Cross-sectional and longitudinal associations between receptive arts engagement and loneliness among older adults

Arts and cultural engagement and subsequent social deficits among older adults: A three-year longitudinal study using the Japan Gerontological Evaluation Study

Arts and cultural engagement has the potential to reduce social deficits such as loneliness and social isolation. However, as most evidence is from Western countries, less is known whether the protective association of engagement with social deficits can also be seen in different cultural settings such as Asia. We explored the associations of arts and cultural engagement, focusing on engagement continuity and type, with loneliness and social isolation among older adults in Japan, one of the fastest-ageing countries. This three-year longitudinal study involved 4,383 individuals (mean age = 74.3 years; 51.3% women) from the Japan Gerontological Evaluative Study 2019; 2022 waves. To assess engagement continuity, respondents were categorised into four groups: none, decreasing, increasing and sustained engagement. A latent class analysis identified four classes of engagement type: low, receptive, creative and diverse engagement. Loneliness and social isolation were measured using the University of California Los Angeles (UCLA) 3-Item Loneliness Scale (range: 3-9) and the Social Isolation Index (range: 0-5), respectively. We applied ordinary least squares regressions to investigate the associations between engagement and the outcomes. Regarding engagement continuity, those who increased or sustained their engagement across waves reported lower loneliness compared with those who did not engage (increased: coef. = -0.22, 95% confidential interval [CI] = -0.41, -0.04; sustained: coef. = -0.26, 95% CI = -0.36, -0.16). Individuals who sustained their engagement also reported lower social isolation (coef. = -0.18, 95% CI = -0.27, -0.09). Regarding engagement type, engaging in diverse activities was associated with lower loneliness compared to low engagement (coef. = -0.34, 95% CI = -0.59, -0.10), while creative and diverse engagement were associated with lower social isolation (creative: coef. = -0.13, 95% CI = -0.22, -0.04; diverse: coef. = -0.33, 95% CI = -0.54, -0.12). These findings suggest that offering a diversity of creative arts and cultural activities and supporting sustainable engagement of older adults may help alleviate their social deficits.

The effects of cultural engagement on health and well-being: a systematic review

Purpose

This paper examines the effectiveness of culture-based activities in improving health-related outcomes among middle-aged and older adults. Based on the biopsychosocial model, this review aims to explore the impact of cultural engagement on health and well-being.

Methods

We conducted a systematic literature review based on peer-reviewed articles retrieved from various electronic databases. In total, 11 studies were included in this review. Our study population consisted of healthy adults aged over 40 years.

Results

The results provide evidence of positive association between cultural participation and better mental health (e.g., cognitive decline, depression, anxiety), frailty, resilience, well-being and social relations.

Conclusion

This review suggests that cultural engagement serves as an effective means for individuals to maintain and enhance their health and well-being. The field is mostly limited by the heterogeneity of the studies and poor conceptualization of cultural activities. Thus, it is recommended that future research consider the effects of different cultural interventions in developing effective strategies for promoting healthy lifestyles and enhancing quality of life in later stages of life.

Evaluation of effectiveness of an art-based museum intervention in reducing loneliness among older adults (ArtGran): a quasi-experimental study

OBJECTIVES

Loneliness is a public health issue among older adults. We designed an intervention offering 10 sessions with diverse artistic methods (ArtGran). This study assessed the effectiveness of ArtGran in reducing loneliness and its negative effects on health in community-dwelling older adults in 2022 in Barcelona.

STUDY DESIGN

Quasi-experimental study, with an intervention group (IG) and a comparison group (CG).

METHODS

The sample included residents aged ≥70 years from 6 selected neighbourhoods of Barcelona. In each neighbourhood, an IG and a CG was formed with participants who reported loneliness and without special mobility needs. The participants were referred from primary care centres, social services, and community health centres. We included 138 participants (IG = 63, CG = 75). We collected data on loneliness, quality of life (QoL-5D), mood, and self-perceived health before and after the intervention through validated questionnaires. To assess the effect of the intervention, we built Poisson models with robust variance and linear regression models.

RESULTS

At the end of the intervention, participants in the IG were more likely than those in the CG to be able to perform their usual activities without problems (adjusted prevalence ratio [aPR] = 1.22; 95% confidence interval [CI]: 1.02-1.45). Compared with the CG, participants in the IG attending more than half of the sessions had lower levels of loneliness (aPR = 1.36; 95%CI: 1.07-1.73), a better ability to perform their usual activities (aPR [95%CI] = 1.24 [1.05-1.48]), and higher happiness scores (β = 0.73; P = 0.01).

CONCLUSIONS

The effectiveness of the intervention was more pronounced when participants had high attendance. Our results suggest that high attendance of the ArtGran program was helpful in shielding older individuals from loneliness, fostering positive moods, and preserving their functional status.

Longitudinal associations between exposure to potentially morally injurious events and suicidal ideation among recently discharged veterans - The mediating roles of depression and loneliness

BACKGROUND

Exposure to potentially morally injurious events (PMIEs) during military service is associated with heightened suicidal ideation (SI). However, no longitudinal study has established temporal associations between these variables and examined the possible mediating roles of depression and loneliness in this effect.

METHODS

Participants were 374 active-duty Israeli combatants who participated in a five-year longitudinal study with four measurement points: T1- one year before enlistment, T2- one month before discharge from army service, and then again six months and twelve months following their discharge (T3 and T4, respectively). Data were assessed through semi-structured interviews and validated self-report questionnaires.

