I turned 50 last month.

As expected, I received many of the handshakes, high-fives, and other celebratory gestures befitting such a milestone. I also received a few of those special birthday cards. You know — those "humorous" cards that poke fun at presumed maladies that come with aging and which tend to focus on difficulties in the sexual and cognitive realms. These types of cards are plentiful at local card shops and drug stores, even my own hospital's gift shop. A presumed decline in one's physical and mental capabilities is built into these funny messages, which are designed to make us laugh at our situation. One of the cards I received inquired of me, "Boxers or briefs?" The answer inside the card: "Depends."


The tradition of sending such cards on "milestone birthdays" is pretty well established in our culture. Even though I am a geriatrician (a doctor who specializes in the care of older adults), these cards have shown up in my mail slot. Maybe that makes it even more humorous? I am not sure.

Honestly, I feel pretty good. As I look around at my friends and colleagues of similar age, I see a whole lot of strong and active people with sharp minds who are engaging the world. The decades that lie ahead for me don't look so bad, and so I wonder: Why do so many choose to embrace the humor of ageism and perpetuate the stereotypes of inadequacy and bodily failures as we cross aging milestones?

I am well aware of the counter argument to this. Relax, they say, it is all in fun. We need to laugh at ourselves and not take these jokes seriously. They are just intended to make us chuckle as we move into the next phase of life.

I am not buying it. I like to laugh as much as anyone, but this type of humor can be corrosive.

Humor associated with ageism — the unfavorable and inaccurate portrayal of people as they age — has remained fair game within our society. Unlike racism, sexism and most other "isms," there seems to be a tolerance for ageist remarks and jokes. This is probably because the experience of aging is universal. All of us will age (if we are lucky), so we might feel that this gives us license to have fun and take liberty with aging stereotypes.

However, widespread harm is caused by perpetuating beliefs that can instill fear and anxiety in many people — feelings that are largely unfounded and unnecessary. People can sometimes even begin to feel dependent or inadequate based on such stereotypes, seeing themselves in terms of the "looking-glass self." In fact, research has shown that belief in the negative stereotypes of aging among older people is associated with diminished quality of life, increased health problems and shorter longevity.

The impact of ageism can extend even further. Perpetuating these images can contribute to age discrimination. If society subconsciously accepts these mostly inaccurate stereotypes, they could have an effect on job retention and hiring, as well as other decisions. In one study, almost three-fourths of older Americans reported experiences of personal and institutional discrimination due to age.

Do I really think that all this could be attributed to a few off-color, meant-to-be-funny birthday cards? Not by themselves. The card is but a symptom. However, this act of sending a funny "jab" does add a brick in the wall of ageism — and its many harmful effects.

Whether we are turning 40, 50, 60 or any age, it is important to embrace where we are in life and to move forward with vigor and enthusiasm. Our lives are not all heading toward inevitable forgetfulness, bladder control problems and hair loss. We can support that mindset by celebrating the continuous growth of all people as they move through the decades of life. There are many ways to do that, but the next time a relative or friend celebrates a round-number birthday, consider your choice of birthday card. Take a pass on the opportunity to promote aging stereotypes and go with a celebratory message for these significant milestones.

Dr. Matthew McNabney is an associate professor of medicine in the Division of Geriatric Medicine and Gerontology at the Johns Hopkins University School of Medicine. His email is mmcnabne@jhmi.edu.