Age-based job demotions, forced retirements and other overt examples of age discrimination can be harmful to older adults.
But what about more subtle forms of ageism -- like jokes about "senior moments," or assuming an older person can't use technology, or the constant barrage of anti-wrinkle ads in the media?
A new poll finds that most older adults encounter at least one form of this "everyday ageism" in their day-to-day lives and that more frequent encounters may affect their health and well-being.
"We can't necessarily confirm that everyday ageism is causing health problems, but the fact that we found strong and consistent relationships suggests that there is something there," said Julie Ober Allen, who helped conduct the poll and analyze the results. She's a postdoctoral research fellow at the University of Michigan Institute for Social Research, in Ann Arbor.
For the survey, pollsters asked more than 2,000 U.S. adults, aged 50 to 80, about their exposure to ageist messages, ageism in their interpersonal interactions and personally held beliefs about aging and older people.
More than eight out of 10 said they experienced one or more forms of everyday ageism. Among them: comments about their ability to hear, see or understand, and assumptions that they need help with tasks they can do on their own.
Sixty-five percent of respondents reported exposure to ageist messages in materials they watch or read that portray aging as unattractive, undesirable or worthy of ridicule.
Almost half said they encountered ageism in their daily interactions -- for example, other people's assumptions that they can't use technology or have a poor memory.
And one-third responded to the questions in ways that suggested they personally have negative beliefs about aging, according to the poll's sponsors.
"They think that being lonely is an inherent part of aging, and that depression and worry are unavoidable and just a natural part of aging when research actually shows that they're not," Allen said.
But ageism may take a toll, the poll suggests. Older adults who said they experienced three or more forms of everyday ageism had poorer physical and mental health than others: 34% rated their overall physical health excellent or very good versus 49% who reported fewer brushes with ageism. And 71% had a chronic condition (such as diabetes or heart disease) versus 60% of those who experienced fewer forms of ageism, the poll found.
"So those who are experiencing a lot more everyday ageism and age-based discrimination, their health may actually be declining faster than those who experienced less," Allen said.
But the results do not prove that everyday ageism causes health problems, only that there's a link. And Allen said that link may exist because many health conditions can be induced or aggravated by stress.
"We believe that it's the cumulative impact of these 'microaggressions' because they happen over and over again, and start to serve as a source of stress in individuals' lives," she said. "In addition to mental health problems, conditions like diabetes and cardiovascular disease tend to be really closely linked to chronic stress."
But the poll offered good news, too: The results suggest most older adults have a positive attitude about growing old.
Nearly nine out of 10 said they were more comfortable being themselves, and 80% said they have a strong sense of purpose.
A full two-thirds said life after age 50 is better than they expected.
And a positive attitude about aging seems to protect against health issues, previous studies have shown.
Dr. Becca Levy is a psychologist and epidemiologist at Yale University in New Haven, Conn., who reviewed the findings.
Levy said other research has found similar evidence that negative beliefs about aging can provoke stress and be harmful to health, while positive beliefs can benefit both.
"Older individuals who've taken in more positive age beliefs tend to have a longer life span than those who've taken in more negative age beliefs," Levy said.
Allen suggested that raising awareness about the health risks of everyday ageism and the health benefits of thinking positively about aging can help shift the cultural narratives about growing old.
But according to Dr. Paul Mulhausen, chief medical director at Iowa Total Care in West Des Moines, promoting a positive outlook doesn't mean eliminating the realities of aging from the conversation.
"So much energy is spent on remaining youthful, and I think it's a distraction," said Mulhausen, who was not involved in the poll. "I think the mistake we make is we frame staying healthy as we get older as remaining young."
The poll was conducted in December, before the coronavirus pandemic introduced new health risks for older adults.
Allen said that policymakers need to put ageism on their radar, and recognize how it may be affecting their response to the COVID-19 pandemic.
The poll was a joint effort of the University of Michigan's Institute for Healthcare Policy and Innovation, AARP and Michigan Medicine. It has a margin of error of plus or minus 1 to 2 percentage points.
There's more about ageism at the World Health Organization.