RESULTS

Above and beyond pre-enlistment personal characteristics (T1) and combat exposure (T2), PMIEs-'betrayal' (T2) predicted more frequent SI over the past twelve months (T4) through the mediation of depression. Moreover, both PMIEs-'betrayal' and 'self' (T2) predicted more frequent SI over the past twelve months (T4) through the mediation of loneliness.

LIMITATIONS

We used self-report measures to assess PMIEs and SI, which may suffer from various biases.

CONCLUSIONS

Our findings are the first to provide evidence of longitudinal, temporal associations between exposure to PMIEs and SI. Notably, potential interventions might consider addressing the loneliness experienced following exposure to PMIEs during military service, among recently discharged traumatized veterans.

Arts Engagement as a Health Behavior: An Opportunity to Address Mental Health Inequities

The significance of mental health inequities globally is illustrated by higher rates of anxiety and depression amongst racial and ethnic minority populations as well as individuals of lower socioeconomic status. The COVID-19 pandemic has further exacerbated these pre-existing mental health inequities. With rising mental health concerns, arts engagement offers an accessible, equitable opportunity to combat mental health inequities and impact upstream determinants of health. As the field of public health continues to shift its focus toward social ecological strategies, the social ecological model of health offers an approach that prioritizes social and structural determinants of health. To capture the impacts of arts engagement, this paper creates an applied social ecological model of health while aiming to advocate that engaging in the arts is a protective and rehabilitative behavior for mental health.

Cultural engagement and prevalence of pain in socially isolated older people: a longitudinal modified treatment policy approach

Background

It remains uncertain whether cultural engagement positively influences the reduction of pain risk, particularly depending on the social isolation status. The aim of this study was to examine the impact of cultural engagement on the reduction of pain prevalence over a 6-year follow-up period among older people, particularly those experiencing different dimensions of social isolation.

Methods

This study was a prospective longitudinal study. We analysed the English Longitudinal Study of Ageing cohort, consisting of 6468 community-dwelling adults aged ≥50 years old who provided data in waves 6 (2012-2013), 7 (2014-2015), 8 (2016-2017), and 9 (2018-2019). Self-reported cultural engagement (going to museums, art galleries, exhibitions, the theatre, concerts, or the opera) measured in waves 6-8 was used as the exposure variable. Meanwhile self-reported moderate-to-severe pain in wave 9 was used as the outcome variable. Social isolation was considered in waves 6-8, and the possibility of effect modification was captured by assessing each component of the social isolation index: not married or cohabiting with a partner, fewer than monthly contact with children/other immediate family/friends, and not engaging in any organisations, religious groups, or committees.

Findings

The estimated pain prevalence was 29.2% (95% confidence interval, 28.1-30.3; reference) after adjusting for time-variant, time-invariant, and loss to follow-up factors. Cultural engagement led to a reduction in pain prevalence to 24.1% for all individuals, representing a decrease of 5.1% (95% confidence interval, 0.6-9.6; P-value, 0.03). In older people who were not married or cohabiting, cultural engagement resulted in a decrease in pain prevalence to 25.8%, a reduction of 3.4% (95% confidence interval, 0.4-6.4; P-value, 0.01). For those with less frequent contact with close family members, the pain prevalence decreased to 25.3%, a reduction of 3.9% (95% confidence interval, 0.2-7.6; P-value, 0.03). Meanwhile, other dimensions of social isolation did not show a significant reduction in pain prevalence.

Interpretation

Cultural engagement may help to reduce the risk of pain in socially isolated older adults. Those who were single or living alone and had less frequent contact with immediate family were particularly vulnerable. While cultural engagement might help certain socially isolated older people feel better, its effectiveness varies, highlighting the need for targeted interventions.

Funding

The Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number (22K17648, Ikeda).

The Impact of Culture-, Health- and Nature-Based Engagement on Mitigating the Adverse Effects of Public Health Restrictions on Wellbeing, Social Connectedness and Loneliness during COVID-19: Quantitative Evidence from a Smaller- and Larger-Scale UK Survey

Numerous UK surveys conducted during COVID-19 examined the pandemic's detrimental effects on health, and the consequences of lockdown and other public health restrictions on mental health. Some surveys considered specific populations and social inequities exacerbated during COVID-19. Fewer surveys examined the ways in which the adverse effects of public health restrictions, such as lockdown, shielding and social distancing, might be alleviated. Drawing upon self-determination theory, the purpose of the current study was to assess whether culture-, health- and nature-based engagement would mitigate the effects of these restrictions on psychological wellbeing, social connectedness and loneliness. Quantitative data from a smaller-scale survey (n = 312) and a subset of questions embedded in a larger-scale survey (n = 3647) were analyzed using univariate and multivariate methods. Frequency of engagement, whether participation was online or offline and with or without other people, and the extent to which type of participation was associated with psychological wellbeing, social connectedness and loneliness were examined. Sports and fitness, gardening and reading occurred frequently in both surveys. For the smaller-scale survey, increases in connectedness and frequency of participation and decreases in loneliness were significantly associated with improved wellbeing, whereas the type of participation and age range were not significant predictors. Outcomes from the smaller-scale survey approximated the larger-scale survey for measures of loneliness, type and frequency of participation and proportion of respondents in each age range. As the frequency of participation was a significant predictor of wellbeing, but the type of participation was not significant, the findings implied that any type of participation in a sufficient quantity would be likely to boost wellbeing.

