Age and the trajectories of joy

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how effectively people can cope with difficulties at different ages, so I can only fall back on my first impressions of unpublished data.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”. 

  References 

1, Austen, M-P, Mitchell, P, Goodwin, GM (2001) Cognitive deficits in depression. Possible implications for functional neuropathology British Journal of Psychiatry, 178: 200-206.

 

2. Beck, A.T., Ward, C.H., Mendelson, M., Mock, J. & Erbaugh, T.G. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.

 

 

 

 

3.Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V. and Adey, M. (1982).Development and validation of am geriatric depression screening scale: a preliminary report. J. Psychiatric Research, 17. 213-229.

 

4. Blazer, D, Williams, C.D. (1980). Epidemiology of dysphoria and depression in an elderly population. American Journal of Psychiatry,137, 439-444.

 

5. Jorm, A.F. (2000). Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the lifespan. Psychological Medicine, 30, 11-22.

 

6. O’Connor, D. (2006). Do older Australians truly have low rates of anxiety and depression? A critique of the 1997 National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry, 40, 623-631.

 

 

7. Blanchflower, D. G., & Oswald, A. J. (2008). Is well-being U-shaped over the life cycle? Social Science & Medicine, 66(8), 1733-1749.

 

8. Pinquart, M. & Duberstein, P.R. (2010). Depression and Cancer Mortality, a Meta-analysis. Psychological Medicine 40, 1797-1810.

 

9. Schultz, R., Beach, S.R., Ives, D.G. Martire, L.M. et al. (2000). Association Between Depression and Mortality in Older Adults. The Cardiovascular Health Study Arch Intern Me ;160. :1761-1768.

 

10. Joynt, K.E. , Whellan, D.J. & O’Connor, C.M. (2003). Depression and cardiovascular disease: mechanisms of interaction. Biological Psychiatry, 54, 248-261.

 

11. Sineone, C. & Clark,K. (1983) Major depressive disorder predicts cardiac events in patients with coronary artery disease. Psychosomatic Medicine, 50, 627-633.

 

12.Schulz,R., Beach,S.R.,Ives,D.G., Martire, L/M., Ariyo, A. A. & Kop, W.J. (2000). Association between depression and mortality in older adults. Arch Intern Med. 160: 1761-1768.

 

13. Nagi, MH, Stockwell, EG (1973). Socioeconomic differentials in Mortality by cause of death. Health Service Reports, 88, 449-456.

 

 

 

 

 

About Gray Rabbitt

Grumpy gerontologist
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5 Responses to Age and the trajectories of joy

  1. iChas says:

    You report an experiment: “Numbers of reported stressful events fell with age. So, also, did the average intensity of the stress that identical events caused. … 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?”
    I suspect it’s because, with age, hormonal (neuromodulatory) influences diminish so that seniors actually care less – have less intense emotions.

    • Gray Rabbitt says:

      Good point. Thanks. I think we also need other factors to explain the persistence of insouciance of some people throughout their lifespans. Do you have a reference on diminishing neuromodulatory influences in old age?
      Best wishes

  2. iChas says:

    There’s extensive research on diminishing dopaminergic, serotonergic, and cholinergic neuromodulation and its effects on cognitive function: memory, decision-making etc.
    But most of the research I’ve found (and it’s not my field, so there may be lots out there) on endocrine hormones, oestrogen, testosterone, appears to be limited to their action as hormones rather than as neuromodulators. I haven’t seen anything on changes in their direct influence in the brain, but I speculate. As one does.
    Anecdotally, I’ve noticed that the older people get (over 80, say), the more detached – there are fewer people they can be bothered to keep up with, or care about.

  3. Gray Rabbitt says:

    Thanks for this. On the apathy of older people towards an increasing number of acquaintances this is also what they tell me. But, as usual, there are obviously many different factors driving this. Know of no useful work on this issue.
    best

    • iChas says:

      Research would have to separate out the possible emotion dampening effects of diminishing hormonal neuromodulation from the probably similar effects of increasing ‘noise’ in the ageing brain.

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