The Trajectory of Joy in old age
We do not like the idea of growing old but we like thinking about the alternative even less. We can only hope that we may have as pleasant a time as possible while age happens to us. How likely is this?
Looking at numbers seems unlikely to cheer us up but is surprisingly reassuring. The beyond-blue end of the spectrum of sadness is severe depression needing clinical treatment. This is associated with changes in brain biochemistry that are not necessarily related to bad things that happen to us1 and is diagnosed by psychiatric interviews or by answers to Depression questionnaires (e.g 2,3 ).An early survey4 and more recent reviews5 find no evidence that severe depression becomes more common in old age But, because age increases the odds of unpleasant events we must ask if the picture changes if we include lesser miseries.
It does not seem so. A national survey in wonderful lucky Australia concluded that depression and anxiety steadily decline through middle and old age. A later analysis of these data questions this conclusion6 but other large surveys do not. A U shaped contentment function, with an initial high in youth followed by a decline in middle age recovering to a second peak in old age was found for 250,000 people N America and West Europe7.Some analysts suggest that the happiness curve may be S shaped: a high in early life, a trough in middle age and then improvement until a small drop in the 70’s and beyond.6 Though the older we get the more likely we are to meet hard times, this is good news. The glum middle-aged must just buck up, pull themselves together and walk more often on the sunny side of the street.
As usual in science the more we think about the data the more questions we find to ask and the less certain we become. A problem with questionnaire answers is that what happens to people is one thing and how they cope with it is quite another. For example older people may be hardened against despairs by lifetimes of dealing with problems that now disturb them much less than when they first experienced them when they were younger.
I haven’t found much research on how effectively people can cope with difficulties at different ages, so I can only fall back on my first impressions of unpublished data. My colleagues and I gave an unusually healthy, robust and cheerful group of 1965 people in Newcastle and Manchester, then aged from 50 to 89, a check-list of 50 different kinds of stressful life events, ranging from bereavement and divorce to small everyday hassles. They reported how often they had encountered each during the past year and how much it had upset them. Numbers of reported stressful events fell with age. So, also, did the average intensity of the stress that identical events caused. To make this comparison properly it is unwise include peoples’ ratings of their responses to their most and least significant disasters because these will be undifferentiated at the upper and lower limits of the scale. When we separately counted only moderate hassles we got the same result. The older volunteers seemed to experience fewer stressful events and also to be less upset by those that they did experience. Again excellent news but, given folk wisdom about our Grey Years, also surprising. How can this be?
A snag is that all of the comparisons that we have discussed are cross-sectional, comparing groups of people of different ages. There is excellent demographic evidence that socio-economic disadvantage not only makes us unhappy but shortens our lives. There is also good evidence that depression increases the odds of earlier death for people suffering from cancers8. People with cardiovascular disease are also more likely to be depressed9 and, if they are this increases risk of poor clinical outcomes10 heart attacks11, and earlier death12. Socio-economic disadvantage not only makes us unhappy for obvious reasons. It also increases risk of pathologies that kill us young.13 The oldest of us are lucky survivors who have, most likely, been atypically healthy, prosperous and cheerful throughout our lives. Those whose youth and middle age are overcast by poor health, misfortune and sadness can no longer answer questionnaires.
So we older-oldies can be glad that we have survived and also that we have survived because we have been, and still are, happier than most. A malign spiral to early deletion is driven by deprivation, illness and sadness but a benevolent reverse spiral is also possible. Obstinate cheerfulness makes illness and deprivation easier to bear, reduces the damage they cause and postpones death. I should be very grateful for evidence (large controlled trials please) that this encouraging and plausible story is true. Even if things do not quite work this way or are, as usual, much more complicated than they first seem, it seems far better to be resolutely and perversely happy until further access to joy becomes irrelevant.
There are surely scores of self-improvement and survival schemes for the elderly, some quite expensive, most richly glistening with snake oil, all promising to instruct people of my age how best to live our lives. Perhaps reading some of these might help my shuffle along precarious paths of geriatric joy. I do not think that I shall bother with them because I doubt that they would do more good than the wisdom distilled from the appalling events that we shall spend 2014 remembering: “Just pack up your troubles in your old kit bag and Smile, Smile, Smile”.
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