Contents

Highlights

Background

Methods
- Review shaping
- What we included
- What we didn't include
- Critical appraisal
- What questions did we ask?

Findings
- Which types of arts and cultural experiences are represented in the literature?
- How is the value of cultural participation researched or evaluated in this area?
- What is known about the effects of cultural participation on social connectivity for older people?
- What is the relationship between older people’s cultural participation and wellbeing?
- What is known about the role of digital technology for the participation of older people in arts and cultural experiences?

Conclusions and implications

Next steps

Studies included in this review

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Highlights

In recent years there has been growing interest in the role that cultural participation can play in older people’s wellbeing and sense of connection to other people. This interest has been noted within the cultural sector, as well as the voluntary, community and social enterprise sectors (e.g. AgeUK, The Baring Foundation). We are all growing older, and so it is important to consider what the cultural landscape looks like for older people and how it can support people to lead meaningful and fulfilling lives as they age. This research digest presents a collaborative review of the literature relating to the value of cultural participation on wellbeing and feelings of social connection as we age.

We identified 70 peer-reviewed studies which examined the role of cultural participation in supporting feelings of wellbeing and social connection for older people (aged 60+). Across these studies, music experiences (i.e. community choirs; community bands) were the most commonly reported within the literature. The older people represented in the literature were largely women, white, and aged 65-75.

The strongest evidence is currently represented within the qualitative literature. For methodological reasons, it is not possible at this point in time to draw any firm conclusions from the quantitative literature. This is because of the limited studies that explored social connection as a primary outcome, and because of the wide range of self-report questionnaires that were used within each individual study, preventing comparison across studies.

The qualitative literature showcased a wide range of benefits for engaging with culture for wellbeing and feelings of social connection. Older people had increased opportunities for social interaction and developed a sense of belonging and/or inclusion. Older people were also able to share exchanges of experience, knowledge and skills with each other and their wider communities (including intergenerational programmes). Theatre and dance programmes led to older people developing a more positive relationship with their bodies, allowing them to see what they could do rather than what they couldn’t do.

In relation to wellbeing, cultural participation afforded older people a range of positive emotional experiences, making them feel happier and helping them to cope with negative life events such as bereavement. Engaging with culture also led to older people feeling a sense of achievement through opportunities to experience challenge and learn new skills. Older people also reported feeling more of a connection with their own personal identity, as well as building a collective identity, which led to increased confidence and self-esteem.

Given the context of the Covid-19 pandemic, we sought to explore the role of digital technology for the participation of older people in arts and cultural experiences. Unfortunately, we were unable to answer this question due to only identifying three studies that used digital technology as part of the cultural experience. However, we anticipate that there will be more publications in due course which focus on digital forms of participation during the pandemic.

Overall, while there is promising evidence for the value of cultural participation for older people’s wellbeing and feelings of social connection, there are concerns about the quality of literature within this research area, particularly mixed-methods research. There is clearly a need for methodological development in this area so that older people can have more agency, voice, and involvement in the research process.

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Background

In recent years there has been growing interest in the role that cultural participation can play in older people’s wellbeing and sense of connection to other people. This interest has been noted within the cultural sector, as well as the voluntary, community and social enterprise sectors (e.g. Age UK, The Baring Foundation). We are all growing older, and so it is important to consider what the cultural landscape looks like for older people and how it can support people to lead meaningful and fulfilling lives as they age.

In order to evaluate the evidence around the value of arts and culture in supporting the wellbeing and social connectedness of older people, we synthesized and appraised literature published since 2011. This rapid review of the literature was conducted between May and October 2021. This review is part of the Centre for Cultural Value’s synthesis of research within the wider theme of cultural participation.

The collaboration

This review is a collaboration between the Centre for Cultural Value and Connecting Through Culture As We Age project (University of Bristol). This is the Centre’s first collaborative review, and it provided an opportunity to engage with and inform a live research project. By coming together, we have been able to deploy a range of experts to examine and appraise the literature, which we hope will make this review as relevant and useful as possible for those who are seeking to understand more about the value of cultural participation for older people.

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Methods

We conducted a rapid review of peer-reviewed academic literature that has been published since 2011 to present a snapshot of the recent evidence. We used a systematic approach to identify literature, using academic databases as well as the Repository for Arts and Health Resources and the Center for Arts in Medicine (University of Florida) Research Database. We also engaged with experts working in the field to ask them to make suggestions for literature that had not been identified within our database searches.

Review shaping

The research questions within this review were shaped in consultation with cultural practitioners and organisations as part of our collaborative research survey and shaping event in May 2021. Stakeholders involved in this research-shaping workshop helped us to narrow the focus of the review to ensure it was accessible and relevant to the questions the sector had about this topic. You can read more about our engaged research process here.

What we included

We included peer-reviewed, primary research that was published in English between January 2011 and June 2021. We looked for research where the focus was on older people (aged 60+) who were living at home within the community, with outcomes relating to social connection (including loneliness and social isolation) or wellbeing.