Art engagement and psychological well-being among community-dwelling older adults in Japan: an observational cross-sectional study

OBJECTIVES

Art engagement, which includes individual art activities and museum and gallery visits, potentially contributes to improving psychological well-being. However, there is insufficient evidence of its effects on the older population, and few reports are from Asia, including Japan. This study examined the association between art engagement and psychological well-being among older adults in Japan.

STUDY DESIGN

An observational cross-sectional study design was used.

METHODS

Community-dwelling older adults aged ≥60 years were recruited from the visitors to public facilities (including community centres, sports centres and cultural centres) in Aichi, Japan, in 2022, and completed questionnaires. The psychological well-being assessment included five domains according to Seligman's PERMA framework: Positive emotion, Engagement, Relationship, Meaning and Accomplishment. Regarding art engagement, the frequencies of active art engagement (e.g. activities by individuals and participation in groups, such as music and painting) and receptive art engagement (e.g. visiting museums, galleries and the theatres) were assessed.

RESULTS

A total of 522 participants were included in the analysis (mean age = 74.1 years; 78.0% females). Results from the multivariable linear regression analysis, which adjusted for demographic and socio-economic factors, revealed that higher frequencies of active art engagement were significantly associated with higher scores in all five PERMA domain scores. Higher frequencies of receptive art engagement were significantly associated with higher levels of Positive emotion, Engagement and Meaning domain scores, but were only marginally associated with the Accomplishment domain and were not associated with the Relationships domain.

CONCLUSIONS

This study indicates that art engagement has the potential to enhance psychological well-being among older adults. National and local government strategies to increase accessibility to art and cultural activities for older adults are recommended.

Building community through higher music education: a training program for facilitating musical engagement among older adults

Preparing music students to design and carry out community-based initiatives can be an effective way to enhance their employability and their wellbeing. With a large body of evidence now pointing to the benefits of musical engagement for older adults, both for individuals and for society as a whole, there is considerable opportunity and value in training aspiring professional musicians to work with and on behalf of those in their third and fourth age. This article describes a seminar designed by a Swiss conservatoire in collaboration with local nursing homes involving residents and music university students in a 10-week group music making program. On the basis of the positive results to emerge in terms of health, wellbeing and career preparation, we aim to provide information relevant for colleagues to replicate this seminar in other higher music education institutions. Moreover, this paper aims to shed light on the complexity of designing music students' training so that they acquire the competences needed to deliver meaningful, community-based initiatives alongside their other professional training commitments, and to provide directions for future research. The development and implementation of these points could foster the increase and sustainability of innovative programs beneficial for older adults, musicians and local communities.

Art Engagement and Risk of Type 2 Diabetes: Evidence From the English Longitudinal Study of Ageing

Objectives: To examine the prospective association between art engagement and the risk of type 2 diabetes. Methods: Adults aged ≥50 from the English Longitudinal Study of Ageing were asked about the frequency of art engagement, including going to the cinema, the art gallery or museum, and the theatre, a concert, or the opera. Cox proportional hazards regression models were used to examine the risk of type 2 diabetes associated with art engagement. Results: During a median follow-up of 12.2 years, we identified 350 cases of type 2 diabetes from 4,064 participants through interviews. After multivariable adjustment, compared with people who never went to the cinema, those going to the cinema frequently had a significantly lower risk of developing type 2 diabetes (HR = 0.61, 95% CI: 0.44-0.86). After further adjustment for socioeconomic factors, the association was slightly attenuated but remained statistically significant (HR = 0.65, 95% CI: 0.46-0.92). Similar results were found for going to the theatre, a concert, or the opera. Conclusion: Frequent art engagement may be associated with a lower risk of type 2 diabetes, which was independent of individuals' socioeconomic factors.

Examining the Flourishing Impacts of Repeated Visits to a Virtual Art Museum and the Role of Immersion

Visiting art museums has been associated with a range of flourishing outcomes. However, there have been recent shifts towards increasing digital engagement with art, leading to a radical change in how people experience visual art. Given the now expansive virtual art viewing options, it is important to understand whether digital engagement can also lead to greater flourishing, and, if so, under what conditions. We examined the flourishing effects of viewing art in a virtual gallery in a pre-registered experiment comprising four sessions over four weeks, with varying viewing instructions designed to increase immersion. Participants were recruited from a USA representative sample on Prolific, resulting in a final sample of 687 participants. People were randomly assigned to one of nine experimental conditions. Eight art viewing conditions involved four 15 min virtual gallery visits with viewing instructions varying on two factors: slow-looking and immersive mindset framing. An active control condition involved reading about (but not viewing) art. Participants completed a battery of baseline flourishing measures in week 1, completed experimental art engagement sessions during weeks 1-4, and completed the battery again in week 5. While immersion levels were greater in the viewing conditions than the reading condition, growth in flourishing did not differ across condition. Exploratory analyses, however, showed that immersion during the gallery visits did predict some changes in specific facets of flourishing (e.g., engagement, meaning, autonomy satisfaction). We suggest a number of possible explanations for these null results and point to what is needed in future research.

The Impact of a Virtual Art Tour Intervention on the Emotional Well-Being of Older Adults

BACKGROUND AND OBJECTIVES

Based on empirical support for the public health value of art-viewing, the present study examines the impact of a novel virtual art tour intervention on the emotional well-being of older adults.

