Emotion regulation in later life

Many people expect old age to be a time of gloom. Research tells a more hopeful story. On average, emotional well-being gets better from early adulthood into the 60s and beyond, and emotions tend to become steadier with age.^1,2

That is not true for everyone, all the time. Depression, pain, loss and brain changes such as dementia can make emotions much harder to manage. Family caregivers also face heavy emotional strain. This page explains how emotional life changes with age, when those changes are a warning sign, and how caregivers can protect their own emotional health.

Emotional aging: often better than expected

Researchers have long noticed a puzzle. The body and some thinking skills decline with age, yet many older people say they are quite satisfied with life.¹

Studies help explain this. Emotional well-being tends to rise through people's 30s, 40s, 50s and into their 60s. Older age is linked with less negative emotion and less anger, and with lower rates of anxiety and depression.¹ Negative feelings tend to become less frequent until very old age, though even then they usually stay below the levels younger adults report.¹

One study asked adults of all ages to report their feelings five times a day for a week. The researchers repeated this five and ten years later. With age, people had more positive emotional well-being and more stable moods. They also more often felt good and bad feelings mixed together. People who felt more positive than negative emotions in daily life were more likely to be alive 13 years later.²

The positivity effect

Older adults tend to notice and remember positive information more than negative information. Younger adults tend to show the opposite pattern. A review of 100 studies with more than 7,000 people found this "positivity effect" was reliable. It was strongest when people were free to pay attention in their own natural way.³

Why emotions often get steadier

A shorter time horizon. According to a theory called socioemotional selectivity, people's goals shift as they sense that time is limited. Younger people, who see a long future ahead, focus on gathering information and new experiences. As people age, they focus more on emotional meaning and on the relationships that matter most. They let go of less important ties and invest in close ones.¹

Experience. Over a lifetime, people learn what upsets them and how to steer around it. Older adults are often skilled at avoiding or limiting upsetting situations, such as stepping away from an argument before it gets heated.⁴

When things change

The same research shows limits. When older adults can avoid or reduce distress, they often handle it better than younger adults. But when stress is intense, long-lasting and cannot be avoided, the age advantage fades. The body may also take longer to return to calm.⁴ Examples might include caring for a spouse with dementia, living with chronic pain, or facing a serious illness.

Depression

Depression is common in later life, but it is not a normal part of aging.^5,6 For some older adults, sadness is not the main sign.⁶ Tiredness, poor appetite and trouble sleeping are common, and they are easy to blame on age or illness.⁵ Risks include:⁵

• Losing a spouse or close friends
• Chronic illness or pain
• Moving, such as to a retirement community
• Losing independence, such as giving up driving
• Illnesses such as heart disease, stroke, Parkinson's disease, thyroid problems and dementia
• Alcohol and some medicines, such as sleep aids

Depression often responds well to treatment.⁵ See Depression in later life, Chronic pain and mood, Medicines and mood and Losing a spouse.

Changes in emotional control with dementia

Some brain conditions change the parts of the brain that manage emotions. When that happens, a person may react in ways that do not seem like them. These changes come from the illness.

Alzheimer's disease. A person may get upset, worried or angry more easily, seem anxious or fearful, or become suspicious of others. Pain, poor sleep, hunger, constipation, trouble seeing or hearing, new medicines and noisy places can all set off these reactions.⁷ See Agitation and aggression and Sundowning.

Frontotemporal dementia (FTD). In the most common form of FTD, people may act on impulse or say and do things that are not appropriate. They may seem to lack empathy, and their emotions may look flat or out of proportion. They may lose interest in family and activities. FTD is sometimes mistaken for depression. It tends to start earlier than other dementias: about 6 in 10 people with FTD are 45 to 64 years old.⁸ See Frontotemporal dementia, Disinhibition and Apathy and depression in dementia.

Sudden crying or laughing. Pseudobulbar affect (PBA) causes sudden episodes of crying, laughing or anger that are hard to control. It can happen after a stroke, with dementia, after a brain injury or with Parkinson's disease. Episodes usually last seconds to minutes, and the outburst may not match how the person feels inside. That makes PBA different from depression, though a person can have both.⁹ If you notice this, tell the doctor.