What we didn't include

We didn’t include studies which included a population of dementia or Parkinson’s disease, and older people living in care home settings as there is a significant body of research within these areas to date. Furthermore, we didn’t include studies which focussed on creative arts therapies. While we recognise the vital work of creative arts therapists, the focus of this review was on impacts or outcomes relating to work produced or supported by the arts and cultural sectors.

Critical appraisal

In order to assess the quality of the studies we reviewed, we engaged in a formal process of appraisal using the Mixed Methods Appraisal Tool Version 2018. A formal process of critical appraisal allowed us to explore whether studies presented clear aims and research methods, as well as examine recruitment processes, ethics, researcher reflexivity and appropriateness of analysis strategies.

We excluded 14 studies on the basis that they were too poor quality to include within the review. These studies did not state clear aims nor outline how their methods would address these aims.

What questions did we ask?

Our broad review questions:

1. Which types of arts and cultural experiences are represented in the literature?
2. How is the value of cultural participation researched or evaluated in this area?

Questions raised by the sector

1. What is known about the effects of cultural participation on social connectivity for older people?
2. What is the relationship between older people’s cultural participation and wellbeing?
3. What is known about the role of digital technology for the participation of older people in arts and cultural experiences?

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Findings

We identified 70 peer-reviewed studies which investigated outcomes relating to older people’s cultural participation, social connection and wellbeing (see the Table of studies on page 15 for more information). Of these studies 19 were conducted in England, 12 in Canada, 11 in Australia, 8 in the United States of America, 3 in Finland, 2 in Hong Kong, and 1 from Brazil, Crete, Ireland, Israel, Italy, Netherlands, Norway, Portugal, Scotland, Singapore, South Korea, Spain, Sweden and Wales (see Figure 1).

The total number of participants represented across studies was 29,264 older people. There were high percentages of female participants, compared to male, and the average ages of participants tended to fall within the 65-75 age range. A large number of studies had predominantly white participants, though a high number of studies did not report participant demographics beyond age and gender.

Which types of arts and cultural experiences are represented in the literature?

Figure 2 presents an overview of the different arts and cultural experiences represented within the literature.

Music participation was the most commonly reported cultural experience reported within the literature (37 per cent of studies), with community choir singing being the most commonly reported experience-type. Music participation also included community orchestras, learning a new instrument as part of a group, intergenerational music-making programmes, and listening to religious music.

Mixed cultural participation was the next most commonly reported cultural experience (20 per cent of studies), with older people taking part in a wide range of cultural activity. These experiences tended to include a range of participatory arts activities that were engaged with in a group.

Dance was the next most commonly reported experience (13 per cent), with a wide range of dance practices reported (including line dancing, ballroom dancing, burlesque and square dancing). All literature that included dance-based participation was group-based.

Less frequently studied participation types included: museum and gallery-based experiences, festivals, heritage focussed experiences, libraries, radio and theatre-based experiences.

Only three of the 70 studies included a digital element within the cultural experience. One focussed on digital storytelling, one on the use of digital music technology and the other on the creation of digital content for YouTube and other social media.

For a full list of cultural experiences and participation types see Appendix 1.

How is the value of cultural participation researched or evaluated in this area?

Qualitative approaches were the most commonly used method to understand the value of cultural participation for older people’s sense of community connection and wellbeing (49 per cent). These studies largely used interviews or focus groups, combined with observation. There were a handful of studies which used more participatory methods, including documentary making, photo elicitation and ‘world café ’ approaches.

The quality of the qualitative literature was varied. When implementing the quality appraisal tool it was clear that quality was significantly impacted by: (1) a lack of consideration about the relationship between researcher and participants, (2) very little reporting of the ethical considerations needed when working with populations of older people, and (3) some poor approaches to data analysis and reporting of findings. It should also be noted that many of the interviews/focus groups were very short in duration (i.e. 10-20 minutes), and so there are questions as to whether the depth of older people’s experiences has truly been captured.

Quantitative methods were the second most commonly used to understand the value of cultural participation for older people’s sense of community connection and wellbeing (30 per cent). Largely, these studies used standardised measures related to wellbeing and mental health, with the most commonly used measures being: Geriatric Depression Scale (6 studies); World Health Organisation Quality of Life assessment (WHOQOL-Bref; 5 studies); Positive and Negative Affect Schedule (4 studies). There were fewer examples of measures that looked specifically at social connectedness but scales such as the Multidimensional Perceived Social Support Scale and UCLA Loneliness Scale were used in two studies.

The quality of the quantitative literature was also varied. In scoring these studies via the quality appraisal tool, it was clear that the limitations of the quantitative literature lay in approaches to recruitment and whether they were appropriate to answer the research questions (i.e. self-selecting samples), as well as whether the interpretation of evidence was consistent with the data presented (i.e. overstating findings).

Fifteen of the studies used a mixed-methods approach to understand the value of culture for older people’s sense of community connection and wellbeing. The approaches used tended to be a combination of interviews or focus groups with questionnaires. Mixed-methods literature was appraised as being of a particularly poor standard - there was little justification or rationale for the methods chosen, and poor integration of quantitative and qualitative findings.

What is known about the value of cultural participation on social connectivity for older people?

