Paradoxical age‐related improvement in mental health in U.S. military veterans: Results from the national health and resilience in veterans study

Abstract

Objective: To determine whether a seemingly "paradoxical" trend whereby mental health improves as a function of age despite declining physical and cognitive health occurs in U.S. military veterans, who are older, and have higher rates of trauma exposure and psychiatric morbidities relative to non-veterans.Methods: Using data from a nationally representative, cross-sectional sample of 4069 U.S. veterans, polynomial regression analyses were conducted to examine changes in self-reported physical, cognitive, and mental health of veterans representing the full age spectrum.Results: Physical health scores were consistently average and stable until around age 80 when they declined. In contrast, cognitive and mental health scores were markedly lower in young veterans and then increased linearly and positively well into late-life. Conclusions:While greater age is associated with relative stability and late-life decline in physical health in U.S. veterans, mental and cognitive health steadily improve until much later in life. Results may help inform age-specific prevention and treatment efforts to promote healthy aging in this population. K E Y W O R D Scognitive health, mental health, paradoxical aging, physical health Key points� Previous research suggests that a "paradoxical" trend in which mental health improves as a function of increasing age despite age-related declines in physical and cognitive health.� In the present study, physical health scores were consistently average and stable until around age 80 when they declined while cognitive and mental health scores were markedly lower in young veterans and then increased linearly and positively well into late-life. | OBJECTIVEGiven the association between older age and physical health difficulties, 1 it may be assumed that increasing age is associated with poorer health outcomes overall, including mental health. However, research has suggested a "paradoxical" trend in which mental health improves as a function of increasing age despite age-related declines in physical and cognitive health. Multiple studies have identified heightened levels of "well-being" and positive mental health characteristics within later adulthood 2,3 ), which has been attributed in part to factors associated with wisdom 4,5 and perceptions regarding aging. 6 In a large study of 1546 predominantly older adults (M age = 66 years), Thomas and colleagues 7 found that although older age was associated with worsening physical and cognitive health,