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1.
BMC Public Health ; 20(1): 208, 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32046670

RESUMO

BACKGROUND: Arts engagement within communities is ubiquitous across cultures globally and previous research has suggested its benefits for mental health and wellbeing. However, it remains unclear whether these benefits are driven by arts engagement itself or by important confounders such as socio-economic status (SES), childhood arts engagement, previous mental health, personality, or self-selection bias. The aim of this study is to use fixed effects models that account for unidentified time-constant confounding measures to examine the longitudinal association between arts (frequency of both arts participation and cultural attendance), mental distress, mental health functioning and life satisfaction. METHODS: Data from 23,660 individuals (with a mean age of 47 years) included in the UK Understanding Society wave 2 (2010-2012) and wave 5 (2013-2015) were analyzed. Aside from controlling for all time-constant variables using fixed-effects models, we additionally adjusted for time-varying demographic factors (e.g. age and marital status), health behaviors and social support variables. RESULTS: After controlling for all time-constant variables and identified time-varying confounders, frequent arts participation and cultural attendance were associated with lower levels of mental distress and higher levels of life satisfaction, with arts participation additionally associated with better mental health functioning. Health-related and social time-varying factors were shown partly but not wholly to explain the observed associations. CONCLUSION: Arts engagement amongst the population as a whole may help enhance positive mental health and life satisfaction, and protect against mental distress. These results are independent of a wide range of time-constant confounding factors.

2.
Prev Med ; 130: 105889, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31765711

RESUMO

Leading a heathy lifestyle in adolescence is vital to individual health in later life. Drawing upon various existing theories, this study hypothesised that engagement in reading for pleasure may enhance healthy behaviours amongst young people. Data were analysed from 11,180 children in the UK Millennium Cohort Study and logistic regressions were used to examine the association between reading frequency at age 11 and health behaviours at age 14. Reading most days was associated with lower odds of trying a cigarette and alcohol and a higher likelihood of having two portions of fruit per day independent of confounding factors. However, spending more time reading was associated with less time spent engaging in moderate to vigorous physical activity. Our findings suggest the importance of further studies exploring the potential health benefits of reading amongst young people.

3.
J Epidemiol Community Health ; 74(1): 71-77, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31662344

RESUMO

BACKGROUND: There is increasing interest in the potential health benefits of referring older adults to engage in community leisure activities ('social prescribing') to help promote healthy cognitive ageing. However, it remains unclear whether beneficial effects of community engagement are independent of the well-known protective effects of broader structural, functional and subjective social factors. METHODS: We analysed data from 9550 adults aged 50+ from the English Longitudinal Study of Ageing, with baseline from 2004 to 2005. We assessed associations between different types of community engagement and dementia incidence over a 12-year period. Specifically, we used Cox proportional hazards models, competing risk regressions models, and modified Fine and Gray subdistribution hazards models while controlling for all identified demographic, health-related, and social covariates. RESULTS: Community cultural engagement (eg, visiting museums, galleries, the theatre) was associated with a lower hazard of developing dementia in older age independent of demographic, health-related and a broad range of social factors, using all three statistical approaches (fully adjusted Cox models: HR 0.58, 95% CI 0.41 to 0.80). Community group engagement (eg, attending clubs or societies) was only associated with dementia prior to adjustment for social factors. Results were robust to sensitivity analyses considering reverse causality, over-adjustment and baseline cognitive function. CONCLUSION: It is not just social factors that are associated with reduced risk of dementia onset, but community engagement may also be protective, particularly when relating to cultural activities. These findings are of relevance when considering the current interest in social prescribing to support healthy ageing.

4.
Brain Behav Immun ; 83: 146-152, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31604140

RESUMO

OBJECTIVES: There is a large literature linking inflammation with mental ill health, but a much smaller literature focusing on mental wellbeing. Specifically, it remains unclear whether mental wellbeing is longitudinally and independently associated with inflammation or only via associated changes in mental ill health. METHODS: This study used data from 8780 adults aged 50+ in the English Longitudinal Study of Ageing. Hedonic wellbeing (both positive affect and life satisfaction) and eudemonic wellbeing (self-realisation and control-autonomy) were measured at data collection waves 2 (2004/05), 4 (2008/09) and 6 (20012/13), along with measures of C-reactive protein (CRP), fibrinogen and white blood cells (WBC). Fixed effects modelling was performed to identify the longitudinal relationship between wellbeing and inflammation, adjusting for time-varying mental ill health and other identified confounders. RESULTS: Both measured aspects of hedonic wellbeing were associated with lower WBC count, independent of mental ill health. For life satisfaction, this relationship was explained by confounders, whilst for positive affect it persisted. Both measured aspects of eudemonic wellbeing were associated with lower CRP, fibrinogen and WBC, independent of mental ill health. For control-autonomy, this relationship was explained by confounders, whilst for self-realisation it persisted. Results were present in both men and women, although more strongly in men, and were robust to a range of sensitivity analyses. CONCLUSIONS: This study builds on the strong literature showing a relationship between mental ill health and inflammation by showing that there is also an apparently independent relationship between mental wellbeing, in particular eudemonic wellbeing, and inflammation that is unexplained by socio-economic or other time-constant factors and in some instances persists independent of time-varying confounders.

