Conventional notions have described aging as an ongoing process of physical and cognitive decline, with mental health mirroring the downward trend. However, a new study by researchers at the University of California-San Diego School of Medicine suggests that people become happier about their lives decade after decade.

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As people age, their mental health improves consistently, and they feel better about themselves.

Findings of the research - published in the Journal of Clinical Psychiatry - show that the mental health of aging adults consistently improves over time.

"Their improved sense of psychological well-being was linear and substantial," says senior author Dilip Jeste, M.D., distinguished professor of Psychiatry and Neurosciences and director of the Center on Healthy Aging at UC-San Diego.

"Participants reported that they felt better about themselves and their lives year upon year, decade after decade," he adds.

Jeste and colleagues noted that individuals in their 20s and 30s exhibited increased levels of perceived stress and symptoms of anxiety and depression. "This 'fountain of youth' period is associated with far worse levels of psychological well-being than any other period of adulthood," says Jeste.

The recognized model of aging follows a deterioration of both the body and thinking over time. However, the study states that little has been discussed about mental health in the context of aging, other than the assumption that mental health worsens in the same way as physical and cognitive function.

Psychological well-being, mental health improves with age

Jeste is the Estelle and Edgar Levi Chair in Aging and director of the Sam and Rose Stein Institute for Research on Aging, both at UC-San Diego.

He has led research on understanding how Americans age and how to help them age well and healthfully. He says that other studies have produced mixed findings regarding the aging versus mental health phenomenon.

"Some investigators have reported a U-shaped curve of well-being across the lifespan, with declines from early adulthood to middle age followed by an improvement in later adulthood. The nadir of mental health in this model occurs during middle age, roughly 45 to 55. However, we did not find such a mid-life dip in well-being."

Dr. Dilip Jeste, UC-San Diego

While the differences in results of various studies are not clear, the inconsistencies could be due to measurement variation across studies and researchers highlighting different indicators that lead to different conclusions. One factor all the studies do have in common is improved well-being in the second half of life.

The research focused on not only psychological well-being, but also the broader area of mental health, which also includes satisfaction with life and low levels of perceived stress, anxiety, and depression.

Excluding dementias, most previous studies suggest that mental illness is less likely in older adults. "Some cognitive decline over time is inevitable, but its effect is clearly not uniform and in many people, not clinically significant - at least in terms of impacting their sense of well-being and enjoyment of life."

Jeste and team collected data using random digit dialing of 1,546 adults living in San Diego County aged between 21-100 years. The researchers analyzed the participants' physical health, cognitive function, and other measures of mental health.

Participants were formed of an almost even split between men and women, arranged by age data, with an oversampling of adults over 75 years old.

Older people retain fewer negative emotions, memories

The study revealed that when compared with the youngest group of adults, the oldest group had significantly better mental health scores than the youngest group and poorer physical and cognitive function.

Previous research has indicated that older adults are more capable of coping with stressful life changes, which may explain improved positive mental health as people age. Jeste says people learn "not to sweat out the little things. And a lot of previously big things become little."

Increased wisdom with age might be another explanation. Older individuals have been shown to be more skilled at regulating emotion and complex social decision-making, and retaining fewer negative emotions and memories - all common elements of wisdom - say the researchers.

Michael L. Thomas, Ph.D., first author of the paper and assistant research scientist in psychiatry at UC-San Diego School of Medicine, cautioned: "Like many other investigations of this type, it was a cross-sectional study, and thus a snapshot of data. Also, there may have been a survivor bias - i.e., less healthy adults do not survive into old age."

Thomas also notes that older participants in the study were physically more disabled than the younger participants; therefore, the sample was not composed of all healthy adults.

Jeste points out that the rates of psychological distress and mental illness in younger people is on the rise.

"Inadequate attention has been paid to mental health issues that continue or get exacerbated post-adolescence. We need to understand mechanisms underlying better mental health in older age in spite of more physical ailments."

Dr. Dilip Jeste, UC-San Diego

That would help develop broad-based interventions to promote mental health in all age groups, including youth," Jeste concludes.

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