Overall, we observed a wide range of benefits to older people’s sense of social connectivity across the different types of literature examined as part of this review. As previously mentioned, there were not many quantitative studies that focussed solely on social connectivity as an outcome, but the five that did showed that cultural participation had a positive impact on social engagement (1 study), interaction (1 study) and integration (i.e. the feeling of being welcomed into a new community) (1 study), as well as a reduction in feelings of loneliness (2 studies). However, due to the differences in focus for each of the quantitative studies that focussed on social connectivity, as well as the different outcome measures used, it is difficult at this moment in time to draw any definitive conclusions from the quantitative literature.

The following section presents the key themes that were developed by the research review team from the qualitative literature that address outcomes and impacts relating to social connectivity.

Increased social interaction

Cultural participation provided older people with opportunities for (increased) social interaction. In the literature, this was shown to enable older people to build new or strengthen existing friendships and other kinds of social connections and to develop or improve confidence and social skills. These factors were often linked to decreased feelings of loneliness or social isolation.

Cultural participation may also lead to increased activity and connectivity in other ways. For example, studies showed how interaction with others during a cultural activity can lead to giving and receiving peer support during difficult times (i.e. during experiences of bereavement or personal illness), to accessing other resources or services, and improving relationships with friends and family.

A sense of ‘belonging’ and/or inclusion

Cultural participation in groups was observed to enable older people to feel a sense of ‘belonging’ and/or inclusion. Study participants sometimes described feeling as if they had found an alternative family. Some studies showed how activities such as singing regularly in a choir or dancing as part of a club can lead to the development of a sense of collective identity through which individuals come to feel bonded together.

Positive feelings were generated through processes that included regular social interaction, pride and enjoyment in participation and collaboration towards a shared goal. Participants also reported feelings of ‘being seen’ or valued by others in the group or outside it as a result of taking part in activities such as public performance or exhibitions of artwork. The literature also contained examples of activities conducted in gendered groups, sometimes experienced as liberating for those involved.

However, similar processes can also lead to experiences of exclusion when participants are not or do not feel accepted within a group. Studies show that feelings of rejection and anxiety can result.

Exchanges of experience, knowledge and skills

Cultural participation often involves processes that facilitate exchanges of experience, knowledge and skills with others. These can allow older people to construct shared meanings and foster reciprocal relationships with people who are like and sometimes also unlike themselves. Cultural activity involving these kinds of processes is often described as being capable of building feelings or skills of compassion, empathy and understanding in those who take part.

In the studies in this review, exchanges of this kind included those creating connections between generations, activities that promoted exploration of shared cultural heritage, nostalgia or life events (for example through learning about and handling cultural artefacts or in storytelling) and activities that sought to build links within and between different communities.

Embodied experiences

Certain kinds of cultural participation such as dance or theatre, or the handling of cultural artefacts, were shown to provide older people with positive embodied experiences. As a result, participants felt a stronger connection to their bodies and senses, as well as engaging in physical activity that allowed them to transcend the limitations of the ageing body or which actively improved how they felt their body worked. The improved relationship with their ageing bodies was sometimes linked to theories of healthy ageing.

Overall, the qualitative literature points to there being a wide range of benefits of cultural participation for older people’s sense of community and connection to others. Perhaps unsurprisingly, this was particularly the case for group-based cultural experiences such as community choirs or intergenerational heritage programmes.

What is the relationship between older people’s cultural participation and wellbeing?

Twenty-five studies used direct or indirect (i.e. depression, quality of life, mood) measures of older people’s wellbeing. Overall, these studies largely pointed towards the positive impacts of cultural participation on older people’s mood, levels of anxiety or depression, life satisfaction, and psychological needs. Similar to the social connection literature, a wide range of outcome measures were used and they were largely indirect measures of wellbeing. Therefore, at this moment in time it is difficult to draw any strong conclusions from the quantitative literature.

The following section presents the key themes developed by the research review team from the qualitative literature which may underpin the positive findings relating to wellbeing observed across studies.

Positive emotional experiences

Cultural activity was perceived to be enjoyable by older people. They described participation as making them feel happiness and joy, producing a sense of euphoria, and they often described laughing with members of the group. This reflects the quantitative findings relating to mood, which suggested an increase in positive moods and emotions as a result of taking part in cultural activity.

A number of studies reported that cultural participation helped older people to cope better with bereavement, as noted in the previous section. The knowledge that there was peer support available helped older people to cope with the negative experiences of losing a partner and created opportunities for experiencing more positive emotions.

It is important to note that emotional experiences were not universally positive. There were examples in the literature of increased anxiety as a result of unfamiliar environments, or frustration from activities perceived to be too challenging or too easy.

Sense of achievement

Participation in arts and culture was reported to offer older people opportunities to experience challenge and learn new skills and to feel a sense of broadened horizons, things that are generally seen as positive at a time when some might feel as if their opportunities are narrowing. Such experiences were seen as helping to counter stereotypes around ageing that may be held both by the older people themselves and by society in general.

Sometimes this can also act as a motivator for continued participation or a bridge to other kinds of activity, resource or support within a community. However, when experienced negatively, it led to feelings of inadequacy, failure or sadness (for example, if activities were too difficult, or when performing in public created anxiety). This impacted on participants’ desire to participate further and in some cases, caused them to withdraw.