5.
Wellcome Open Res ; 4: 156, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31840089

RESUMO

Economic, physical, built, cultural, learning, social and service environments have a profound effect on lifelong health. However, policy thinking about health research is dominated by the 'biomedical model' which promotes medicalisation and an emphasis on diagnosis and treatment at the expense of prevention. Prevention research has tended to focus on 'downstream' interventions that rely on individual behaviour change, frequently increasing inequalities. Preventive strategies often focus on isolated leverage points and are scattered across different settings. This paper describes a major new prevention research programme that aims to create City Collaboratory testbeds to support the identification, implementation and evaluation of upstream interventions within a whole system city setting. Prevention of physical and mental ill-health will come from the cumulative effect of multiple system-wide interventions. Rather than scatter these interventions across many settings and evaluate single outcomes, we will test their collective impact across multiple outcomes with the goal of achieving a tipping point for better health. Our focus is on early life (ActEarly) in recognition of childhood and adolescence being such critical periods for influencing lifelong health and wellbeing.

6.
Cyberpsychol Behav Soc Netw ; 22(12): 753-760, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31841647

RESUMO

Family belonging may influence relationships between the amount of time spent on social networking sites (SNS) and well-being. We examined the SNS and well-being association among young adults and investigated whether different markers of family belonging moderated this association. SNS, well-being, and family data (n = 2,229) were collected from adults aged 16-21 years living with their parent(s) in the United Kingdom. Participants were classed as nonusers (0 hours/weekday spent chatting or interacting with friends through social Web sites), moderate (nonzero to 4 hours/weekday), or heavy users (4+ hours/weekday). Multivariable linear regressions examined the SNS use and well-being associations; interaction terms tested whether these varied by family belonging (family meal frequency, strength of family support, and importance of family to personal identity). Well-being scores were lower for heavy users of SNS compared with moderate users (p = 0.044), and for those sharing few or no family meals (p < 0.001). The SNS use and well-being association was significantly moderated by family meal frequency (p = 0.009). Among those reporting no family meals, well-being scores were lower for heavy users versus nonusers (22.4 vs. 25.3). Well-being scores were similar across the SNS use categories among those having more family meals. Among heavy users of SNS, young adults having no family meals may be particularly vulnerable to the harms of being online. Our findings highlight the importance of minimizing the harms of heavy SNS use, including support for families to enable them to develop and build young adults' resilience to the stresses and anxieties that potentially accompany online social networking.

7.
BMJ ; 367: l6377, 2019 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-31852659

RESUMO

OBJECTIVE: To explore associations between different frequencies of arts engagement and mortality over a 14 year follow-up period. DESIGN: Prospective cohort study. PARTICIPANTS: English Longitudinal Study of Ageing cohort of 6710 community dwelling adults aged 50 years and older (53.6% women, average age 65.9 years, standard deviation 9.4) who provided baseline data in 2004-05. INTERVENTION: Self reported receptive arts engagement (going to museums, art galleries, exhibitions, the theatre, concerts, or the opera). MEASUREMENT: Mortality measured through data linkage to the National Health Service central register. RESULTS: People who engaged with receptive arts activities on an infrequent basis (once or twice a year) had a 14% lower risk of dying at any point during the follow-up (809/3042 deaths, hazard ratio 0.86, 95% confidence interval 0.77 to 0.96) compared with those who never engaged (837/1762 deaths). People who engaged with receptive arts activities on a frequent basis (every few months or more) had a 31% lower risk of dying (355/1906 deaths, 0.69, 0.59 to 0.80), independent of demographic, socioeconomic, health related, behavioural, and social factors. Results were robust to a range of sensitivity analyses with no evidence of moderation by sex, socioeconomic status, or social factors. This study was observational and so causality cannot be assumed. CONCLUSIONS: Receptive arts engagement could have a protective association with longevity in older adults. This association might be partly explained by differences in cognition, mental health, and physical activity among those who do and do not engage in the arts, but remains even when the model is adjusted for these factors.


