Can Cultural Engagement Protect Against Depression?

A new study examines the preventative effects of cultural engagement has on depression among older adults.


A new longitudinal study, led by Daisy Fancourt, a researcher from the University College London, explores cultural engagement as a preventative tool for depression in older adults. Results of the study, published in The British Journal of Psychiatry, found a dose-response association between cultural engagement and levels of depressive symptoms in aging adults.

“Going to cultural venues is a way of reducing sedentary behavior, which is associated with depression, partly through increased inflammatory responses. Furthermore, the emotional response to cultural activities such as music has been found to involve brain regions critical to the processing of positive emotions and reward,” write Fancourt and colleagues.

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While overall rates of depression are difficult to measure, depressive symptoms are believed to increase with age and are more likely to go undiagnosed and untreated. As depression is linked to an increase in dementia, stroke, and mortality, a need for depression interventions among older adults is evident. However, as Fancourt and colleagues highlight, “there is a recognized lack of effective multimodal psychosocial interventions for the prevention of depression in older adults.”

A growing body of literature suggests cultural engagement, activities such as singing, dancing, doing art, and visiting a museum, can aid in the recovery and treatment of depression. Less work has been done exploring the preventative aspects these activities may provide to individual’s mental health. Cultural engagement is often comprised of social interactions, reduced sedentary behavior, and positive emotional response, all of which contribute to wellbeing and may serve to protect against depression.

“Mental health is an important determinant of successful aging and longevity. It is, however, prone to decline with age because of life events and circumstances commonly experienced by older adults such as bereavement, lone living, impoverished social interactions, poor health, retirement, and worsening economic condition,” the authors write.

Fancourt and colleagues used over a decade of data from the English Longitudinal Study of Ageing to conduct the first longitudinal study utilizing validated depression scales to examine the relationship of cultural engagement on depressive symptoms in older adults, The study sampled 2,148 participants with a mean age of 62.9 years (age range= 52-89).

The researchers collected the frequency of cultural engagement activities through self-report and used the Centre for Epidemiologic Studies Depression Scale (CES-D) to measure depression symptoms among participants. At baseline, all participants were below the threshold for depression. Sociodemographic covariates, socioeconomic position, employment status, and physical health data were collected. The Midlife Development Inventory personality scale was used to control for openness as a protective factor associated with cultural engagement.

After analyzing a decade of data and employing five sensitivity tests to ensure accurate measurement of variables, the study found an increase in cultural engagement was associated with reduced rates of depression among older adults.

“There was evidence of a dose-response relationship with more frequent attendance associated with a lower risk. For fully adjusted models, this equated to a 32% lower risk of developing depression for people who attended every few months and a 48% lower risk for people who attended once a month or more,” the authors report.

“Notably, this finding was independent of sociodemographic factors, health, and behavioral factors and other forms of social and civic engagement including other hobbies, social interactions, community group and civic engagement. It was also independent of open personality type.”

This study provides strong evidence for the use of cultural engagement in the promotion of positive mental health among aging adults. As noted by the researchers, Fancourt’s study was observational and not interventional. Therefore, interventional studies could be done to further explore the effects of cultural engagement on depressive symptomology among this population.

The authors conclude:

“We found that engagement with cultural activities (including going to the cinema, museums or galleries or the theatre, concert or opera) appears to be an independent risk-reducing factor for the development of depression in older age. Given our analyses specifically tested the potential contribution of reverse causality but found no change in results, this association may be ascribed to multiple components of cultural engagement including social interaction, mental creativity, cognitive stimulation, and gentle physical activity.”



Fancourt, D., & Tymoszuk, U. (2018). Cultural engagement and incident depression in older adults: evidence from the English Longitudinal Study of Ageing. The British Journal of Psychiatry, 1-5. (Link)


  1. Might there be anything other than the “depression”, causing the “..dementia stroke and mortality in older Adults..”

    “…As depression is linked to an increase in dementia, stroke, and mortality, a need for depression interventions among older adults is evident…”

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    • Could definitely be, as the “depressions” preceding these neurological diseases are simply indicative something’s amiss, like the falling barometer pressure preceding hurricanes. Fixing the barometer won’t prevent the hurricane.
      Probably more “depressions” are like this, but ones that don’t lead to spectacular neurological disasters. These are the ones that get you addicted to antidepressants that fail to relieve your depressed mood.

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  2. “Furthermore, the emotional response to cultural activities such as music has been found to involve brain regions critical to the processing of positive emotions and reward,”

    Its like use it or loose it or something.

    This is interesting because when trying to get over zyprexa/olanzapine induced anhedonia that did not go away after quitting that poison I took amphetamines (adderal) just to be able to feel any kind of positive emotions and reward and it was almost like it reset something as I had forgotten what positive emotions and reward felt like but once I felt them from the amphetamine a few times it helped with the motivational anhedonia even without it.

    This was over 10 years ago, still angry no one from Eli Lilly went to prison for illegally marketing that poison and hurting thousands of people. Killing some too.

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  3. “Going to cultural venues is a way of reducing sedentary behavior, which is associated with depression, partly through increased inflammatory responses. Furthermore, the emotional response to cultural activities such as music has been found to involve brain regions critical to the processing of positive emotions and reward,”

    I’m so glad you’re teaching the “mental health professionals” this, since my “mental health professionals” had insanely told me to “quit all your activities” and to stop listening to the music I like. I was shocked by my “mental health professionals” insanely stupid advise.