The skills developed by older people across the duration of their cultural participation was often acknowledged by other members of the group, or members of the wider community if they shared works outside of the core group.

Strengthening of personal and collective identity

Arts and cultural participation led to older people developing greater self-esteem and building their sense of confidence, particularly social confidence. This confidence helped older people to try new things and to share their experiences with friends and family.

Older people were able to share their life stories through what they created or performed. This allowed other people to understand the rich lives of older people, particularly in projects with an intergenerational focus. In one study of indigenous older women in Canada, younger people reported that they saw older people as sources of wisdom and keepers of cultural heritage, which led to the women feeling a sense of being valued.

Building a more positive relationship with the ageing body

Older people reported that talking part in cultural activities, especially dance and singing groups, allowed them to develop a more positive relationship with their bodies. A number of older people reported that they felt more flexible and had more energy as a result of taking part in dance classes, as well as being surprised by what their bodies were still able to do given some of the physical challenges they experienced. A handful of studies also discussed the ways in which engaging with dance helped older women feel more beautiful and sensual through this renewed connection to their bodies.

However, there were also reports that arts and cultural participation could heighten older people’s awareness of the physical constraints of their bodies, especially in dance, singing and craft studies. For example, older people were impacted by stiff joints when crafting, or could feel out of breath when singing for long periods of time.

What is known about the role of digital technology for the participation of older people in arts and cultural experiences?

Unfortunately, this is a question we are currently unable to answer due to only identifying three studies that used digital technology as part of the cultural experience: one focussed on digital storytelling, the other on content creation for YouTube and the other social media. While we cannot determine any clear conclusions from this literature, we observed that engaging with culture through digital means had many of the same benefits as in person participation including, feeling a sense of connectedness and sharing life stories. Two of these studies were intergenerational in nature, and older people reported that they valued being able to learn new skills from younger people and share skills with the younger people. There were some concerns reported about data privacy but the benefits of engaging with culture digitally were more consistently reported. Overall, while there are similarities between the digital and face-to-face experiences, more research is needed to understand the differences between these experiences and any barriers or facilitators for this type of cultural participation.

This question was rated particularly highly as a priority for the cultural sector during our research shaping workshop for this review. This was primarily motivated by the context of the Covid-19 pandemic when face-to-face activity with older people was extremely limited. While we only identified three studies when we ran the searches for this review, we anticipate there will be more publications in due course on digital forms of participation that took place during the pandemic, which can be examined at a later date.

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Conclusions and implications

There is a clear interest globally in the role that cultural participation plays in the wellbeing and social connectivity of older people. The qualitative literature in this area in particular illuminates the role that cultural activity can play in empowering older people to feel more connected to their communities, especially when performing or showcasing their creative works. It also contributes to their sense of wellbeing, through affirming their sense of identity and facilitating positive emotional experiences. Although these findings reflected across these studies indicate an overwhelmingly positive benefit to the role that cultural participation plays in the wellbeing and social connectedness of older people, we have some significant concerns about the quality of a high proportion of the studies represented in this review. With this in mind, we can therefore draw the following conclusions:

1. Group-based cultural activities lead to an increase in wellbeing and sense of social connectedness for older people. The strongest evidence for this is from music-based participation in community choirs. There was much less research relating to individual cultural pursuits. Future research could therefore examine the role of both group-based and solo activities to understand more about impacts on individual wellbeing and social connectivity.
2. Older people who are female, white and aged 65-75, are the most commonly represented group within the literature. There is far less research relating specifically to men, the oldest-old, and taking into account race, ethnicity, socioeconomic status, disability etc. In order to understand the reach of cultural participation for older people, it is essential that research widens its focus to ensure that these populations are represented within the literature in the future.
3. There appears to be a need for methodological development in this area. Older people’s responses across a lot of the literature were very surface level, with some interviews reported to only last 10-20 minutes. There is a need to consider the methods that are most appropriate within this research context, as well as an acknowledgement of the ethical considerations of working with older people in a research capacity – something that was made apparent during the quality appraisal of the literature. There was also a notable absence of participatory and co-produced approaches to research, which offer older people more agency, voice and involvement in the research process. Given the cross-disciplinary nature of this research area, there is great potential in the use of well-designed mixed-methods research that brings together larger scale data with older people’s lived experiences across time.
4. A large body of the literature frames older people as a ‘burden’. A large proportion of studies frame the use of cultural participation as an intervention to prevent the need for social care services for older people. It is important to acknowledge the role of arts and culture beyond keeping older people more ‘independent’ for longer, and to consider the broader role that cultural participation in maintaining older people’s roles as active and engaged citizens within their communities.

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Next steps

Our research and evidence base for cultural value needs to respond to what works now and what needs to change in the future, so that we can support practitioners and policymakers to develop models and practices that are more robust, equitable and sustainable.