RESEARCH DESIGN AND METHODS

We used a pre-post quantitative survey design to evaluate an art tour intervention delivered to older adults (N = 155) directly in their homes and community centers. Emotion was measured using the modified Differential Emotions Scale, and life satisfaction was measured with the Satisfaction with Life Scale. To gain insight into participants' experiences during the tours, we also conducted qualitative interviews with program coordinators at partnering organizations who viewed the tours with participants.

RESULTS

Following the art tours, participants reported significant improvements in positive emotions (especially awe) and life satisfaction. There were no significant effects on negative emotions. Program coordinators provided feedback that the tour was engaging, intellectually stimulating, and enjoyable for participants.

DISCUSSION AND IMPLICATIONS

Findings support the beneficial mental health potential of virtual art-viewing experiences for older adults. Technology may provide an effective platform to deliver wellness-oriented cultural enrichment programming while addressing accessibility barriers linked to in-person arts engagement.

Loneliness is associated with unhealthful dietary behaviors and physical inactivity among US college students

Objective: To evaluate dietary and physical activity behavior in relation to loneliness among college students. Participants: Three-hundred forty-six incoming first-year students in Fall 2019 at a large state University in the US. Methods: Students completed online surveys in Fall 2019. Multivariable regression analyses were used to model associations of health behaviors with loneliness, adjusting for gender and body mass index (BMI). Results: Two-hundred sixty-four students were included in this analysis. Students in loneliness score ranges of 4-6 and 7-9 have higher fat diet than students in score range of 10-12 (p = .007). Sedentary (19.2%) and low active (53.8%) behaviors were more frequent in students reporting high loneliness than those reporting low loneliness (13.8%, 36.7%, respectively) (p = .006). Conclusions: In this sample of college students, loneliness was related to altered diet quality and physical inactivity. Interventions to reduce loneliness may have a positive effect on health promotion in this population.

Cross-sectional and longitudinal associations between arts engagement, loneliness, and social support in adolescence

PURPOSE

Although arts engagement holds promise for reducing loneliness and enhancing social support, previous research has focussed on older adults. We investigated whether arts engagement was associated with loneliness and social support during adolescence.

METHODS

We included 11,780 adolescents aged 11-21 years from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative cohort study. We measured whether adolescents engaged in school-based arts activities (band, book club, chorus, choir, cheerleading, dance, drama club, newspaper, orchestra) at wave one (1994-1995). Loneliness and perceived social support from peers were measured at waves one and two (1996). We used logistic regression to test whether arts engagement was associated with concurrent and subsequent loneliness and social support.

RESULTS

Arts engagement was not associated with concurrent or subsequent loneliness. Compared to not engaging, doing one or more school-based arts activities was associated with 59% higher odds of high social support concurrently (odds ratio [OR] = 1.59, 95% CI = 1.32-1.91). However, this cross-sectional association was attenuated after adjusting for demographic, socioeconomic, and health-related covariates (adjusted OR [AOR] = 1.16, 95% CI = 0.95-1.42). In contrast, doing arts activities was associated with 28% higher odds of reporting high social support one year later (AOR = 1.28, 95% CI = 1.03-1.59), independent of covariates and previous social support.

CONCLUSIONS

Extracurricular arts activities are associated with increased odds of reporting good subsequent social support from peers. This may be because they provide opportunities for social engagement, developing friendships, and building a sense of community. Exploring these associations in more detail should be a priority, enabling better understanding of this strategy for enhancing social ties during adolescence.

Can a Brief Interaction With Online, Digital Art Improve Wellbeing? A Comparative Study of the Impact of Online Art and Culture Presentations on Mood, State-Anxiety, Subjective Wellbeing, and Loneliness

When experienced in-person, engagement with art has been associated—in a growing body of evidence—with positive outcomes in wellbeing and mental health. This represents an exciting new field for psychology, curation, and health interventions, suggesting a widely-accessible, cost-effective, and non-pharmaceutical means of regulating factors such as mood or anxiety. However, can similar impacts be found with online presentations? If so, this would open up positive outcomes to an even-wider population—a trend accelerating due to the current COVID-19 pandemic. Despite its promise, this question, and the underlying mechanisms of art interventions and impacts, has largely not been explored. Participants (N = 84) were asked to engage with one of two online exhibitions from Google Arts and Culture (a Monet painting or a similarly-formatted display of Japanese culinary traditions). With just 1–2 min exposure, both improved negative mood, state-anxiety, loneliness, and wellbeing. Stepdown analysis suggested the changes can be explained primarily via negative mood, while improvements in mood correlated with aesthetic appraisals and cognitive-emotional experience of the exhibition. However, no difference was found between exhibitions. We discuss the findings in terms of applications and targets for future research.

Frequency of leisure activity engagement and health functioning over a 4-year period: a population-based study amongst middle-aged adults

Rationale

Leisure activities have wide-ranging benefits for physical and mental health. However, previous studies have often focused on “leisure” as a homogeneous group of activities. This study was therefore designed to take a prospective and comparative approach exploring different types of leisure activities, as well as investigating whether frequency of engagement is associated with strength of benefits.

Method

Data from the 1970 British Cohort Study Waves 9 (age 42) and 10 (age 46) were analysed (N = 5,639). Eight domains derived from the SF-36 health survey questionnaire were used to measure health functioning (general health, vitality, bodily pain, social functioning, physical functioning, mental health, role limitations due to emotional, and role limitations due to physical problems). Leisure activities included physical activity, culture engagement, arts participation, volunteering or community engagement, and literature activities. Both ordinary least squares and logistic regressions were applied.