Assuntos
Arte , Participação da Comunidade/estatística & dados numéricos , Mortalidade/tendências , Idoso , Cognição , Inglaterra/epidemiologia , Exercício , Feminino , Seguimentos , Comportamentos Relacionados com a Saúde , Humanos , Longevidade , Estudos Longitudinais , Masculino , Saúde Mental , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Medicina Estatal
9.
Sci Rep ; 9(1): 14236, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31578344

RESUMO

Arts engagement has been shown to have benefits for young people's psychological and behavioural adjustment. However, it is unknown whether it is frequency of arts engagement or individual ability in arts activities that is associated with these benefits. This study therefore examines the link between arts ability and children's behavioural difficulties and self-esteem independent of frequency of engagement. We analysed data from the 1970 British Cohort Study with an overall sample size of 7700 for the behavioural difficulties outcome, and of 4991 for the self-esteem outcome. Baseline measures were taken when the children were aged 10 and followed up at age 16. OLS regression analysis adjusted for identified confounders shows that ability in the arts at age 10 was associated with a lower level of behavioural difficulties at age 16 independent of baseline behaviours, identified confounders and frequency of arts engagement. An association between arts ability and self-esteem was only found amongst children who have higher educational ability. These result suggest that there may be a value to encouraging the cultivation of arts skills at the onset of adolescence as a way of helping to foster children's positive behavioural development.

11.
Artigo em Inglês | MEDLINE | ID: mdl-31511928

RESUMO

PURPOSE: Loneliness in older adulthood is a societal and public health challenge warranting identification of sustainable and community-based protective factors. This study investigated whether frequency of receptive arts engagement is associated with lower odds of loneliness in older adults. METHODS: We used data of respondents from waves 2 (2004-2005) and 7 (2014-2015) of the English Longitudinal Study of Ageing (ELSA) and examined cross-sectional (n = 6222) and longitudinal (n = 3127) associations between frequency of receptive arts engagement (including visits to the cinema, museums/galleries/exhibitions, theatre/concerts/opera) and odds of loneliness (cut-off ≥ 6 on three-item short form of the Revised UCLA Loneliness Scale). We fitted logistic regression models adjusted for a range of sociodemographic, economic, health and social, community and civic engagement factors. RESULTS: Cross-sectionally, we found dose-response negative associations between engagement with all receptive arts activities and odds of loneliness. Prospectively, in the fully-adjusted models we found most robust evidence for the negative association between engagement with museums/galleries/exhibitions and odds of loneliness (OR = 0.68, 95% CI 0.48-0.95) for those who engaged every few months or more often compared with those who never engaged. We found weaker evidence for lower odds of loneliness for more frequent engagement with theatre/concerts/opera. CONCLUSIONS: Frequent engagement with certain receptive arts activities and venues, particularly museums, galleries and exhibitions, may be a protective factor against loneliness in older adults. Future research is needed to identify the mechanisms through which this process may occur, leading to better understanding of how arts activities and venues can reduce loneliness among older adults.

12.
Brain Behav Immun ; 82: 224-229, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31491488

RESUMO

OBJECTIVES: This study aimed to explore time-varying associations between social engagement, living status and loneliness and neuro-immune markers in older adults, and ascertain whether results are explained by socioeconomic position, health behaviours or depression. METHODS: We analysed blood samples from 8780 adults aged 50 and above from the English Longitudinal Study of Ageing across three waves of data collection: 2004/5, 2008/9 and 2012/2013. We used fixed effects modelling to estimate the relationship between loneliness, social isolation, living alone and levels of fibrinogen, insulin like growth factor-1 (IGF-1), white blood cell (WBC) count and C-reactive protein (CRP), whilst accounting for all time-invariant and identified time-varying confounders. RESULTS: Higher levels of social engagement and living with somebody were associated with lower levels of CRP, fibrinogen and WBC, while lower levels of loneliness were associated with higher levels of IGF-1. These associations were found to be independent of time-invariant factors such as gender, medical history, previous patterns of social behaviours, unobserved aspects of social class, and genetics, and time-varying factors such as income, physical health, health behaviours, and depression. CONCLUSIONS: Aspects of social engagement were associated with lower levels of inflammation whilst loneliness was inversely related to the regulation of inflammation. This suggests there could be different biological pathways involved in objective and subjective aspects of social connections.

