Negative suggestions impair task performance in older adults
In an online randomized trial involving 96 healthy older adults, negative suggestions impaired task performance, while positive suggestions improved expectations but not performance.
Placebo-controlled
Limit: Gender composition differed between groups, with no gender-specific analyses to check its influence
Edited by Boris Djordjevic · AgingResearch.News
In a randomized online trial, 96 healthy adults aged 65–80 completed tests of attention and perception. They identified unusual tones or differently sized circles before and after hearing a four-minute, 240-hertz tone used as an inactive intervention. Before hearing it, participants read randomly assigned positive, negative or neutral descriptions of its effects.
Afterward, the negative-suggestion group performed worse on the visual task and failed to show the gains seen in the other groups on the sound task. Yet they did not report more negative expectations or perceived effects than controls. The positive-suggestion group expected improvement and perceived benefits, but their performance did not differ from controls.
Why it matters
For interventions aimed at age-related cognitive decline, the study raises the question of how to limit negative suggestions while distinguishing perceived benefits from measured gains.
Caveats
Performance-based exclusions left 79 participants in the sound-task analysis (37 women) and 86 in the visual-task analysis (45 women). These were immediate task results in healthy adults who passed cognitive and hearing screening, not evidence of lasting effects or effects in people with cognitive impairment.
From the paper
- Participants
Of these, 96 participants completed Session 2.
- Who took part
A total of 204 older adults were initially recruited.
- Duration
Participants were then exposed to a four-minute inert acoustic frequency.
- Analyzed for cognitive performance
A two-step outlier removal procedure was implemented separately for the auditory and visual oddball tasks (see Statistical Analyses section), resulting in final samples of 79 (mean age = 68.44, SD = 3.65, 37 females) and 86 older adults (mean age = 68.84, SD = 3.56, 45 females), respectively.
- Limitation
In the auditory oddball task analyses, the groups differed significantly in both SATURN scores and gender composition, whereas in the visual oddball task, only gender differences reached significance.
- Cognitive performance
To further investigate the interaction, post-hoc pairwise comparisons of the delta of trial-by-trial difficulty level trends between groups revealed significant differences between the Control and Nocebo groups, t(3315) = 3.735, p < 0.001, as well as between the Nocebo and Placebo groups, t(3315) = −3.141, p = 0.005 …
- Cognitive performance
The difference between the Control and Placebo groups was not significant, t(3315) = 0.741, p = 1.
Quoted word for word from the full text on PubMed Central.
The paper
Beyond expectations: nocebo suggestion affects cognitive performance in older adults
University of Trento
Psychological Research, May 15, 2026, Open access
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