Results

Physical activity was associated with greater levels of physical functioning, general health, and vitality at higher frequencies, while cultural engagement was associated with social functioning and physical functioning when engaged in several times a year. Arts participation and literature activities had a general negative association with health functioning. Engagements in volunteering/community groups showed varying associations with health functioning (both positive and negative) depending on the levels of engagements.

Conclusion

This research suggests that the types of leisure activities and levels of engagement can have differential associations with health amongst middle-aged adults. This may be helpful for public health initiatives and programmes such as social prescribing schemes when formulating programmes, especially regarding ‘dosage’ of engagement. Further, the overall benefits of high engagement frequency suggest that increasing leisure engagement could play an important role in supporting improving health and wellbeing at a population level.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13670-3.

Factors Associated with the Participation of Older Adults in Cultural and Sports Activities

In the context of population aging, we have witnessed an increased interest in studying the participation of older persons in cultural and sport activities. The aim of this paper is to identify the participation rate in cultural and sports activities among Romanian older adults and the sociodemographics/behavioral variables that correlate with the participation rate in cultural and sports activities. In order to answer our research questions, we employed a questionnaire-based survey, and we used a nationally representative sample. Results point to low participation in both cultural and sports activities. Gender, residence, education, income, degree of mobility, internet connection, and availability of financial resources are significant variables that correlate with the engagement of older people in cultural and sports activities. Our study could serve as a base for concrete policy measures in the field of health and social inclusion of older persons.

Art and cultural activity engagement and depressive symptom onset among older adults: A longitudinal study from the Japanese Gerontological Evaluation Study

OBJECTIVES

Art and cultural activities can benefit mental health. However, there is insufficient evidence on active engagement in art and cultural activities for preventing depressive symptoms among older adults. Therefore, we examined the association of active engagement in art and cultural activities with depressive symptom onset among older adults using 3-year longitudinal data.

METHODS

This longitudinal study recruited non-institutionalised older adults independent in daily living from the Japan Gerontological Evaluation Study (JAGES) established in 2010, and those without depressive symptoms were followed for three years. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale. Active engagement in nine art and cultural activities, including Japanese traditional cultural activities, were evaluated (musical performance, singing, dancing, handicrafts, painting, photography, poetry composition, calligraphy, and tea ceremony/flower arrangement).

RESULTS

Ultimately, 37,627 older adults without depressive symptoms at baseline were analysed. The participants' mean age (standard deviation) was 72.6 (5.5) years, and 51.5% were female. During the follow-up period, depressive symptoms occurred in 3844 participants (10.2%). Multivariable logistic regression analysis revealed that active engagement in art and cultural activities was inversely associated with depressive symptom onset (odds ratio = 0.80, 95% confidence interval = 0.73-0.87, p < 0.001). This association was confirmed regardless of age, gender, and socioeconomic status. Among the activities, especially dancing and photography were protective against depressive symptoms.

CONCLUSION

Active engagement in art and cultural activities may contribute to preventing depressive symptoms among older adults. Promoting art and cultural engagement could be important to protect their mental health.

How arts engagement supported social connectedness during the first year of the COVID-19 pandemic in the UK: findings from the HEartS Survey

Objectives

This study investigated how adults in the United Kingdom perceived their arts and cultural engagement to facilitate social connectedness over two phases in the first year of the COVID-19 pandemic.

Study design

The study used the HEartS Survey, a newly designed online survey tool to capture arts engagement in the United Kingdom and its associations with social and mental well-being, over two phases in 2020: March to May (Phase 1) and October (Phase 2).

Methods

Qualitative data were provided at both phases by 581 respondents, who identified which arts and cultural activity they felt most connected them to others and how during the last month.

Results

Thematic analysis revealed that, at both phases, arts and cultural engagement was perceived to facilitate social connectedness through four pathways that were also identified prepandemic: social opportunities, sharing, feelings of commonality and belonging and collective understanding. The subthemes shed light on specific ways that respondents used the arts during the pandemic to connect with others, including using the arts: as a catalyst for conversations, to maintain, reinstate or strengthen relationships during social distancing and to facilitate social interactions (Theme 1); to bring people together through shared experiences and sharing of art (Theme 2); to elicit feelings of direct and indirect proximity to others, to connect people with common interests, to feel a sense of belonging to something and to feel part of a collective ‘COVID-19 experience’ or to feel collectively distracted from the pandemic (Theme 3); and to learn from and about other people and to relate to others (Theme 4). The activity most frequently cited as connecting was watching a film or drama, followed by listening to recorded music.

Conclusions

Engagement in arts and cultural activities supported feelings of social connection among adults in the United Kingdom over two phases in the first year of the COVID-19 pandemic, highlighting the importance of access to the arts and culture to support social connectedness.

Understanding the Effects of Music Care on the Lived Experience of Isolation and Loneliness in Long-Term Care: A Qualitative Study

This qualitative study aims to understand the lived experience of residents and other stakeholders during the implementation of a comprehensive music program in long-term care. It was conducted using a subset of 15 long-term care homes from the Room 217 Foundation Music Care Partners (MCP) “Grow” study in Ontario, Canada. The MCP program’s approach to music delivery uses therapeutic music practices such as “music care” to improve the care experience for caregivers and residents in long-term care homes. Thirty-two participants were interviewed, including staff, volunteers, and residents. Data were transcribed and analyzed using a modified grounded theory approach based on emergent themes. In total, seven themes arose from the data: limited resources, distinct experiences, life enrichment, dynamic relationships, program flexibility, potential continuity, and enhanced socialization. This study provides insight on barriers, enablers, and outcomes of the MCP program and on key considerations for implementing a novel interdisciplinary music program in a healthcare setting.