13.
BMJ Open ; 9(8): e026995, 2019 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-31401592

RESUMO

OBJECTIVE: The mental health challenges facing people who care for somebody with cancer are well documented. While many support interventions focus on provision of information or cognitive behavioural therapy, the literature suggests that psychosocial interventions could also be of value, especially given the low social support frequently reported by carers. Singing is a psychosocial activity shown to improve social support, increase positive emotions, and reduce fatigue and stress. This study explored whether weekly group singing can reduce anxiety, depression and well-being in cancer carers over a 6-month period. DESIGN: A multisite non-randomised longitudinal controlled study. SETTING: The Royal Marsden National Health Service Trust in Greater London. PARTICIPANTS: 62 adults who currently care for a spouse, relative or close friend with cancer who had not recently started any psychological therapy or medication. INTERVENTIONS: On enrolment, participants selected to join a weekly community choir for 12 weeks (n=33) or continue with life as usual (n=29). OUTCOME MEASURES: The primary outcome was mental health using the Hospital Anxiety and Depression Scale. The secondary outcome was well-being using the Warwick Edinburgh Mental Wellbeing Scale. Using linear mixed effects models, we compared the change in mental health and well-being over time between the two groups while adjusting for confounding variables including demographics, health-related variables, musical engagement and length of time caring. RESULTS: Participants in the choir group showed a significantly greater decrease in anxiety over time than participants in the control group (B=-0.94, SE=0.38, p=0.013) and a significantly greater increase in well-being (B=1.25, SE=0.49, p=0.011). No changes were found for depression. Sub-group analyses showed carers with anxiety or below-average well-being were most likely to benefit. CONCLUSIONS: This study builds on previous research showing the mental health benefits of singing for people with cancer by showing that weekly singing can also support anxiety and well-being in cancer carers.

14.
PLoS One ; 14(8): e0220195, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31369590

RESUMO

BACKGROUND: Social engagement protects against dementia onset. Less is known about patterns of social engagement around the time of dementia diagnosis. We investigated face-to-face and telephone contact at three times (pre-diagnosis, at report of diagnosis, 2 years post-diagnosis) in individuals who developed dementia and a comparison group. METHODS: Social engagement was assessed at waves 2-7 of the English Longitudinal Study of Ageing in 4171 individuals aged 50 and older. Dementia was ascertained by either self-reported physician diagnosis or through an informant evaluation of a participant's functional and cognitive performance compared with a few years earlier. Generalized estimating equations were used to examine differences by group, time, and group-by-time interactions. RESULTS: The dementia group reported less face-to-face (p < 0.001) and telephone contact (p < 0.001) than the dementia-free group pre-diagnosis. The dementia group experienced greater reductions in social engagement leading up to dementia diagnosis and in the 2 years following diagnosis (p's < 0.001). CONCLUSION: Given that social engagement reduces dementia risk and supports the lived experience of people with dementia, it is important to find ways of promoting social interaction in older adults.

15.
Soc Sci Med ; 236: 112425, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31336219

RESUMO

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.

16.
Sci Rep ; 9(1): 9897, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31289298

RESUMO

The ability to effectively regulate our emotions has been shown to be impaired in people with depression. Arts activities have been found to improve depression, but whether people with depression make differential use of emotion regulation strategies (ERSs) when engaging in the arts remains unclear. This study analysed data from 11,248 individuals with depression who were matched on demographics, personality and arts experience with a further 11,248 individuals without depression. We found a significantly lower overall use of self-reported ERSs when engaging in arts amongst those with depression; specifically lower use of approach strategies (e.g. reappraisal) and self-development strategies (e.g. improved self-esteem), but the same use of avoidance strategies (e.g. distraction). However, these differences were very slight (very small effect size and <1% difference). This suggests that people with depression still experience benefits for emotion regulation, which could help to explain the beneficial effects of arts interventions reducing symptoms of depression.

17.
Artigo em Inglês | MEDLINE | ID: mdl-31287550

RESUMO

OBJECTIVES: This study investigated whether frequency of receptive arts engagement over 10 years contributes to experienced, evaluative and eudaimonic well-being in older adults. METHODS: We used repeated data of 3,188 respondents from waves 2 to 7 (2004/2005-2014/2015) of the English Longitudinal Study of Ageing. We examined longitudinal associations between short-term (frequent engagement at one wave), repeated (frequent engagement at 2-3 waves), and sustained (frequent engagement at 4-6 waves) arts engagement and experienced, evaluative and eudaimonic well-being. We fitted linear and logistic regression models adjusted for baseline well-being and a number of sociodemographic, economic, health and social engagement factors. RESULTS: In the fully-adjusted models, short-term engagement was not longitudinally associated with well-being, but repeated engagement with the theatre/concerts/opera and museums/galleries/exhibitions was associated with enhanced eudaimonic well-being and sustained engagement with these activities was associated with greater experienced, evaluative and eudaimonic well-being.

