Cognitive impairment and happiness are not mutually exclusive.
As Americans age, their happiness and life satisfaction tend to follow a U-shaped pattern, research shows. On average, people in the United States are happiest and most satisfied with their lives when they’re young, experience a decline in both metrics in their 40s (often called a midlife crisis), and then rebound in their 60s.
But what happens after age 65? Do spirits stay high in later life? How is happiness affected by events that happen as people age—like the onset of disabling health conditions or chronic pain, or the deaths of partners and friends?
Findings are mixed and researchers disagree; it depends on how, when, and to whom you ask these questions. “It’s a very heated area of study,” says Anthony Bardo of the University of Kentucky.
Research by Bardo and Scott Lynch of Duke University shows that the cognitive impairment than can accompany aging does not preclude happiness and a high quality of life. But other studies find that satisfaction with life and positive emotions decline with mobility problems and the deaths of spouses and other loved ones.
Despite puzzling society-wide patterns, research offers clues on how individuals might buffer their losses and buoy their spirits as they age, including staying involved in meaningful activities and maintaining a positive outlook. But more research is needed to confirm whether these actions can make and keep us happy or whether happy people are just more likely to do them.
Older adults can be happy and have a high quality of life despite experiencing some cognitive impairment, Bardo and Lynch show.1
They analyzed data for 1998 to 2014 from the nationally representative Health and Retirement Study. The study incorporated tests that examined participants’ ability to recall words and count backwards, among other tasks. It gauged happiness by asking whether respondents were happy all or most of the time or some or none of the time in the past week.
“This is a simple yet valid and reliable measure that is commonly used to assess how one feels about her or his overall quality of life,” Bardo says. If respondents needed a proxy to respond for them, the researchers categorized them as unhappy because the proxy version of the survey did not include questions about happiness.
On average, 65-year-olds can expect five out of 18 total years of remaining life to be lived with some cognitive impairment, the study found. Of those five years with cognitive impairment, the average person will live 4.4 years happy and about seven months (0.8 years) unhappy.
“Our findings show that happiness and cognitive impairment do coexist. Happy years of life were shown to substantially exceed the number of years one can expect to live with some cognitive impairment, on average,” Bardo reports.
The study’s main takeaway is that “even when cognitive impairment does occur, older adults can expect a large proportion of those remaining years to be happy ones,” Bardo says.
“People are frightened by the idea of dementia,” he points out. “Some cognitive decline is a normal process. Ideally, these findings will contribute toward reducing some of the stigma and fear.”
Programs that enable older adults with some cognitive decline to remain in their own homes, where most older people prefer to live, may add to their happiness and quality of life, Bardo suggests.
He also notes that we don’t yet know “how to assess the happiness or quality of life of someone with severe cognitive impairment. It’s an issue of great moral and ethical concern.”
Another study shows that health problems and losing spouses make people less satisfied with life as they age.
Péter Hudomiet, Michael D. Hurd, and Susann Rohwedder are RAND researchers affiliated with the National Bureau of Economic Research (NBER). They analyzed respondents’ reports of life satisfaction from the Health and Retirement Study from 2008 to 2016.2
“When we looked at cross-sectional data that captures a group of people at one point in time, then life satisfaction did indeed increase between ages 65 and 71 and hold steady thereafter, similar to earlier studies,” Rohwedder explains.
“But when we examined a group of individuals tracked over multiple years, we find their life satisfaction tends to fall as they age, and the rate of decline accelerates. Losing a spouse and deteriorating health play important roles in the growing dissatisfaction,” she adds.
Source: Péter Hudomiet, Michael D. Hurd, and Susann Rohwedder, “The Age Profile of Life Satisfaction After Age 65 in the U.S.,” Journal of Economic Behavior & Organization 189 (2021): 431-42.
Note: The cross-sectional line shows average life satisfaction in the full sample. The longitudinal line is restricted to observations with valid reports in two adjacent survey waves; and the 2-year changes are tied together starting from the average level observed at age 65.
People with low life satisfaction die younger and thus make up a shrinking share of the older population, the researchers note—making drawing conclusions from data collected at a single point in time challenging.
“Mortality is substantially higher among those who tell interviewers that they are less satisfied with their lives compared to those who are more satisfied with their lives,” Rohwedder notes. “In addition, older people with physical or cognitive impairments are less likely to fill out a survey.”
The research team suggests their findings offer a more realistic perspective on the well-being and resilience of older people. “Without these findings, policymakers balancing the needs of the older population with those of the younger population may incorrectly conclude that older people are more satisfied with their lives than they really are and are of lesser concern,” Rohwedder explains.
In later life, lower-body impairments may play a greater role than age in determining life satisfaction and emotional and physical well-being, a study led by Vicki Freedman at the University of Michigan finds.3
The research team challenges the notion of the U-shaped well-being curve—highest at youngest and oldest ages—by exploring multiple measures of well-being and considering the interplay of age and lower body limitations.