Neurology Telemusic Program at the Time of the COVID-19 Pandemic: Turning Hospital Time Into Aesthetic Time During Crisis

Strict precautions during the COVID-19 pandemic left patients isolated during already stressful hospital stays. Research indicates that listening to music recruits regions in the brain involved with social interaction and reduces feelings of loneliness. We formed a team of clinicians and clinical musicians to bring music to the bedside, as “psychological first aid.” Our goal was to reduce feelings of anxiety and isolation in patients admitted to the Northwestern Memorial Hospital's neurosciences unit. Participants were offered 30–40-min live music sessions over FaceTime by a violist in consultation with a music therapist and a certified music practitioner. Music used for the interventions was personalized. Participants were evaluated with the Music Assessment Tool where they indicated their musical preferences and music to which they objected. Following the intervention, participants answered a questionnaire assessing how music impacted their emotional state based on a 1–10 Likert scale. Scores were then averaged across all patients and were calculated as percentages. Eighty-seven sessions were completed during a 3-month period. Despite different degrees of disability, most patients engaged aesthetically with the music. The likelihood to recommend (LTR) for the program was 98%; participants tended to highly agree that the intervention improved their emotional state (92%); that it provided a pleasurable experience (92.4%); and that it reduced their stress and anxiety (89.5%). This pilot project showed that the telemusic intervention was feasible for our neurosciences patients during the COVID-19 pandemic. Our results are consistent with previous in-person hospital-based music interventions and highlight the importance of such programs when in-person interventions are not possible. This pilot project serves as a prelude to further investigate mechanisms by which music interventions can support admitted neurology patients.

A Scoping Review of Aging Experiences Among Culturally and Linguistically Diverse People in Australia: Toward Better Aging Policy and Cultural Well-Being for Migrant and Refugee Adults

BACKGROUND AND OBJECTIVES

Australia's population is growing, aging, and becoming more ethnically diverse, resulting in barriers and challenges around social inclusion for non-English-speaking migrants and refugees. This scoping review investigates the experiences of aging within Australia among older adults from culturally and linguistically diverse (CALD) migrant and refugee backgrounds to identify barriers to social integration.

RESEARCH DESIGN AND METHODS

A scoping review of English language literature and gray literature on the experiences of aging among CALD migrants and refugees living in Australia was conducted from January 2000 to January 2021, according to Arksey and O'Malley's review process. A total of 34 studies were identified for analysis.

RESULTS

Three primary themes were identified: (a) sociocultural similarities in settlement experiences, (b) engagement with technology for social connection, and (c) engagement with family and community networks.

DISCUSSION AND IMPLICATIONS

Aging, language, sociocultural, and technology contexts shape attitudes to belonging, as well as access to sociomedical services. We argue a cultural well-being framework may assist in developing policy for improved social integration of older CALD adults. As the focus is on social and cultural experiences, all studies with a primary focus on medical and other chronic conditions were excluded. Future studies could include health-related articles to present a more comprehensive approach regarding older CALD adult needs. Follow-up research could focus on the impact of the coronavirus disease 2019 pandemic on the experiences of older adults in Australia, in particular those of CALD backgrounds.

Arts engagement supports social connectedness in adulthood: findings from the HEartS Survey

Background

Loneliness is a public health challenge, associated with premature mortality and poorer health outcomes. Social connections can mitigate against loneliness, and there is evidence that the arts can support social connectedness. However, existing research on the arts and social connectedness is limited by focus on particular age groups and arts activities, as well as a reliance on typically small-scale studies.

Methods

This study reports survey data from 5892 adults in the United Kingdom, closely matched to the national profile in terms of sociodemographic and economic characteristics. It investigates the extent to which arts engagement is perceived to be linked with feelings of social connectedness, which forms of arts engagement are reported as most connecting, and how. Data were collected via the HEartS Survey, a newly designed tool to capture arts engagement in the United Kingdom and its associations with social and mental health outcomes. Demographic and quantitative data, pertaining to the extent to which arts engagement is perceived to be linked with social connectedness, were analysed descriptively. Qualitative data pertaining to respondents’ perceptions of how arts engagement is linked with feelings of social connectedness were analysed using inductive thematic analysis.

Results

Results demonstrated that the majority of respondents (82%) perceive their arts engagement to be linked with feelings of social connectedness at least some of the time. The forms of arts engagement most linked with feelings of social connectedness were attending a live music performance, watching a live theatre performance, and watching a film or drama at the cinema or other venue. Four overarching themes characterise how arts engagement is perceived to facilitate feelings of social connectedness: social opportunities, sharing, commonality and belonging, and collective understanding.

Conclusions

The findings suggest that arts engagement can support social connectedness among adults in the UK through multiple pathways, providing large-scale evidence of the important role that the arts can play in supporting social public health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11233-6.

