Receptive and participatory arts engagement and healthy aging: Longitudinal evidence from the Health and Retirement Study

Background: There is increasing interest in the potential benefits of referring older adults to engage in community-based arts activities to enhance health. The arts have been found to have wide-ranging benefits for older adults including being associated with an increased lifespan. However, it remains unclear whether they are additionally associated with an increase in the portion of people’s lives for which they remain healthy ('healthspan’).

Methods: We included 1,269 older adults who completed the 2014 Arts and Culture Supplement of the Health and Retirement Study and were alive in 2016 and 2018. We measured the number of participatory arts activities engaged in (e.g., reading, crafts, dancing) and the frequency of receptive arts engagement (e.g., going to a gallery or performance) in the past year. Healthy aging was a binary outcome, conceptualized using a previously validated definition of no major chronic diseases, no cognitive impairment, good physical functioning, and good mental health. Logistic regression models tested whether receptive and participatory arts engagement were associated with healthy aging two and four years later.

Results: After adjusting for demographic and socioeconomic covariates, doing receptive arts activities once a month or more was associated with 84% higher odds of healthy aging two years later compared to never engaging (adjusted OR [AOR]=1.84, 95% CI=1.06-3.19). There was some weak evidence that this association was maintained four years later (AOR=1.68, 95% CI=0.97-2.90). Although doing one participatory arts activity was associated with 53% lower odds of healthy aging four years later compared to no participation (AOR=0.47, 95% CI=0.26-0.87), this association was not present at two years or for higher levels of participatory arts engagement.

Conclusions: Expanding on previous studies, which have suggested that receptive arts engagement is related to prolonged longevity, our findings suggest that receptive arts engagement may also be associated with better overall health and function in those who survive. Those with poorer health may have been engaging in participatory arts because they were unable to attend receptive arts or broader leisure activities (indicating reverse causality), or receptive arts activities may contain specifically beneficial active ingredients for healthy aging. These possibilities present promising avenues for future research.