Engaging in receptive arts may prolong life

The art of life and death: 14 year follow-up analyses of associations between arts engagement and mortality in the English Longitudinal Study of Ageing

BMJ 2019;367:l6377 http://dx.doi.org/10.1136/bmj.l6377

Abstract

Objective

To explore associations between different frequencies of arts engagement and mortality over a 14 year follow-up period.

Design

Prospective cohort study.

ParticiPants

English Longitudinal Study of Ageing cohort of 6710 community dwelling adults aged 50 years and older (53.6% women, average age 65.9 years, standard deviation 9.4) who provided baseline data in 2004-05.

Intervention

Self reported receptive arts engagement (going to museums, art galleries, exhibitions, the theatre, concerts, or the opera).

Measurement

Mortality measured through data linkage to the National Health Service central register.

Results

People who engaged with receptive arts activities on an infrequent basis (once or twice a year) had a 14% lower risk of dying at any point during the follow-up (809/3042 deaths, hazard ratio 0.86, 95% confidence interval 0.77 to 0.96) compared with those who never engaged (837/1762 deaths). People who engaged with receptive arts activities on a frequent basis (every few months or more) had a 31% lower risk of dying (355/1906 deaths, 0.69, 0.59 to 0.80), independent of demographic, socioeconomic, health related, behavioural, and social factors. Results were robust to a range of sensitivity analyses with no evidence of moderation by sex, socioeconomic status, or social factors. This study was observational and so causality cannot be assumed.

Conclusions

Receptive arts engagement could have a protective association with longevity in older adults. This association might be partly explained by differences in cognition, mental health, and physical activity among those who do and do not engage in the arts, but remains even when the model is adjusted for these factors.

What is already known about this topic

There is increasing interest in the health benefits of the arts, and debate about potential evolutionary benefits of arts engagement.
Several theories suggest that the arts could support longevity by improving mental health, enhancing social capital, reducing loneliness, developing cognitive reserve, reducing sedentary behaviours, and reducing risk taking behaviours.

While “leisure” has been broadly linked to a lower risk of premature death, few studies have focused specifically on arts engagement, and data from the UK are lacking.

What this study adds

This study followed a nationally representative sample of adults aged 50 and older in England for 14 years and used linked mortality data from National Health Service records.
Receptive arts engagement could have a protective association with longevity in older adults.
This association could partly be explained by differences in cognition, mental health, and physical activity among those who do and do not engage in the arts, but remains even when the model is adjusted for these factors.

Defining arts engagement for population-based health research: Art forms, activities and level of engagement

Background: The arts and health evidence base needs to be grounded by common terminology and concepts from which original research and comparative studies can be developed. The aim of this study was to elucidate terminology central to understanding the arts and health causal pathway by defining arts engagement via art forms, activities and level (magnitude) of engagement. Method: The study design was cross-sectional. International experts (n = 280) completed an online survey about the concept of arts engagement (response fraction 44%) to generate a list of art forms and activities. Responses were analysed using NVivo. Participating experts then completed a second survey to rate activities by level of engagement (response fraction 57%). Ratings were analysed via descriptive statistics and factor analysis. 

Results: Arts engagement can be defined by five art forms 

(1) performing arts; (2) visual arts, design and craft; (3) community/cultural festivals, fairs and events; (4) literature; and (5) online, digital and electronic arts – and measured via 91 activities. ‘Active’ arts activities had higher levels of engagement than ‘passive’ activities.

Conclusion: Study findings provide guidance about which art forms and activities should be included in population surveys and provide a measurement of exposure for use in studies investigating the relationship between arts engagement and health.

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