Cultural engagement is related to decelerated physiological but not subjective age: doubly-robust estimations in a national cohort study

Cultural engagement (e.g. going to live music events, museums, galleries, theatre performances, and the cinema) is longitudinally associated in repeated epidemiological studies with age-related mental and physical health outcomes. However, it is unclear whether it also influences how fast older adults age psychologically and physically – so-called age acceleration. This study aimed to ascertain whether regular cultural engagement amongst older adults is related to slower physiological and subjective ageing using a previously-derived physiological age index and a doubly-robust estimation approach to account for confounders. Using older adults from the English Longitudinal Study of Ageing (n=4,467), we found that cultural engagement was related to lower physiological age cross-sectionally (average treatment effect -2.17; 95% CI-3.48 to -0.86), and 4 and 8 years later. The effect was seen consistently for all three types of cultural activity explored (going to the cinema, galleries, museums and exhibitions, and the theatre or live music events). However, cultural engagement was not related to subjective ageing. These analyses were robust to multiple sensitivity analyses, including considering alternative confounding structures, outliers, and treatment specification. Overall, these findings provide insight into how cultural engagement may be related to processes of ageing.