If you are aware of new publications or feel we have missed a vital piece of research or evaluation that should be included in this digest, please get in touch at: ccv@leeds.ac.uk

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Studies included in this review

1. Ali-Haapala, A., Moyle, G. and Kerr, G., 2020. Pleasurable challenges: competing with the ageing body and mind through Ballet for Seniors. Leisure Studies. 39(4), pp.532-544. DOI: 10.1080/02614367.2019.1670720
2. Anderson, S., Fast, J., Keating, N., Eales, J., Chivers, S. and Barnet, D., 2017. Translating knowledge: Promotinghealth through intergenerational community arts programming. Health Promotion Practice. 18(1), pp.15-25. DOI: 10.1177/1524839915625037
3. Barbeau A-K, Mantie R., 2019. Music Performance Anxiety and Perceived Benefits of Musical Participation Among Older Adults in Community Bands. Journal of Research in Music Education. 66(4):408-427. DOI:10.1177/0022429418799362
4. Barbeau A-K, Cossette, I., 2019. The effects of participating in a community concert band on senior citizens’ quality of life, mental and physical health. International Journal of Community Music. 12(2), pp. 269-288(20). DOI: 10.1386/ijcm.12.2.269_1
5. Beauchet, O., Bastien, T., Mittelman, M., Hayashi, Y., Hau Yan Ho, A., 2020. Participatory art-based activity, community-dwelling older adults and changes in health condition: Results from a pre–post intervention, single-arm, prospective and longitudinal study. Mauritas.134, pp. 8-14. DOI: 10.1016/j.maturitas.2020.01.006.
6. Bernard, M., Rickett, M., Amigoni, D., Munro, L., Murray, M., & Rezzano, J. , 2015. Ages and stages: the place of theatre in the lives of older people. Ageing and society, 35(6), pp.1119-1145. DOI:10.1017/s0144686x14000038
7. Bradshaw, M., Ellison, C.G., Fang, Q., Mueller C. 2015. Listening to Religious Music and Mental Health in Later Life. Gerontologist. 55(6):961-71. DOI: 10.1093/geront/gnu020.
8. Brustio, P.R., Liubicich, M.E., Chiabrero, M., Rabaglietti, E., 2018. Dancing in the golden age: a study on physical function, quality of life, and social engagement. Geriatric Nursing. 39(6), pp.635-639. DOI: 10.1016/j. gerinurse.2018.04.013.
9. Burns J, Oliver S, Karkou V., 2021. Creativity in retirement: psychosocial experiences of recently retired people participating in a creative arts project. Perspectives in Public Health. 141(5), pp.295-302. DOI:10.1177/1757913920919449
10. Collard-Stokes, G., 2020. Recreational burlesque and the aging female body: challenging perceptions. Journal of Women and Aging. DOI: 10.1080/08952841.2020.1839319
11. Coulton, S., Clift, S., Skingley, A., Rodriguez, J., 2015. Effectiveness and cost-effectiveness of community singing on mental health-related quality of life of older people: randomised controlled trial. British Journal of Psychiatry. 207(3), pp.250-5. DOI: 10.1192/bjp.bp.113.129908.
12. Creech, A., Hallam, S., Varvarigou, M., McQueen, H., Gaunt, H. 2013. Active music making: a route to enhanced subjective well-being among older people. Perspectives in Public Health. 133(1), pp.36-43. DOI:10.1177/1757913912466950.
13. Cruz-Ferreira, A., Marmeleira, J., Formigo, A., Gomes, D., Fernandes, J., 2015. Creative Dance Improves Physical Fitness and Life Satisfaction in Older Women. Research on Aging. 37(8), pp. 837-855. DOI:10.1177/0164027514568103
14. Davidson, J.W., McNamara, B., Rosenwax, L., Lange, A., Jenkins, S. and Lewin, G., 2014. Evaluating the potential of group singing. Australasian Journal on Ageing. 33(2), pp.99-104. DOI:10.1111/j.1741-6612.2012.00645.x
15. de Araujo, F.F., da Rocha, A. 2019. The redefining of later life through leisure: music and dance groups in Brazil. Leisure Studies. 38(5), pp.712-727, DOI: 10.1080/02614367.2019.1636847
16. de Medeiros, K., Mosby, A., Hanley, K.B., Pedraza, M.S., Brandt, J. 2011. A randomized clinical trial of a writing workshop intervention to improve autobiographical memory and well-being in older adults. International Journal of Geriatric Psychiatry. 26(8), pp.803-11. DOI: 10.1002/gps.2605.
17. de Vries P., 2012. Intergenerational Music Making: A Phenomenological Study of Three Older Australians Making Music With Children. Journal of Research in Music Education. 59(4), pp.339-356. DOI:10.1177/0022429411423581
18. Douse, L., Farrer, R., Aujla, I., 2020 The Impact of an Intergenerational Dance Project on Older Adults’ Social and Emotional Well-Being. Frontiers in Psychology. 16(11):561126. DOI:10.3389/fpsyg.2020.561126.
19. Fancourt, D., Tymoszuk, U., 2019. Cultural engagement and incident depression in older adults: evidence from the English Longitudinal Study of Ageing. British Journal of Psychiatry. 214(4), pp. 225-229. DOI:10.1192/bjp.2018.267.
20. Ferreira, S.M., Sayago, S., Blat, S. 2017 Older people’s production and appropriation of digital videos: an ethnographic study. Behaviour & Information Technology, 36(6), pp.557-574, DOI:10.1080/0144929X.2016.1265150
21. Gadoua, G., 2014 Making Sense through Touch. The Senses and Society, 9(3), pp. 323-341, DOI: 10.2752/174589314X14023847039719
22. Goth, U. S., and Småland, E., 2014. The role of civic engagement for men’s health and well being in Norway-a contribution to public health. International journal of environmental research and public health. 11(6), pp.6375–6387. DOI: 10.3390/ijerph110606375
23. Goulding A., 2013. How can contemporary art contribute toward the development of social and cultural capital for people aged 64 and older. Gerontologist. 53(6), pp.1009-19. DOI: 10.1093/geront/gns144.
24. Griffin, M., Harvey, K., Gillett, J., Andrews, G., 2019. Writing as/about Leisure: Connecting with Oneself and Others through Creative Practice. Leisure Sciences. DOI: 10.1080/01490400.2019.1694609