The Moderating Effect of Older Adults' Receptive Arts Engagement on the Association Between Resilience and Anxiety Symptoms During Coronavirus Breakout

ABSTRACT

In this study, we evaluated whether levels of receptive arts engagement (visiting museums/concerts/the theater/the cinema) during the year preceding the COVID-19 outbreak may have served as a psychological resource for older adults that mitigated the association between resilience levels and COVID-19 anxiety when the pandemic broke out. Data were collected after the enactment of the first emergency regulations (between March 15 and April 1, 2020) via the Qualtrics Survey Software link that was sent out through social media platforms. In total, 205 participants aged 65 to 92 (mean age, 72.32; SD, 5.63) reported general anxiety symptom levels (GAD-7) (Spitzer et al., 2006), resilience (Connor-Davidson Resilience Scale), frequency of receptive arts engagement in the previous year, health status, exposure to risk situations, and behavioral changes due to the pandemic. Our hypothesis that receptive arts would moderate the resilience-COVID-19 anxiety link was examined by a multiple hierarchical regression analysis and with the PROCESS computational tool. Findings show that resilience was associated with COVID-19 anxiety and that this association was moderated by levels of receptive arts engagement. The findings show that high levels of prior art engagement constituted a potent buffer against subsequent COVID-19 anxiety. Policy makers may benefit older adults by encouraging their engagement in arts activities, even during social distancing.

The Anxiety Depression Pathway Among Men Following a Prostate Cancer Diagnosis: Cross-Sectional Interactions Between Anger Responses and Loneliness

Anger has been a largely neglected emotion in prostate cancer research and intervention. This paper highlights the role of anger in the anxiety depression pathway among men with prostate cancer, and whether its impact is dependent on loneliness. Data are presented from a sample of men with prostate cancer (N = 105, M = 69.12 years, prostatectomy = 63.8%) and analysed using conditional process analysis. Dimensions of anger were evaluated as parallel mediators in bi-directional anxiety and depression pathways. Loneliness was evaluated as a conditional moderator of identified significant mediation relationships. Moderate severity depression (16.5%) was endorsed more frequently than moderate severity anxiety (8.6%, p = .008), with 19.1% of the sample reporting past two-week suicide ideation. Consistent with hypotheses, anger-related social interference (but not other dimensions of anger) significantly mediated the anxiety-depression pathway, but not the reverse depression-anxiety pathway. This indirect effect was conditional on men experiencing loneliness. Sensitivity analyses indicated the observed moderated mediation effect occurred for affective, but not somatic symptoms of depression. Findings support anger-related social interference (as opposed to anger frequency, intensity, duration or antagonism) as key to explaining the previously established anxiety-depression pathway. Results underscore the need for enhanced psychosocial supports for men with prostate cancer, with a particular focus on relational aspects. Supporting men with prostate cancer to adaptively process and manage their anger in ways that ameliorate negative social consequences will likely enhance their perceived social support quality, which may in turn better facilitate post-diagnosis recovery and emotional adjustment.

Social Isolation and Loneliness during COVID-19 Lockdown: Associations with Depressive Symptoms in the German Old-Age Population

Lockdowns during the COVID-19 pandemic increase the risk of social isolation and loneliness, which may affect mental wellbeing. Therefore, we aimed to investigate associations between social isolation and loneliness with depressive symptoms in the German old-age population during the first COVID-19 lockdown. A representative sample of randomly selected individuals at least 65 years old (n = 1005) participated in a computer-assisted standardized telephone interview in April 2020. Sociodemographic data, aspects of the personal life situation, attitudes towards COVID-19 and standardized screening measures on loneliness (UCLA 3-item loneliness scale), depression (Brief Symptom Inventory/BSI-18), and resilience (Brief Resilience Scale/BRS) were assessed. Associations were inspected using multivariate regression models. Being lonely, but not isolated (β = 0.276; p < 0.001) and being both isolated and lonely (β = 0.136; p < 0.001) were associated with higher depressive symptoms. Being isolated, but not lonely was not associated with depressive symptoms. Thus, the subjective emotional evaluation, i.e., feeling lonely, of the social situation during lockdown seems more relevant than the objective state, i.e., being isolated. Normal (β = -0.203; p < 0.001) and high resilience (β = -0.308; p < 0.001) were associated with lower depressive symptoms across groups. Therefore, strengthening coping skills may be a support strategy during lockdowns, especially for lonely older individuals.

Exploring Changes in Musical Behaviors of Caregivers and Children in Social Distancing During the COVID-19 Outbreak

The coronavirus disease 2019 (COVID-19) pandemic has had profound effects on all aspects of society. Families were among those directly impacted by the first measures imposed by health authorities worldwide to contain the spread of the Sars-CoV-2 virus, where social distancing and mandatory quarantine were the main approaches implemented. Notably, little is yet known about how social distancing during COVID-19 has altered families' daily routines, particularly regarding music-related behaviors. The aim of this study was 2-fold: (i) to explore changes in families' daily routine and caregivers' levels of well-being and stress during the COVID-19 outbreak in Brazil and (ii) to investigate whether musical behaviors of caregivers and the children under their care (aged from 3 to 6 years old) changed during social distancing. One hundred and eighty-eight caregivers residing in Brazil participated in an online cross-sectional study conducted between July and August 2020. Our findings suggest significant changes in families' dynamics during the COVID-19 outbreak, with parents (especially mothers) spending more time on childcare and a substantial decrease in caregiver's well-being. Regarding music-related behaviors, our results revealed considerable changes in caregivers' and children's musical activities at home during social distancing, including an increase in child-only musical behaviors and shared caregiver-child activities. Moreover, sociodemographic factors such as caregiver background and well-being as well as the child's disability status significantly influenced musical engagement at home during social distancing. This study captured some features of the home musical environment of middle-class families in Brazil in the first stages of social distancing restrictions during the pandemic and caregivers' role in providing an environment where musical experiences are nurtured. Further research is needed to better understand aspects such as the long-term impact of the changes of musical behaviors at home on musical parenting and families' well-being.