Sudden change is urgent. A quick change in behavior, especially after an infection or a new medicine, should be checked by a doctor right away.⁷ It can have a medical cause, such as delirium (sudden confusion).

Caregivers: managing your own emotions

Caring for someone with dementia or another serious illness is one of the hardest emotional jobs there is. Frustration, guilt, sadness and anger are common and human. They do not make you a bad caregiver.

Signs of caregiver stress

The National Institute on Aging lists signs such as:¹⁰

• Feeling exhausted, overwhelmed or anxious
• Being quick to anger or impatient
• Feeling lonely or cut off
• Trouble sleeping
• Sadness, hopelessness or losing interest in things you used to enjoy
• Frequent headaches or other aches
• Drinking more, or misusing drugs or medicines

The NIA's advice is not to wait until you are completely overwhelmed.¹⁰

In the moment

When your loved one is upset, the NIA suggests staying patient, trying not to show frustration, and not arguing. Reassure them that you are there to help, and try redirecting their attention to music, a book or a walk.⁷

Staying calm is easier with a plan for yourself:

1. Notice your early signs, such as a tight jaw, a raised voice or a racing heart.
2. Pause. If your loved one is safe, step into another room for a minute.
3. Breathe slowly, with a longer out-breath. Try the cyclic sigh.
4. Rethink the moment. "This is the disease talking, not my mother."
5. Go back with one simple step, such as offering a drink or putting on familiar music.
6. Later, look for the trigger. Was it pain, noise, hunger or tiredness? A behavior diary can help you spot patterns.

Look after yourself

The NIA suggests these steps:¹⁰

• Stay active, and aim for 7 to 9 hours of sleep.
• Try stress-reducing practices like meditation, tai chi or yoga.
• Set aside relaxing time each week that has nothing to do with caregiving.
• Keep up with your own health care.
• Join a support group, and take breaks with help from family, an aide or adult day care.
• Be kind to yourself. Let yourself feel sadness, frustration and guilt, perhaps by journaling or talking with a friend.

Support programs help. In a large U.S. trial called REACH II, 642 family caregivers of people with Alzheimer's disease or related dementias got 12 in-home and phone sessions over 6 months. The sessions covered caregiver depression, burden, self-care, social support and the loved one's difficult behaviors. Most groups of caregivers in the program reported a better quality of life. Only about 13 in 100 had clinical depression afterward, compared with about 23 in 100 in the comparison group.¹¹

See Caregiver stress in dementia, Caregiver burnout, Caregiver training programs, Respite care, Adult day care and Caring for a spouse. Our Care Circle can help you share tasks.

Everyday steps for emotional health in later life

• Stay connected. Plan regular contact with people you care about. See Ways to feel more connected.
• Do things that matter to you. See Purpose and meaning.
• Treat hearing loss. Losing hearing or sight can strain conversations.¹ See Hearing loss and loneliness.
• Review your medicines with your doctor or pharmacist once a year.
• Practice a skill or two from Emotion regulation skills. It is never too late to learn.

Common questions

Is it normal to become more emotional with age?

Many people feel their emotions more richly with age, including mixed feelings like joy and sadness together.² But a big change, such as frequent outbursts or crying spells that seem out of character, should be checked by a doctor.

My father has become short-tempered. Could it be dementia?

It could be one of many things, including pain, poor sleep, hearing loss, depression, a medicine side effect or an early brain change.^5,7 Start with a visit to his doctor. See Normal aging or not?

Can older adults learn new emotion skills?

Yes. Skills like slow breathing, rethinking a situation and planning pleasant activities can be learned at any age. Many older adults already use strategies like steering around situations they know will upset them.⁴

When to get help

See a doctor if you or an older loved one has:

• Low mood, worry or irritability that lasts two weeks or more
• New outbursts, crying spells or behavior that does not seem like them
• Emotional changes along with memory problems or confusion
• Any sudden change in behavior, especially after an illness or a new medicine⁷

Caregivers should also get help if stress is affecting their sleep, health or patience. See Getting started with dementia care and Geriatric psychiatry.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.