    “A growing body of literature suggests cultural engagement, activities such as singing, dancing, doing art, and visiting a museum, can aid in the recovery and treatment of depression.” Regular moderate exercise, volunteering, a healthy diet, time in nature, journaling – all these things are things the “mental health professionals” need to be educated are good for people.

    One psychiatrist thought my love of painting was “bipolar”????? Another one, ironically named after an Indian dance, thought dancing was “mania”????? I had no idea that there was an entire industry of people who were so completely lacking in common sense, until I had the misfortune of dealing with the completely delusional “mental health professionals.” “I declare you’re life is a fictional story!” Bye, bye, insane psychiatrist.

    But I now have an entire, shockingly descriptive portfolio all about painting iatrogenic “bipolar,” then healing from iatrogenic “bipolar,” by going off the psychosis inducing psychiatric drugs. And, how disgusting, I live in a society with an enormous, completely iatrogenic bipolar epidemic. Ick! to our satanic “mental health” professionals. I’m not certain why my “mental health professionals” wanted my work to be about their malpractice, however. I think they would have been better off if they had left me alone, rather than attacking me and my family, so they could profiteer off of covering up the abuse of my child.

    Because after a recent show of my work, a psychologist apparently was concerned about the truthfulness of my work. So he disingenuously handed over an “I want to manage your art” contract, that is actually an I want to steal all your artwork and all your money contract. Apparently he’s terrified my artwork might end up in the art history books some day.

    But in this very divisive society in which we live, we not only have Spirit cooking and pedophilia artists that are all the rage. But we also have Spirit led, anti child abuse, and shame on the “mental health professionals” for profiteering off of covering up child abuse on a massive societal scale, artists as well.

    It’s a shame that covering up child abuse is the number one actual function of our “mental health” industries. Especially since such illegal “mental health professional” behavior aids, abets, and has empowered the pedophiles. So we now have human trafficking and pedophilia run amok societal problems.

    But I did see Psychiatric Times is finally starting to do more than just deny the reality that human trafficking is a reality, so hopefully they will soon stop advocating turning child abuse victims into the “mentally ill” with their psychiatric drugs, en mass. Or at least, I do so hope.

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    • The Mental Illness System strongly encouraged us to do nothing but sit in front of the tube and drool between visits to the center. (As well as cook, clean apt, sleep.) They only expected us to talk to each other.

      Excessive TV is known to cause depression and cognitive decline. Yet they think 16 hours a day is good for you and keep it on nonstop in psych wards for some reason.

      When I volunteered at the Humane Society, read books, went to community plays and art galleries all the Center’s workers were surprised. A few were gratified. Many seemed displeased that I “didn’t know my place.”

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  4. I don’t know about *preventing* depression, because it can be caused by all sorts of things which would need to be addressed at one time or another. But I know from experience that, in the past, when I’d been extermely depressed even for a good long while–in the dark, emotionally suffering, and completely uninspired–I’d go see a really awesome musical show or concert and it would pull me right out of it because not only would I be entertained and distracted, it would also open my heart and touch my spirit, and from there, I’d spiral upward. I could feel myself again, my inner light. I still had to address the issues which were causing me distress, but it was much easier with an open and relaxed heart, like a new ground zero.

    During my darkest time, way beyond depression, as I was just starting to heal from withdrawal, I had one particular CD which spoke to me, which I played over and over because it was the only thing that would bring me any kind of relief at that time. I also found this one DVD called “The American Songbook,” which was clip after clip of historic performances of classic American standards through the ages, in film and on stage. It’s a 3 hour show, so that would nourish me quite a bit.

    I found music to be paramount to my healing. Probably the reason I started doing musical theater, which was a happy accident. Other than coming off a lot of psych drugs, the biggest leap of faith I ever took was enrolling in a class to learn to sing publically and perform on stage, which was perhaps the most healing activity I ever did. And on top of that, it opened a few doors for me which I had not expected. Got over all sorts of insecurities and learned to trust the creative process. In that sense, I’d call it curative.

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  5. This, I would put in the file labeled things your grandma could have told you or any other wise elder type of folk.
    Any type of any artistic engagement is always going to be a good thing no matter what age or background of human. Duh!
    This is a good example of labeling being essentially meaningless.
    When one looks as people as just individual human beings not as cancer patients, or psychos, or head trauma pets, or TB pts, or stroke victims – btw why does that phrase come so readily too mind?
    And thanks Alex for your own story and great example of art allowing us to be away from ourselves and the daily realities of life as it is.
    And Soneone Else I am sorry the MH professionals were so ignorant of culture and the artistic process. They seemed to be ignorant of more than that especially compassion.
    The United States lost much when the WPA and its many divisions were broken up and destroyed. We need to get that structure back. In the eighties I spent time with two Dutch artists. There is or was I assume still is a national work program that has every government building use work of Dutch artitists for appreciation of employees and other citizens. This gives folk work, there is an evaluative process so staked are still high, and created a win , win situation for all.
    I have been at nationally acclaimed hospitals where very beautiful but extremely high priced works are presented on fine marble walls. I know artist in the city who are working several jobs while still creating art and as I walked past the art work at 3:am, I would think how much more meaningful it would be to see a local artist works and one that I may know. It would provide a much more human connection in the lonely corridors one one’s family member could be at stake.
    Also- psych patients DO NOT HAVE the comfort of family members during their stay. Irony of all Irnonies/ as a mother I slept in the ICU , I spent literally DAYS 34/7 with my family relative/s and when I was held- visiting hours were strictly curtailed and strongly enforced.
    This is what a truly ethical researcher should be/ would be working on. Fluff is fluff whether in academic journals or everyday reporting.

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