Their study analyzed 2013 disability and time-use data from the nationally representative Panel Study of Income Dynamics—a different data set than the Bardo and Lynch and NBER studies. These data, based on 1,600 adults ages 60 and older, include participants’ reporting of overall life satisfaction and their experienced well-being, or how they felt while doing certain tasks.
Life satisfaction was measured with the question, asked at one point in time, “Taking all things together, how satisfied are you with your life these days?” For well-being, respondents used daily diaries to record their emotions (happy, calm, frustrated, worried, or sad) and their pain and energy levels while doing randomly selected activities. They also reported lower body limitations—problems with hip, leg, knee, or foot movements.
The researchers found that overall life satisfaction was higher for individuals ages 65 to 74 than those ages 60 to 64, but they observed no age differences in the experienced well-being measures (mood, pain, and fatigue).
“What surprised us is that lower body limitations mattered much more than age in determining all three measures of well-being,” explains Freedman, “and this finding held across age groups.”
People ages 65 to 74 with mobility problems reported the highest pain and fatigue levels. According to Freedman, there may be an initial mismatch for people in this age range between activities and abilities (in other words, people overexert themselves), resulting in more pain and fatigue.
Older adults report they are happiest and most satisfied with their lives while socializing, working, volunteering, and exercising, a research team led by Jacqui Smith of the University of Michigan showed.4 Their 2014 study examined daily diaries of 4,600 participants in the Health and Retirement Study who recorded the amount of time they spent doing specific activities the previous day, the feelings they experienced, and the intensity of those feelings.
The researchers found that participants spent an average of 3.6 hours a day viewing television, an activity that some people experienced positively and others experienced extremely negatively. Television is passive, Smith notes, while activities that involve more social, mental, and physical engagement contribute the most to the positive side of adults’ daily emotional balance sheets, she says.
Finding ways to enable older people with disabilities to be involved in physical activity and volunteering could improve their well-being and satisfaction with their lives, Freedman argues. She points to research showing that older adults who make accommodations that allow them to carry out daily activities without assistance or difficulty—such as using a walker or taking public transportation instead of driving—report emotional well-being at levels close to those who don’t need accommodations.
Having adequate income may help some people adapt to their limitations, buffering the negative impact of impairment on their emotional well-being, another study led by Freedman shows.5
The loss of spouses and other family members presents different, more complicated challenges to happiness and life satisfaction. In Bardo’s view, humans tend to be resilient. He points to a body of research showing that as people reach older ages, they shed things in their lives that make them unhappy and accentuate the positive.
Bardo’s own research finds that as people move into their 70s and beyond, their family becomes a less important component of day-to-day happiness, and other aspects of life, such as health, friends and acquaintances, place of residence, and hobbies play a bigger role.6
This process of shifting focus and accentuating the positive “may largely explain why Americans, on average, become happier with age,” Bardo argues.
However, Rohwedder cautions that future research will need to confirm whether activities associated with greater life satisfaction and other measures of well-being actually cause this effect. “If the least happy die or drop out of the survey at greater rates, as our study documents, then individuals will appear happier at advanced ages, but they did not become happier.”
This article reflects research supported by the National Institute on Aging of the National Institutes of Health at the Centers on the Demography and Economics of Aging and Centers on the Demography and Economics of Alzheimer’s Disease/Alzheimer’s Disease and Related Dementias. Findings from researchers affiliated with the following centers are highlighted: Center for Population Health and Aging, Duke University; NBER Center for Aging and Health Research, National Bureau of Economic Research; and Michigan Center on the Demography of Aging, University of Michigan. Lindsey Piercy of the University of Kentucky contributed to this piece.
1. Anthony R. Bardo and Scott M. Lynch, “Cognitively Intact and Happy Life Expectancy in the United States,” The Journals of Gerontology: Series B, Psychological Sciences and Social Sciences 76, no. 2 (2021): 242-51.
2. Péter Hudomiet, Michael D. Hurd, and Susann Rohwedder, “The Age Profile of Life Satisfaction After Age 65 in the U.S.,” Journal of Economic Behavior & Organization 189 (2021): 431-42.
3. Vicki A. Freedman et al., “Aging, Mobility Impairments and Subjective Wellbeing,” Disability and Health Journal 10, no. 4 (2017): 525-31.
4. Jacqui Smith et al., “Snapshots of Mixtures of Affective Experiences in a Day: Findings From the Health and Retirement Study,” Population Ageing 7, no. 1 (2014): 55-79.
5. Vicki A. Freedman et al., “Late Life Disability and Experienced Wellbeing: Are Economic Resources a Buffer?” Disability and Health Journal 12, no. 3 (2019): 481-8.
6. Anthony R. Bardo, “A Life Course Model for a Domains-of-Life Approach to Happiness: Evidence from the United States,” Advances in Life Course Research 33 (2017): 11-22.