Dataset Information

Cultural Engagement Is a Risk-Reducing Factor for Frailty Incidence and Progression.

ABSTRACT:

Objectives

Given that frailty is a multifaceted health condition of increasing importance to policy-makers and care providers, it is relevant to consider whether multimodal interventions could provide combined psychophysiological support. As studies have demonstrated the beneficial effects of cultural engagement (including visiting museums/theatre/cinema) for many of the components of frailty, this study sought to explore whether community cultural engagement is associated both with a reduced risk of becoming frail and a slower trajectory of frailty progression in older adults.

Methods

We used data from the English Longitudinal Study of Ageing to measure frequency of cultural engagement and both incident frailty and frailty progression over the following 10 years in 4,575 adults.

Results

Our analyses used competing risks regression models and multilevel growth curve models adjusting for socioeconomic, health behaviors, social confounders, and subthreshold symptoms of frailty. There was a dose-response relationship between increasing frequency of cultural engagement and both incidence and progression of frailty (attendance every few months or more: incidence subhazard ratio = 0.79, 95% confidence interval [CI] = 0.63 to 0.996; trajectory coefficient = -0.0039, 95% CI = -0.0059 to -0.0019).

Discussion

Older adults who engaged in cultural activities every few months or more had a reduced risk of becoming frail and a slower progression of frailty over time. Findings are in line with current calls for multimodal, multifactor, community approaches to support health in older age.

SUBMITTER: Rogers NT

PROVIDER: S-EPMC7768715 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Cultural Engagement Is a Risk-Reducing Factor for Frailty Incidence and Progression.

Rogers Nina Trivedy NT Fancourt Daisy D

The journals of gerontology. Series B, Psychological sciences and social sciences 20200201 3

<h4>Objectives</h4>Given that frailty is a multifaceted health condition of increasing importance to policy-makers and care providers, it is relevant to consider whether multimodal interventions could provide combined psychophysiological support. As studies have demonstrated the beneficial effects of cultural engagement (including visiting museums/theatre/cinema) for many of the components of frailty, this study sought to explore whether community cultural engagement is associated both with a re ...[more]

PMID: 30624696

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Project description:BackgroundThe use of mobile health (mHealth) interventions, including smartphone apps, for the prevention of cardiovascular disease (CVD) has demonstrated mixed results for obesity, hypercholesterolemia, diabetes, and hypertension management. A major factor attributing to the variation in mHealth study results may be mHealth user engagement.ObjectiveThis systematic review aims to determine if user engagement with smartphone apps for the prevention and management of CVD is associated with improved CVD health behavior change and risk factor outcomes.MethodsWe conducted a comprehensive search of PubMed, CINAHL, and Embase databases from 2007 to 2020. Studies were eligible if they assessed whether user engagement with a smartphone app used by an individual to manage his or her CVD risk factors was associated with the CVD health behavior change or risk factor outcomes. For eligible studies, data were extracted on study and sample characteristics, intervention description, app user engagement measures, and the relationship between app user engagement and the CVD risk factor outcomes. App user engagement was operationalized as general usage (eg, number of log-ins or usage days per week) or self-monitoring within the app (eg, total number of entries made in the app). The quality of the studies was assessed.ResultsOf the 24 included studies, 17 used a randomized controlled trial design, 4 used a retrospective analysis, and 3 used a single-arm pre- and posttest design. Sample sizes ranged from 55 to 324,649 adults, with 19 studies recruiting participants from a community setting. Most of the studies assessed weight loss interventions, with 6 addressing additional CVD risk factors, including diabetes, sleep, stress, and alcohol consumption. Most of the studies that assessed the relationship between user engagement and reduction in weight (9/13, 69%), BMI (3/4, 75%), body fat percentage (1/2, 50%), waist circumference (2/3, 67%), and hemoglobin A1c (3/5, 60%) found statistically significant results, indicating that greater app user engagement was associated with better outcomes. Of 5 studies, 3 (60%) found a statistically significant relationship between higher user engagement and an increase in objectively measured physical activity. The studies assessing the relationship between user engagement and dietary and diabetes self-care behaviors, blood pressure, and lipid panel components did not find statistically significant results.ConclusionsIncreased app user engagement for prevention and management of CVD may be associated with improved weight and BMI; however, only a few studies assessed other outcomes, limiting the evidence beyond this. Additional studies are needed to assess user engagement with smartphone apps targeting other important CVD risk factors, including dietary behaviors, hypercholesterolemia, diabetes, and hypertension. Further research is needed to assess mHealth user engagement in both inpatient and outpatient settings to determine the effect of integrating mHealth interventions into the existing clinical workflow and on CVD outcomes.

Project description:There is a growing body of literature suggesting that the arts can support mental health. However, both arts participation and cultural engagement are unevenly patterned across the population, with a strong social gradient. This social gradient is also evident in mental health. So it remains unclear whether the relationship between arts engagement and mental health can in fact be explained by socio-economic status (SES). This study explores this question specifically in relation to cultural engagement (e.g. visiting museums/galleries/cinema/theatre/concerts) using data from 8780 adults aged 50 + from the English Longitudinal Study of Ageing. We used a statistical triangulation approach, running three separate sets of analyses that each have different strengths and address different statistical limitations or biases. Using logistic regression, the relationship between cultural engagement and mental health was still present when including covariates relating to SES, and there was no evidence of moderation by SES either through the inclusion of interaction terms or stratification. Using propensity score matching, matching participants based on their SES, we also consistently found evidence of the relationship. Finally, using fixed-effects regression which takes account of all time-invariant factors (which include multiple aspects of SES) even if unobserved, we also found no attenuation of the relationship. Overall, this confirms previous reports that cultural engagement is linked with a lower odds of depression amongst adults aged 50 + by demonstrating a robust association in a nationally-representative sample of older adults. While SES does explain around half of the association between cultural engagement and depression, we found no evidence that it either acts as a moderator or the main explanatory factor, with independent associations maintained across all three approaches. However, the fact that higher SES is associated with more frequent engagement indicates that, in population terms, SES is still an important determinant of the salutogenic impact of culture.

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Dataset Information

Cultural Engagement Is a Risk-Reducing Factor for Frailty Incidence and Progression.

Objectives

Methods

Results

Discussion

Publications

Cultural Engagement Is a Risk-Reducing Factor for Frailty Incidence and Progression.

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