Cultural Engagement Is Related to Decelerated Physiological Age: Doubly Robust Estimations in a National Cohort Study.

Cultural engagement was associated with lower physiological age cross-sectionally in older adults.

• Sample drawn from the English Longitudinal Study of Ageing (ELSA), n = 4467 older adults.
• Average treatment effect of cultural engagement on physiological age was -2.17 (95% CI -3.48 to -0.86) cross-sectionally.
• A doubly robust estimation approach was used to account for confounders.
• A previously derived physiological age index was used as the outcome measure.

The association between cultural engagement and lower physiological age persisted longitudinally at 4 and 8 years of follow-up.

• Longitudinal effects were observed at both 4-year and 8-year follow-up time points.
• The study used the English Longitudinal Study of Ageing cohort (n = 4467).
• The doubly robust estimation approach was applied across all time points to account for confounding.
• The longitudinal associations were described as consistent with the cross-sectional findings.

The effect of cultural engagement on physiological age was consistent across all three types of cultural activity examined.

• Three types of cultural activity were explored: cultural performances (e.g., live music events and theater), museums/galleries/exhibitions, and the cinema.
• Each activity type was independently associated with lower physiological age.
• The consistency across activity types was noted as a key feature of the findings.
• Examples of cultural performances included going to live music events and theater performances.

The findings were robust across multiple sensitivity analyses.

• Sensitivity analyses considered alternative confounding structures.
• Outlier analyses were conducted as part of the sensitivity testing.
• Alternative treatment specifications were also examined.
• Results remained consistent across all sensitivity analyses performed.

Cultural engagement has been longitudinally associated with age-related mental and physical health outcomes in repeated epidemiological studies prior to this work.

• Prior studies established associations between cultural engagement and age-related mental and physical health outcomes.
• The current study extended this work by examining physiological age acceleration specifically.
• Cultural engagement was defined as going to live music events and theater performances, museums, galleries and exhibitions, and the cinema.
• The study population was older adults, consistent with prior epidemiological work in this area.