Auditing and Benchmarking the Core of Healthy Communities
New research out of Yale is a direct challenge to how the wellness industry measures success – and it lands right at the center of the question Irving Stackpole will be tackling at ICAA 2026: are your audits and benchmarks actually capturing what’s happening in your community, or just confirming what everyone already assumes?
The assumption baked into most assessments
Ask most people, including healthcare providers, what happens to cognitive and physical function with age, and the answer is almost universally “decline.” It’s baked so deeply into the field that even the World Health Organization’s standard assessment tool for older adults doesn’t have a way to record improvement. It only measures whether someone is declining or not. There’s no box to check for “got better.”
A study “Aging Redefined: Cognitive and Physical Improvement with Positive Age Beliefs” just published in Geriatrics by researchers at Yale set out to test that assumption directly. Using 12 years of data from a large, nationally representative U.S. study of adults 65 and older, Becca Levy and Martin Slade tracked cognitive performance and walking speed – two well-established, objective markers of aging health – from a baseline measurement to a final one.
What they found
Nearly half of participants – 45% – showed measurable improvement in cognitive function, physical function, or both, over the course of the study. Almost a third improved cognitively. Twenty-eight percent walked faster than they had years earlier. Extrapolated across the U.S. population, that’s more than 26 million older adults getting better, not worse, at things researchers assumed only ever went one direction.
Here’s the part that matters for anyone running a program, a community, or an audit: when the researchers averaged everyone’s scores together – the standard approach in most studies – the group as a whole looked like it was declining, right on schedule. It was only when they stopped averaging and started looking for who was improving that the real picture showed up. The decline was there. So was a meaningful, measurable group of people moving in the opposite direction. Averaging erased them.
The study also found something practical about what predicts who improves: people who held more positive beliefs about aging – measured well before any outcome was known – were significantly more likely to be among those who got better, both cognitively and physically. That relationship held up even after controlling for health conditions, depression, sleep, and other factors, and it held up across multiple sensitivity checks the researchers ran to stress-test the finding.
Why this belongs in a session on auditing and benchmarking
If your benchmarking tools are built the way most cognitive and physical assessments have historically been built – designed only to flag decline – they’re structurally incapable of showing you your wins. A resident who’s walking faster, thinking more clearly, or recovering function they’d lost doesn’t show up as a success story. They show up as noise in an average, or they don’t show up at all.
That’s exactly the gap Irving will be addressing in his ICAA 2026 session, The Core of Healthy Communities: Auditing and Benchmarking. The question isn’t just “are we measuring the right things” – it’s “are our measurement tools even capable of detecting the outcomes we’re trying to produce.” A community that’s genuinely helping residents improve, and using an assessment framework that only tracks decline, will never be able to prove it.
The Yale findings also point to something benchmarking frameworks rarely account for: belief and expectation as a measurable, modifiable input. If positive age beliefs predict who improves, then the messaging, culture, and expectations a community sets for its residents aren’t a soft-touch extra – they’re part of the outcome data.
Join us in Orlando
If this resonates with how you think about program design and measurement, Irving’s session is where the practical version of this conversation happens – how to build audits and benchmarks that can actually see the full picture, improvement included.
Wellness Is Your Strategy: The Core of Healthy Communities – Auditing and Benchmarking, ICAA Conference 2026, November 17-19, 2026, Orlando, FL icaaconference.icaa.cc
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Source: Levy, B.R. & Slade, M.D. (2026). “Aging Redefined: Cognitive and Physical Improvement with Positive Age Beliefs.” Geriatrics, 11(2), 28.