When patients complained about their aging and the prospects of  aging, my cavalier remark was “it beats the alternative”. This phrase  I’ve recently learned hearkens back to a remark credited to Maurice  Chevalier, who in his later life became the symbol of glorious and  glamourous aging: “Old age isn’t so bad when you consider the  alternative”. In both of these remarks, there is an unstated belief that  the changes of old age – declining mental abilities and speed of  motion, stiffened joints and fading eyesight and hearing are to be  feared.  Aging is a long slow decline that is not much fun and certainly  not anything to look forward to. I am certain I believed this when I  first began my work with patients and families with dementia and  eventually had the opportunity to study aging and especially dementia.  In fact, I actually resisted focusing on aging and dementia in the early  years of my career. I didn’t want to be identified as someone with  focused interest on aging and dementia.  Studying geriatrics and aging  seemed a dismal place to devote my intellectual efforts. In those days,  the field certainly was not popular and the specialty of geriatrics  remains one of the least popular in all medicine.

I was probably caught up in the spirit of the 60s and 70s, which  focused on youth and the glories of our youth. The heady times were  characterized by a celebration of the youth culture and what came to be  known as the Boomer generation’s willingness to challenge conventional  ideas and especially conventional behavior. Our attitude at the time  might be summed up by lyrics penned by Pete Townshend of The Who, a  leading rock group of the time: “Things they do look awful cold/Hope I  die before I get old”.

In my research and practice, (and as I grow older) I began to notice  that “things ain’t what they used to be”, another phrase that we used to  characterize the late 60’s and early 70’s. In fact, there are a lot of  very happy people who are quite old, including persons with significant  old age decline and problems.  The happiness I saw in the face of aging  and the changes of old age surprised me. In addition to the celebration  of youth culture of the times, I probably had inherited the dominant  view, which for centuries has been that the life course is characterized  by a general improvement in well-being and contentedness through middle  age followed by a sharp decline towards death and the grave. Most of us  inherited that view. It certainly fits with our celebration of youth  and what seems a natural and universal desire to preserve youthful  characteristics. However, the view that youth and youthful  characteristics equals happiness and with age comes only changes  associated with unhappiness is now known to be a myth.

I believe that the myth surrounding happiness and aging is harmful to  all those approaching aging.  The coming epoch for baby boomers, as  they enter old age can and should revolutionize our beliefs about aging  and happiness. We should not go on with the mistaken belief that aging  is all about unhappiness – – because it isn’t. The activism that has  characterized the boomer generation, who challenged conventional wisdom  and behavior during and after the late 60’s, can challenge this notion.  Why accept that aging is all about being unhappy or less happy?  Especially since we now know that belief is a myth?

Here’s a brief synopsis of what we have learned in the past couple of  decades about happiness and aging. The evolution of my thinking about  happiness and aging occurred over many years and continues to mature.  One paper provided an epiphany moment in what has been a transformative  journey in my own view on aging and well-being.  It involved a study published in 2006  where investigators asked a group of 30 year olds and a group of older  subjects (mean age 68), which group they thought was likely to be  happier, persons aged 30 or those aged 70. They also asked them to rate  their own well-being using scientifically valid measurement scales. As  expected, both groups thought the 30 year olds would be happiest. But  the well-being and happiness levels reported indicated that older  persons were the happier bunch.

Happiness and well-being research has emerged as a new branch of  economics that seeks a more satisfactory measure than money of human  well-being. Derek Bok, former president of Harvard University, wrote a  thought provoking book called “The Politics of Happiness”  where he establishes that there are valid scientific ways to measure  happiness. Furthermore, well-being as measured by happiness is not well  correlated with traditional economic measures of utility, money or, for  countries, Gross National Product. Clearly, one is happier if one has  enough monetary resources to meet basic needs.  But otherwise happiness  is influenced by many factors beyond just availability of money.  Economists are now trying to sort out determinants of happiness. Bhutan  uses the concept of “Gross National Happiness”  to guide its planning process, not its gross national product.  David  Cameron, the current prime minister of the UK, has announced that the British government would start collecting figures on well-being.

There are already a lot of data on happiness in various national  surveys. What is enlightening about this research, is that age emerges  as one of the four main factors that determine happiness. The  relationship with age is described as “U-shaped”, meaning it starts out  fairly high, dips down and then rises again. Overall, in contemporary  surveys people are relatively happy as measured by self-reported levels  of well-being. From a study in the US  , well-being is highest at age 18-21 and then drops steadily until  about age 50-53. From that age onward, the level of well-being increases  gradually, exceeding the high levels of the youngest adults in the  survey by about age 70 and increasing into the highest levels until age  82-85 – which was the last age group in the survey. We don’t know if it  might be higher at later ages.