25. Hallam, S., Creech, A., 2016. Can active music making promote health and well-being in older citizens? Findings of the music for life project. London Journal of Primary Care. 8(2), pp. 21-25. DOI: 10.1080/17571472.2016.1152099
26. Hansen, P., Main, C., Hartling, L., 2021. Dance Intervention Affects Social Connections and Body Appreciation Among Older Adults in the Long Term Despite COVID-19 Social Isolation: A Mixed Methods Pilot Study. Frontiers in Psychology. Feb 25; 12:635938. DOI: 10.3389/fpsyg.2021.635938
27. Hausknecht, S., Vanchu-Orosco, M., Kaufman, D., 2019. Digitising the wisdom of our elders: Connectedness through digital storytelling. Ageing and Society, 39(12), pp.2714-2734. DOI:10.1017/S0144686X18000739
28. Heo, J., Lee, S., Im, S., Bae, J., 2021. “When I Sing, I Feel Peaceful”: Experiences of Older Choral Singers From North Korea. Journal of Applied Gerontology. Jan 27:733464820988799. DOI: 10.1177/0733464820988799.
29. Hunt, B., Truran, L., Reynolds, F., 2018. “Like a drawing of breath”: leisure-based art-making as a source of respite and identity among older women caring for loved ones with dementia, Arts & Health. 10:1,pp.29-44, DOI: 10.1080/17533015.2016.1247370
30. Johnson, J.K., Carpenter, T., Goodhart, N., Stewart, A.L., du Plessis, L., Coaston, A., Clark, K., Lazar, A., Chapline, J., 2020 Exploring the effects of visual and literary arts interventions on psychosocial well-being of diverse older adults: a mixed methods pilot study. Arts Health. 13(3), pp.263-277. DOI: 10.1080/17533015.2020.1802603.
31. Johnson, J.K., Louhivuori, J., Stewart, A.L., Tolvanen, A., Ross, L., Era, P. 2013. Quality of life (QOL) of older adult community choral singers in Finland. International Psychogeriatrics. 25(7), pp.1055-64. DOI: 10.1017/S1041610213000422.
32. Johnson, J.K., Louhivuori, J., Siljander, E., 2017. Comparison of well-being of older adult choir singers and the general population in Finland: A case-control study. Musicae Scientiae. 21(2), pp.178-194. DOI:10.1177/1029864916644486
33. Johnson, J.K., Stewart, A.L., Acree, M., Nápoles, A.M., Flatt, J.D., Max, W.B., Gregorich, S.E., 2020. A Community Choir Intervention to Promote Well-Being Among Diverse Older Adults: Results From the Community of Voices Trial. The Journal of Gerontology. Series B, Psychological sciences and social sciences. 75(3), pp.549-559. DOI: 10.1093/geronb/gby132.
34. Keisari, S., Hoffman, Y., Ring, L., Palgi, Y., 2021. The Moderating Effect of Older Adults’ Receptive Arts Engagement on the Association Between Resilience and Anxiety Symptoms During Coronavirus Breakout. The Journal of nervous and mental disease. 209(6), pp.443-448. DOI: 10.1097/NMD.0000000000001326.
35. Krause A. E., 2020. The Role and Impact of Radio Listening Practices in Older Adults’ Everyday Lives. Frontiers in psychology. 11, 603446. DOI: 10.3389/fpsyg.2020.603446
36. Krmpotich, C., Howard, H., & Knight, E. 2016. From collection to community to collections again: Urban Indigenous women, material culture and belonging. Journal of Material Culture. 21(3), pp. 343–365. DOI:10.1177/1359183515610362
37. Lamont, A., Murray, M., Hale, R., & Wright-Bevans, K., 2018. Singing in later life: The anatomy of a community choir. Psychology of Music. 46(3), pp. 424–439. DOI:10.1177/0305735617715514.
38. Liddle, J.L., Parkinson, L. and Sibbritt, D.W. 2012. Painting pictures and playing musical instruments: Change in participation and relationship to health in older women. Australasian Journal on Ageing, 31, pp. 218-221. DOI: 10.1111/j.1741-6612.2011.00574.x
39. Liddle, J.L., Parkinson, L., Sibbritt, D.W., 2013. Purpose and pleasure in late life: Conceptualising older women’s participation in art and craft activities. Journal of Aging Studies. 27(4), pp.330-8. DOI: 10.1016/j.jaging.2013.08.002.
40. Liddle, J., Parkinson, L., Sibbritt, D. 2014. Health-related factors associated with participation in creative hobbies by Australian women aged in their eighties. Arts & Health, 6:2, pp. 132-142, DOI: 10.1080/17533015.2013.808253
41. Lindblad, K., de Boise, S., 2020. Musical engagement and subjective wellbeing amongst men in the third age. Nordic Journal of Music Therapy. 29:1,pp. 20-38, DOI: 10.1080/08098131.2019.1646791
42. Lo, W. 2015. The music culture of older adults in Cantonese operatic singing lessons. Ageing and Society, 35(8), pp.1614-1634. DOI:10.1017/S0144686X14000439
43. Luyt, B., Chow, Y., Ng, K. & Lim, J., 2011. Public Library Reading Clubs and Singapore’s Elderly. Libri. 61(3), pp.205-210. DOI: 10.1515/libr.2011.017
44. MacAulay, R. K., Edelman, P., Boeve, A., Sprangers, N., & Halpin, A., 2019. Group music training as a multimodal cognitive intervention for older adults. Psychomusicology: Music, Mind, and Brain. 29(4), pp. 180–187. DOI: 10.1037/pmu0000239
45. Maidment, J., Macfarlane, S., 2011. Crafting Communities: Promoting Inclusion, Empowerment, and Learning between Older Women. Australian Social Work. 64:3, pp. 283-298, DOI: 10.1080/0312407X.2010.520087
46. Man, D.W., Lai, F.H., Yu, E.C., Lee, G.Y., 2021. Effects of traditional Cantonese opera songs on Cantonese-speaking, community-dwelling older adults’ cognitive and psychological function, well-being, and health. Ageing and Mental Health. 19, pp.1-13. DOI: 10.1080/13607863.2021.1871880.
47. Maury, S., and Rickard, N., 2020. The Benefits of Participation in a Choir and an Exercise Group on Older Adults’ Wellbeing in a Naturalistic Setting. Musicae Scientiae. DOI:10.1177/1029864920932633