18.
Artigo em Inglês | MEDLINE | ID: mdl-31243022

RESUMO

OBJECTIVES: Bereavement is associated with negative affective, cognitive, behavioural and physiological responses. However, factors, such as coping, self-efficacy and self-esteem, can buffer negative effects of grief, and can be increased through mutual support interventions, such as shared leisure activities. This study used a non-randomised controlled design to explore the effects of group choir singing on mental health among people who have been bereaved due to cancer. METHODS: A total of 58 adults bereaved in the last 5 years who had not started psychological therapy in the last 12 weeks or medication for anxiety or depression in the last month were recruited and elected to join a choir (n=29) or participate in the non-intervention control group (n=29). Joining a choir involved engaging in 90 min weekly singing and social sessions for 12 weeks with a post-intervention assessment at week 24. We used linear mixed effects models adjusted for demographics, health-related variables, musical engagement and time since bereavement to model changes over time between the two groups in symptoms of anxiety, depression, well-being, self-efficacy and self-esteem. RESULTS: Participants who sang in a choir had more stable symptoms of depression and levels of well-being, as well as gradual improvements in their sense of self-efficacy and self-esteem over the 24 weeks. In contrast, those in the control group showed gradual increases in depressive symptoms, reductions in levels of well-being and self-esteem and no improvement in their self-efficacy. These results were independent of all covariates. CONCLUSIONS: Weekly group singing could be a promising mutual support intervention for people experiencing grief. TRIAL REGISTRATION NUMBER: NCT02756780.

19.
J Epidemiol Community Health ; 73(10): 906-912, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31243046

RESUMO

BACKGROUND: Considerations of modifiable risk factors for the development of disability in older age have traditionally focused on physical activity. However, there is increasing evidence that psychological, social, and cognitive factors also help to maintain functional independence. This study compared the protective associations between physical and social activities and disability onset. METHODS: We analysed data from 5434 adults aged 50+ years tracked biennially from 2004/2005 to 2016/2017, measuring self-reported difficulty in carrying out any basic activities of daily living (ADLs) or instrumental ADLs. Exposures included mild, moderate and vigorous physical activity, frequency of socialising with friends/family, cultural engagement (eg, going to the theatre/museums/concerts), and participation in community groups. RESULTS: Over the 12-year follow-up, 1945 adults developed disability. Using Cox proportional hazards regression models adjusted for all identified demographic and health-related variables, vigorous exercise or activity once a month or more (HR 0.82, 95% CI 0.71 to 0.96), moderate exercise or activity more than once a week (HR 0.81, 95% CI 0.67 to 0.97) or cultural engagement once or twice a year or more (HR 0.84, 95% CI 0.73 to 0.97) were associated with a lower hazard of developing disability. Other exposures did not show independent protective associations. Results were robust to sensitivity analyses considering reverse causality and exploring the potential confounding role of time-invariant factors, such as socioeconomic status. CONCLUSION: These results suggest the importance of either developing multimodal interventions to protect against disability and promote healthy ageing or promoting greater physical and social engagement with existing community activities among older adults.

20.
Front Psychol ; 10: 778, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31024405

RESUMO

Over the past two decades, many musical experiences have become mediated by digital technology, including the distribution of music online, the generation of new content and participation in virtual musical experiences. However, whether virtual musical experiences lead to different experiences of social presence or differential use of emotion regulation strategies (ERSs) compared to live musical experiences remains un-researched. We compared the experiences of 1,158 singers in a virtual choir (VC) with the experiences of 1,158 singers from a live choir using propensity score matching based on a range of demographic, social and musical factors. Participants in VCs reported a slightly greater feeling of social presence than participants in live choirs [t(1157) = -19.85, p < 0.002]. They also made less use of overall ERSs [t(1157) = 3.10, p = 0.002], avoidance strategies [t(1157) = 4.51, p < 0.001], and approach strategies [t(1157) = 3.34, p < 0.001]. However, they made greater use of self-development strategies [t(1157) = -3.11, p = 0.002]. Social presence was associated with greater use of all ERSs. This study showed that although a sense of social presence in a choir is not reduced by engagement in VCs compared to live choirs, there is a lowered use of ERSs when engaging in VCs. However, as the difference in use of ERSs is relatively modest, virtual musical experiences may still have a role to play in supporting those who cannot engage in live experiences such as people who are socially isolated.

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