So my original view, like Pete Townshend’s when he was a youthful  1970 rocker, that old age is unhappiness and misery is simply mistaken.  The survey of 70 year olds that was an epiphany moment for me suggests  that we were and are not the only ones who are mistaken. This view of  old age as misery is also a pernicious one – one that needs to be  changed. The large bulge in our population that the Baby Boomers  represent can change that view as aging boomers move into old age.

It is important to understand why people might be happier in old age.  What we can learn from that is also valuable for all those approaching  old age. Perhaps the most significant factor that comes from our  anecdotal experience with research subjects and is confirmed by research  is the notion that there is a natural tendency towards greater  acceptance of oneself and one’s life circumstances as we age. As we age,  we naturally learn to accept who we are, rather than focusing on the  need to figure out who want to become or what else we need to  accomplish. For many people early adulthood and midlife consists of  seeking a vast multitude of activities and possibilities – in our work,  family and recreational life. Persons likely become more content when  they have figured out what is most important for them and those in their  life. Instead of a broad array of possibilities and activities, their  lives become more focused. They focus on both what provides them with  the most meaning – which is not just their own well-being but often and  importantly includes the well-being of others.

People who “age well” not only focus on a more limited set of  possibilities, they also have learned to generally set more realistic  expectations. Disappointments of younger life, which can be a great  source of stress and unhappiness, are less likely. People learn from  experience what to expect and what is more likely. In old age, people do  experience important and sometimes sudden loss of persons that are dear  to them. But they also typically eventually recover and as they get  older these losses, while not welcome are something less shocking.

Altered and more realistic expectations may be a key feature of what  has been called the “wisdom” of aging. This does not mean people do not  have expectations and goals – they in fact do. The goals are ones that  are important and add meaning to their lives, they are typically fewer  in number and more likely to be achievable, often on a day to day basis,  especially as people go into late old age.

One striking feature that characterized many of our subjects in our  large ongoing study of aging called the Adult Changes in Thought (ACT)  Study, who ranked themselves “happiest” is that they remained active in  their communities. This corresponds to happiness research findings that  people who are employed are happier than people who are not. Among the  most happy in surveys were those involved in part time voluntary or paid  work, something that seniors are particularly well suited for. For  example, several of our subjects are involved in a group called “Raging  Grannies” who protest for social justice. Another retired botanist who  is well over 90 years old works to inform the public about the danger of  a proposed coal terminal – she wrote, printed, and distributed 2000  fliers and distributed them to ferry riders and leads nature walks on  one of the beautiful islands in the San Juan islands. One of our 100  year old subjects worked as a beautician (hairdresser) for 49 years.  When she retired she then volunteered to cut hair in nursing homes until  her vision failed at 90. These are examples of people who stayed active  and were uniformly seen as happy. And of course, happy people are  healthier and are better able to handle stress and have better outcomes  when they are beset by illness.

Our experience is that people who age well and experience happiness  in late life have not just an optimistic attitude but also have figured  out ways that work for them to handle challenges and the setbacks.  Most  persons in our study have experienced challenges in earlier times that  probably help them approach aging challenges and setbacks in ways that  “work”. Many of the challenges are extreme – well beyond the pale of  what I and our staff of interviewers have faced. When I asked one of our  interviewers if she remembered people who were particularly resilient  and happy in the face of adversity, she recalled an older Norwegian  woman in her 90s who was part of a depression study.  When asked about  stressful times in her life she recalled when the Nazis marched through  her home town in 1940 and how she witnessed the murder of her adult  daughter in Washington State. When asked about depression she replied:  “Oh no, Honey, I just scrub the floor little harder”. We have several  subjects who had their lives uprooted when they were moved to settlement  camps at the time when Japanese Americans were forced out of their  homes, often abandoning and then losing their property. It seems that  the key to approaching old age with wisdom is a strong engagement with  one’s community and immediate family. They invariably have hobbies and a  keen interest in the world around them. They are not stuck in feeling  sorry for themselves. They tend to acknowledge the changes of aging and  adapt.

People find ways that allow them to cope with stress and what might  be sources of unhappiness and despair. In these and many other  instances, the challenges of old age seemed to pale by contrast to being  occupied during the second World War, the tragic loss of an adult  daughter or the disruption of a family home.  And, people benefit by  finding ways to keep themselves busy and occupied.   More often than not  they seem to follow the Buddha’s advice: “Peace comes from within.  Do  not seek it from without”.  One study found that acceptance of what  can’t be changed was a significant predictor of satisfaction in later  life. This echoes the words of the famous Serenity prayer, authored by  Reinhold Niebuhr and popularized by many groups but especially  Alcoholics Anonymous:  “God grant me the serenity to accept the things I  cannot change, the courage to change the things I can, and the wisdom  to know the difference”.