48. Meeks, S., Vandenbroucke, R. J., Shryock, S. K., 2020. Psychological benefits of attending the theatre associated with positive affect and well-being for subscribers over age 60. Aging & mental health, 24(2), pp.333–340. DOI: 10.1080/13607863.2018.1534082
49. Moody, E., and Phinney, A., 2012. A community-engaged art program for older people: fostering social inclusion. Canadian journal on aging = La revue canadienne du vieillissement. 31(1), pp.55–64. DOI: 10.1017/S0714980811000596
50. Moore, R. C., Straus, E., Dev, S. I., Parish, S. M., Sueko, S., Eyler, L. T., 2017. Development and Pilot Randomized Control Trial of a Drama Program to Enhance Well-being Among Older Adults. The Arts in psychotherapy. 52, pp. 1–9. DOI: 10.1016/j.aip.2016.09.007
51. O’shea, E., Léime, Á., 2012. The impact of the Bealtaine arts programme on the quality of life, wellbeing and social interaction of older people in Ireland. Ageing and Society, 32(5), pp. 851-872. DOI:10.1017/S0144686X11000717
52. Olsson, E.A., Heikkinen, S., 2019 “I will never quit dancing”. The emotional experiences of social dancing among older persons. Journal of Aging Studies. 51, 100786. DOI: 10.1016/j.jaging.2019.100786
53. Owen-Booth, B., Lewis, E., 2020. An exploratory study of older persons’ perceptions of engaging in line dancing classes. Journal of Occupational Science. 27:2, pp.216-221, DOI: 10.1080/14427591.2019.1654403
54. Pentikäinen, E., Pitkäniemi, A., Siponkoski, S. T., Jansson, M., Louhivuori, J., Johnson, J. K., Paajanen, T., & Särkämö, T., 2021. Beneficial effects of choir singing on cognition and well-being of older adults: Evidence from a crosssectional study. PloS one, 16(2), e024566. DOI: 10.1371/journal.pone.0245666
55. Perkins, R., Williamon, A., 2014. Learning to make music in older adulthood: A mixed-methods exploration of impacts on wellbeing. Psychology of Music. 42(4), pp.550–567. DOI:10.1177/0305735613483668
56. Phinney, A., Moody, E., Small, J., 2014. The Effect of a Community-Engaged Arts Program on Older Adults’ Well-being. Canadian Journal on Aging / La Revue Canadienne Du Vieillissement. 33(3), pp.336-345. DOI:10.1017/ S071498081400018X
57. Rose, E., Lonsdale, S., 2016. Painting place: Re-imagining landscapes for older people’s subjective wellbeing. Health & place. 40, pp.58–65. DOI:10.1016/j.healthplace.2016.05.002
58. Schneider, B., McCoy, L., 2018. Serious Leisure, Play and the Construction of Community among Older Adult Square Dancers, Activities. Adaptation & Aging. 42:1, pp.54-68, DOI:10.1080/01924788.2017.1376178
59. Skingley, A., Martin, A., Clift, S., 2016. The Contribution of Community Singing Groups to the Well-Being of Older People: Participant Perspectives From the United Kingdom. Journal of applied gerontology: the official journal of the Southern Gerontological Society. 35(12), pp.1302–1324. DOI: 10.1177/0733464815577141
60. Southcott, J., Joseph, D., 2015. Singing in La Voce Della Luna Italian women’s choir in Melbourne, Australia. International Journal of Music Education. 33(1), pp.91–102. DOI: 10.1177/0255761414546244
61. Southcott, J., & Nethsinghe, R. 2019. Resilient senior Russian-Australian voices: “we live to sing and sing to live”. Applied Research in Quality of Life. 14(1), pp.39–58. DOI:10.1007/s11482-017-9580-1
62. Stevens-Ratchford, R. G., 2016. Ballroom Dance: Linking Serious Leisure to Successful Aging. The International Journal of Aging and Human Development. 83(3),pp. 290–308. DOI:10.1177/0091415016652405
63. Teater, B., & Baldwin, M. J., 2014. Singing for successful ageing: The perceived benefits of participating in the golden oldies community-arts programme. The British Journal of Social Work,.44(1), pp. 81-99. DOI:10.1093/bjsw/bcs095
64. Todd, C., Camic, P.M., Lockyer, B., Thomson, L., Chatterjee, H. 2017. Museum-based programs for socially isolated older adults: Understanding what works.Health & Place. 48, pp. 47-55. DOI: 10.1016/j.healthplace.2017.08.005
65. Toepoel, V., 2011. Cultural participation of older adults: investigating the contribution of lowbrow and highbrow activities to social integration and satisfaction with life. 10(2), pp.123-129. DOI:10.1515/ijdhd.2011.027
66. Tymoszuk, U., Perkins, R., Fancourt, D., & Williamon, A., 2020. Cross-sectional and longitudinal associations between receptive arts engagement and loneliness among older adults. Social psychiatry and psychiatric epidemiology. 55(7), pp.891–900. DOI:10.1007/s00127-019-01764-0
67. Tymoszuk, U., Perkins, R., Spiro, N., Williamon, A., & Fancourt, D., 2020. Longitudinal Associations Between Short-Term, Repeated, and Sustained Arts Engagement and Well-Being Outcomes in Older Adults. The journals of gerontology. Series B, Psychological sciences and social sciences. 75(7), pp.1609–1619. DOI:10.1093/geronb/gbz085
68. Tzanidaki, D., Reynolds, F., 2011. Exploring the Meanings of Making Traditional Arts and Crafts among Older Women in Crete, Using Interpretative Phenomenological Analysis. British Journal of Occupational Therapy. 74(8), pp. 375–382. DOI: 10.4276/030802211X13125646370852
69. Vogelpoel, N., Jarrold, K. 2014. Social prescription and the role of participatory arts programmes for older people with sensory impairments. Journal of Integrated Care. 22(2), pp. 39-50. DOI: 10.1108/JICA-01-2014-0002
70. Waddington-Jones, C., King, A., & Burnard, P., 2019. Exploring Wellbeing and Creativity Through Collaborative Composition as Part of Hull 2017 City of Culture. Frontiers in psychology. 10, 548. DOI: 10.3389/fpsyg.2019.00548
71. Wlodarczyk, N. 2020 “It’s My Time”: Older Adults’ Experiences and Perceived Benefits of Participation in an Intergenerational Rock Band. Music Therapy Perspectives. 38(2). pp.187–194. DOI: 10.1093/mtp/miz021