Arts engagement trends in the United Kingdom and their mental and social wellbeing implications: HEartS Survey

Evidence on the role of the arts in promoting health and wellbeing has grown over the last two decades. In the United Kingdom, studies using secondary data sources have documented temporal variations in levels of arts engagement in the population, its determinants and its mental wellbeing implications. However, arts engagement is often characterized by prioritizing "high-brow" art forms. In this article, we introduce the HEartS Survey, a tool that aims to increase the balance between inclusivity and brevity of existing arts engagement measures and to focus specifically on the connection between arts engagement and social wellbeing. We explore trends in participatory and receptive engagement with literary, visual, performing, crafts and decorative arts among 5,338 adults in the UK in 2018-2019 using summative engagement scores and cluster analysis. Regression models, adjusted for demographic, socioeconomic, health, and social covariates, examine correlations between arts engagement and psychological and social wellbeing measures. Over 97% of respondents reported engagement in one or more arts activities at least once during 2018-2019, with reading and listening to music being the most popular activities. Arts engagement grouped into three distinct clusters: 19.8% constituted "low engagers" whose main source of engagement was occasional reading; 44.4% constituted "receptive consumers" who read and listened to music frequently and engaged with popular receptive arts activities such as cinema, live music, theater, exhibitions, and museums; and 35.8% constituted "omnivores" who frequently engaged in almost all arts activities. In agreement with existing studies, more arts engagement was associated with higher levels of wellbeing, social connectedness, and lower odds of intense social loneliness. In contrast, we found a positive association between more arts engagement, depression, and intense emotional loneliness for the most highly engaged omnivores. We conclude that arts engagement in the population forms specific profiles with distinct characteristics and consider implications for mental and social wellbeing.

Art for Ages: The Effects of Group Music Making on the Wellbeing of Nursing Home Residents

In many countries, life expectancy has increased considerably in past years, and the importance of finding ways to ensure good levels of wellbeing through aging has become more important than ever. Arts based interventions are promising in this respect, and the literature suggests that musical activities can reduce isolation and anxiety and foster feelings of achievement and self-confidence. The present study examined the effects of group music making programs on the health and wellbeing of nursing home residents in Southern Switzerland. A team of professional and student musicians delivered 10 weekly music sessions in four nursing homes, focusing on singing, rhythm-based activities with percussion instruments, and listening to short, live performances. 22 participants (16 women and 6 men, aged 72-95 years, mean 83.6, SD ± 6.9) were recruited to take part in the study and were interviewed after the last music session. The data were analyzed with thematic analysis to investigate how residents experienced group music making and its effects. The findings show that the music programs were beneficial for residents’ wellbeing. Music plays an important role in their lives, both in their pasts and presently, and being involved in musical activities offers engagement and novelty in daily life, providing learning opportunities and facilitating interpersonal relationships. Moreover, these results were due to interactions with the musicians involved. Residents particularly appreciated the opportunity to listen to live performances as part of the sessions. This study suggests that nursing home residents value music and that music based interventions play an important and direct role in enhancing their wellbeing.

Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health

This study sought to identify factors associated with depression, anxiety, and PTSD symptomatology in U.S. young adults (18-30 years) during the COVID-19 pandemic. This cross-sectional online study assessed 898 participants from April 13, 2020 to May 19, 2020, approximately one month after the U.S. declared a state of emergency due to COVID-19 and prior to the initial lifting of restrictions across 50 U.S. states. Respondents reported high levels of depression (43.3%, PHQ-8 scores ≥ 10), high anxiety scores (45.4%, GAD-7 scores ≥ 10), and high levels of PTSD symptoms (31.8%, PCL-C scores ≥ 45). High levels of loneliness, high levels of COVID-19-specific worry, and low distress tolerance were significantly associated with clinical levels of depression, anxiety, and PTSD symptoms. Resilience was associated with low levels of depression and anxiety symptoms but not PTSD. Most respondents had high levels of social support; social support from family, but not from partner or peers, was associated with low levels of depression and PTSD. Compared to Whites, Asian Americans were less likely to report high levels across mental health symptoms, and Hispanic/Latinos were less likely to report high levels of anxiety. These factors provide initial guidance regarding the clinical management for COVID-19-related mental health problems.

Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health

This study sought to identify factors associated with depression, anxiety, and PTSD symptomatology in U.S. young adults (18-30 years) during the COVID-19 pandemic. This cross-sectional online study assessed 898 participants from April 13, 2020 to May 19, 2020, approximately one month after the U.S. declared a state of emergency due to COVID-19 and prior to the initial lifting of restrictions across 50 U.S. states. Respondents reported high levels of depression (43.3%, PHQ-8 scores ≥ 10), high anxiety scores (45.4%, GAD-7 scores ≥ 10), and high levels of PTSD symptoms (31.8%, PCL-C scores ≥ 45). High levels of loneliness, high levels of COVID-19-specific worry, and low distress tolerance were significantly associated with clinical levels of depression, anxiety, and PTSD symptoms. Resilience was associated with low levels of depression and anxiety symptoms but not PTSD. Most respondents had high levels of social support; social support from family, but not from partner or peers, was associated with low levels of depression and PTSD. Compared to Whites, Asian Americans were less likely to report high levels across mental health symptoms, and Hispanic/Latinos were less likely to report high levels of anxiety. These factors provide initial guidance regarding the clinical management for COVID-19-related mental health problems.