Cultural engagement and physiological ageing: a fixed-effects analysis

Background Cultural engagement reportedly enhances older adults’ well-being. Physiological age (PA) reflects the deterioration of physical and physiological systems, and a greater PA increases the risks of various health conditions and mortality. This study aimed to investigate the association between cultural engagement and physiological ageing in UK older adults, accounting for time-invariant unmeasured confounders. Methods The data were derived from the English Longitudinal Study of Ageing. Older adults who participated in at least two of waves 2, 4 or 6 were analysed (n=1899 individuals, N=4207 observations; 46.9% were male). Cultural engagement scores were calculated based on the frequency of going to cinemas, museums and theatres, ranging from 0 (lowest engagement) to 15 (highest engagement). PA was derived from 10 physiological markers and clinical indicators, including blood pressure, forced expiratory volume, grip strength and body mass index, using the Klemera-Doubal method. A fixed-effects linear regression model was fitted to estimate the association between the cultural engagement score and PA. Time-varying confounders, including socioeconomic and health status, were adjusted for. Results The participants exhibited a cultural engagement score with a mean of 4.3 (SD=3.2) and PA with a mean of 68.7 years (SD=7.8). The fixed-effects analysis showed that a 1-point higher cultural engagement score was significantly associated with a 0.085-year lower PA after adjusting for time-varying confounders (non-standardised coefficient (B) = –0.085; 95% CI –0.161 to –0.008). Conclusions Enhancing cultural engagement may slow physiological ageing and promote healthy ageing.