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Appendix 1

A full list of cultural experiences and participation types included in the studies.

Cultural category	Participation type
Craft	Community-based craft groups
Creative writing	Library-based guided writing group Autobiographical writing
Dance	Square dancing Couple dance Ballroom dancing Line dancing Ballet Group dance Burlesque dance Creative dance
Digital content creation	Digital video production for YouTube and Facebook
Digital storytelling	Creating multimedia stories
Festival	Creative arts festival for older people
Gallery	Group visits to contemporary art gallery Group visits to gallery venues
Heritage	Voluntary activities involved in preservation and restoration of historic ships
Library	Group-based reading club
Mixed activity	Creative hobbies (arts, craft) Painting or playing musical instrument Ballroom dancing and music social groups Community-engaged art making Receptive arts activities Intergenerational programme of dance and photography Visits to range of cultural venues Arts programme as part of social prescribing initiative Museum-based art making programme
Museums	Object handling in museum context Group museum visits
Music	Intergenerational music-making programme Community concert band Community choir Composition residencies Range of active music activities and performances Music tuition Operatic singing Intergenerational rock band Religious music listening
Participatory arts	Museum-based participatory arts programme
Radio	Radio listening
Theatre	Intergenerational community theatre Theatre attendance Community-based theatre
Visual arts	Community-engaged art making Participatory painting programme