging evidence suggests many older adults maintain—or even improve—their function over time. A large longitudinal study published in Yale School of Public Health and reported in the journal Geriatrics found that more than 45% of adults age 65 and older demonstrated improvement in cognitive function, physical function, or both over more than a decade of follow-up.[1]
Researchers identified one major predictor of successful aging: positive beliefs about aging itself. Older adults with more optimistic attitudes toward aging were significantly more likely to improve in cognition and walking speed, a key geriatric “vital sign” strongly associated with disability, hospitalization, falls, and mortality.[1,2]
These findings challenge the assumption that decline in later life is unavoidable. When individuals with stable cognition were also included, more than half of participants avoided measurable cognitive decline.[1]
Physical function also remains highly modifiable. Preservation of muscle mass and lower-body strength—particularly gluteal strength—is closely tied to balance, mobility, fall prevention, and independence in older adults.[3] Exercises such as squats, glute bridges, and sit-to-stand movements may help maintain functional capacity and reduce frailty risk.
Clinical Implications
Encourage patients to view healthy aging as achievable and potentially improvable.
Assess gait speed routinely, as slower walking speed predicts morbidity and mortality.
Reinforce resistance and mobility training to preserve strength, balance, and independence.
Address age-related pessimism, which may reduce engagement in exercise, rehabilitation, and preventive care.
Implications for practice
Mindset as a modifiable factor: Positive beliefs about aging may influence physical and cognitive trajectories. Clinicians can consider addressing patients’ aging expectations as part of care.
Routine gait-speed assessment: Walking speed is a strong predictor of disability and mortality; it can be a useful routine measure in primary and specialty care.
Emphasize strength and mobility: Lower-body strength, especially glute strength, supports balance, independence, and fall prevention.
Simple at-home or beginner-friendly exercise ideas (glute/lower-body focus)
Glute bridges: Lie on your back with knees bent, feet flat, lift hips to form a straight line from shoulders to knees; hold briefly and lower.
Bodyweight squats or chair squats: Stand with feet hip-width apart, lower into a squat while keeping the chest up; sit to a chair if needed.
Sit-to-stand: From a seated position, stand up fully and sit back down slowly; progress to fewer supports or add a bit of resistance.
Step-ups: Step onto a stable platform or step with one leg at a time, then lower and switch legs.
Progressions: Increase reps, tempo (slower e.g., 3 seconds down), or add ankle weights as appropriate and safe.
References
Levy BR, et al. Positive age beliefs and functional improvement in later life. Geriatrics. 2025.
Becca Levy, Yale School of Public Health press release, 2025.
American Geriatrics Society guidance on mobility and fall prevention in older adults.
Northeastern University interview with Elaina Manolis on muscle mass and longevity.
