Background 1 in 4 older adults in the UK is affected by depression, which is associated with a range of physical health outcomes. So there is a recognised need to identify behavioural interventions that might protect against the development of depression. Over the past decade, research has demonstrated the effects of community cultural engagement (which combines a number of protective factors including social interaction, cognitive stimulation and gentle physical activity) on the treatment of depression. This has included studies on active cultural engagement (such as singing, dancing and crafts) and receptive cultural engagement (including visiting museums and galleries). But as yet there is little research on community cultural engagement and prevention of depression. Consequently, this study aimed to explore whether cultural engagement in older adults is associated with a reduced risk of developing depression over the following decade.

Methods This study used data from the English Longitudinal Study of Ageing: specifically data from Wave 2 (2004/2005) across every biennial wave through to Wave 7 (2014/2015); a total of 6 waves and a decade of data. We selected individuals who had no indication of depression at baseline using the Centre for Epidemiologic Studies Depression Scale (CES-D; score of <3) and used logistic regression models to explore the odds of developing depression at any wave over the following 10 years in relation to how often people engaged in community cultural activities (including visiting museums/galleries, attending the theatre/concerts/opera, and going to the cinema). For all analyses, we controlled for all identified socio-demographic confounders, health confounders (including sensory impairment, chronic conditions and pain) and social confounders (including other forms of social/civic engagement).

Results There was a dose-response relationship between frequency of cultural engagement and the risk of developing depression independent of socio-demographic, health-related and social confounders. This equated to a 34% lower risk of developing depression for people who attended every few months (OR=0.66, 95% CI 0.46 to 0.96, p=0.03) and a 50% lower risk for people who attended once a month or more (OR=0.5, 95% CI 0.33 to 0.76, p=0.001). Results were robust for sensitivity analyses exploring reverse causality and alternative CES-D thresholds.

Conclusion The results presented here suggest that cultural engagement is an independent risk-reducing factor for the development of depression in older age. In light of these data, it is suggested that behavioural intervention studies are designed to test further whether community cultural engagement can causally decrease the risk of developing depression.