From the research in this new field of economics, two personality  traits stand out in analyses of traits associated with happiness:  Neuroticism and Extroversion. Persons who are prone to guilt, anger and  anxiety tend to be more unhappy whereas those who are more extroverted  tend to be happier. While these two contrasting personality types seem  self obviously to lead to more or less happiness, we see something in  the people who stay happy throughout their late life that characterizes  their activities:  that is an interest and commitment to help others –  to think about not just their own happiness but to be caring for others.  I recall that my aging father, even as he was beginning to fail, never  failed to visit the severely impaired persons residing in the nursing  home in the senior living compound where my parents lived. During these  daily visits, he would usher himself in with a happy “Hello Sunshine”  and “how are you today” to every resident, even those who may not have  spoken a word for long periods of time. He cared for others. A sprightly  85 year old continues to volunteer at her Roman Catholic Church and its  school, a 94 year old who had a stroke 3 years earlier continues to  operate a tree farm and wins awards for the contributions his voluntary  works provide the community. A woman who, as a retired social worker  once said she would kill herself if she lost her vision, developed  macular degeneration – a degenerative condition that leads to blindness.  What did she do? She started a support group for people with limited  vision at Group Health. These are people who are not only looking inward  but look outward and gain life satisfaction from helping others right  into very old age.

When I was in college, like a normal college student I looked for  posters and art to decorate my room.  Sometime during those years, I  encountered a poem called the Desiderata. It made a deep impression on  me, which is why I placed it on the wall of my room. Now some almost  five decades later, it is this poem, along with the Serenity Prayer and  the thoughts of the Buddha that comes to mind as I think about what I  and others have learned about why people might be happier as they age.  I’m quite certain I could not have appreciated all the meaning of these  beautiful words when I was younger. Today great masses of people, like  me, who once may have thought of old age as a time of pain and  unhappiness are now advancing into old age.

The Desiderata  poem, written by a minister in the 1920’s, Max Ehrmann, contains great  wisdom, a wisdom that is likely more apparent to persons entering into  old age than it was for a young college student discovering late 60’s  Flower Power rock and roll. Many people, some very well known, have  found it inspirational for themselves and for others. The poem was  discovered at American presidential candidate, Adlai Stevenson’s bedside  when he died in 1965. He planned to use it in his Christmas cards but  died before he was able to send cards that year. That story spread and  the Desiderata became more widely known around that time. I suspect  that’s why I became aware of it. Desiderata means “desired things” in  Latin:

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“Go placidly amid the noise and haste, and remember what  peace there may be in silence.  As far as possible without surrender be  on good terms with all persons.

Speak your truth quietly and clearly, and listen to others, even the dull and the ignorant; they to have their story.

Avoid loud and aggressive persons, they are vexations to the spirit.   If you compare yourself with others, you may become vain and bitter;  for always there will be greater and lesser persons than yourself.

Enjoy your achievements as well as your plans.  Keep interested in  your own career, however humble; it is a real possession in the changing  fortunes of time.

Exercise caution in your business affairs; for the world is full of  trickery.  But let this not blind you to what virtue there is; many  persons strive for high ideals and everywhere life is full of heroism.

Be yourself. Especially, do not feign affection. Neither be cynical  about love; for in the face of all aridity and disenchantment it is as  perennial as the grass.

Take kindly the counsel of the years, gracefully surrendering the things of youth.

Nurture strength of spirit to shield you in sudden misfortune. But do  not distress yourself with dark imaginings. Many fears are born of  fatigue and loneliness.

Beyond a wholesome discipline, be gentle with yourself.  You are a  child of the universe, no less than the trees and the stars; you have a  right to be here.  And whether or not it is clear to you, no doubt the  universe is unfolding as it should.

Therefore be at peace with God, whatever you conceive Him to be, and  whatever your labors and aspirations, in the noisy confusion of life  keep peace with your soul.  With all its sham, drudgery, and broken  dreams, it is still a beautiful world.  Be cheerful. Strive to be  happy.”

It’s time to rethink the relationship of aging and happiness. We do  not need to buy into the myth of aging being a time of unhappiness.  Knowing more about aging through experience and research provides the  source for a new and much more optimistic and valid view of aging. The  words of our wise forebears from the Buddha, to the Desiderata and the  Serenity prayer give us a foundation to go with the new knowledge of  aging and happiness.