You might already know that your attitude about aging has a powerful effect on your health. Example: People with a positive view of aging are less likely to develop heart disease—and more likely to live longer—than people with a gloomier outlook. They also perform better on cognitive tests.

But what if your DNA, the essence of what makes you who you are, makes you particularly susceptible to dementia? What if, because of your DNA, your chance of developing dementia is nearly one in two? Can attitudes be so powerful that they can protect you from your own genetic predisposition? That’s what researchers at Yale University and the National Institute on Aging (NIA) set out to discover.

The Dementia Gene

One of the strongest risk factors for dementia (including Alzheimer’s, one form) is having the APOE e4 gene variant. One quarter of people have this variant, and nearly half (47%) of those people will develop dementia.

No one knows why the other 53% of people with the APOE e4 variant remain unaffected. The Yale-NIA researchers decided to explore whether having positive beliefs about aging, which we tend to absorb from the culture around us from an early age, might help explain why some people with the APOE e4 variant don’t wind up with dementia. They also explored how attitudes affect the rest of us who don’t carry such a risky gene.

They selected 4,765 men and women, average age 72, all free of dementia, who had already participated in the Health and Retirement Study, a biennial survey of nationally representative older Americans, and followed them for four years. The participants provided saliva samples at the outset to determine whether or not they had the APOE e4 variant, and just as expected, about one-quarter (26%) were found to have it.

To learn the participants’ attitudes, they were given validated psychological tests. (Sample test statement, which they were asked to rate on a sliding scale: “The older I get, the more useless I feel.”) After two years, and again at the end of the study, they were given cognitive tests, which included measures of both short-term and delayed recall as well as math skills, to see whether they had developed dementia. In addition, the researchers weighed the possible effects of other factors that have been associated with dementia including age, education, gender, race and incidence of cardiovascular disease or diabetes.

Results: While studies like this can’t show cause and effect, positive attitudes about aging were strongly associated with less risk of developing dementia…

Among participants without the “dementia gene,” 2.6% of those with positive attitudes developed dementia—compared with 4.6% of those with negative attitudes.

  • Among participants with the gene variant, 2.7% of those with positive attitudes about aging developed dementia—but 6.2% of those with negative attitudes developed dementia.

In short, people with a very high genetic dementia risk were able to have an almost-normal level of risk during the study period if they had positive attitudes about aging. A negative attitude was particularly risky for those people already at high genetic risk.

How can a positive outlook be so powerful? The researchers suggest it might affect the same pathway that leads to the increased genetic risk from APOE e4. This is referred to as an epigenetic effect—a nongenetic influence that nevertheless affects genes. In other words, these participants were able to halt the expression of their dementia gene.

Negative Attitudes, Stress and Dementia

What could cause gene expression to change? In a word, stress. Other studies have found that chronic stress may contribute to the development of dementia. And holding negative attitudes about aging—that it makes you feeble, incompetent, over-the-hill, useless—has been found to ratchet up stress. On the other hand, having positive views—such as that aging makes you wiser, kinder, more skillful and empathetic—has been shown to help buffer the harmful effects of stress.

If you’re concerned that your own views on aging could use a makeover, rest assured that you can transform negative into positive beliefs. Here are four tips adapted from the “Reframing Aging” initiative, a consortium of nonprofit organizations dedicated to helping individuals and society change attitudes toward aging:

  • Choose to focus on what’s positive in your life. Whenever you find yourself zeroing in on what’s going wrong—that pain in your knee, your accumulating wrinkles—catch yourself and refocus on what’s going right. Examples: Your grandkids think you’re funny…you own your home free and clear…your garden produced beautiful tomatoes this year.
  • Embrace new images. Instead of dwelling on those scary/depressing ads for AFib drugs or TV shows that mock older people to a laugh track, choose to watch shows like Grace and Frankie and movies like Book Club or The Old Man and the Gun that celebrate the lives and creativity of older people.
  • Post positive words. Make a list of words that say “aging well” to you and write “I am fill-in-the-blank” on sticky notes that you post where you can see them. Suggestions: “wise,” “strong,” “fit,” “resourceful,” “creative.”
  • Remind yourself of people who break the age “mold.” There are plenty of pioneering older people, including Jane Goodall (84) and Carl Reiner (96)…and probably someone you know personally.
  • Speak up and engage with others. Our culture has stereotypical views of aging that need to be changed. You’ll feel more positive and empowered if you encourage others to be more respectful of older people and to include them as peers rather than to talk down to them or ignore them.