Creative engagement is to the aging brain as physical activity is to the aging body. Just as studies have shown older adults who maintain higher levels of muscle strength, flexibility, and aerobic capacity are healthier and better able to preserve their independent function longer than their more sedentary peers, an emerging body of literature suggests that those who engage in creative activities exhibit increased psychological well-being.
For example, findings from the federally funded Creativity and Aging study spearheaded by the late Dr. Gene D. Cohen and colleagues in the Center on Aging, Health, and Humanities at George Washington University, Washington, showed that participation in community-based cultural programs improved both the general health and mental health of older adults.
Specifically, the study recruited 300 healthy, ambulatory, older adults between the ages of 65 and 103 in New York, Washington, and San Francisco. Half of the participants were assigned to participate in professionally conducted arts programs, such as singing, creative writing, poetry, painting, or jewelry making, while the other half maintained usual activity.
Results from the Washington group showed that, after 2 years, the arts group reported better overall physical health, fewer doctor visits, fewer falls, and better scores on depression and loneliness scales. Additionally, the authors noted that participation in the community-based arts activities had a positive impact on the individuals' ability to maintain their independence by reducing the risk factors “that drive the need for long-term care” (Gerontologist 2006;46:726-34).
Other studies have produced similar findings. In 1999, Frederick Tims, Ph.D., professor and area chair of music therapy at Michigan State University, East Lansing, reported the results of the Music Making and Wellness Project in which the investigators compared the well-being of 61 older adults who were assigned to participate in group keyboard lessons with that of a control group of similar aged adults who did not participate. After the music intervention, the keyboard group showed significant decreases in anxiety, depression, and loneliness, and increasing levels of human growth hormone–which has been implicated in a range of age-related health conditions.
In 2004, investigators in the psychology and theatre departments at Elmhurst (Ill.) College, evaluated the impact that a short-term theater arts intervention had on the cognitive and affective functioning of older adults living in the community. A total of 124 participants aged 60–86 years were assigned to one of three group: theater arts, non–content specific visual arts, and no treatment. After 4 weeks, the adults in the theater arts group improved significantly more than the no-treatment control group in each of the four measures: word recall, memory, problem solving, and psychological well-being.
Adults in the visual arts group showed smaller improvements relative to the control group, according to the authors. Four months after the study, the theater group had maintained their performance improvements across all measures, they wrote. The authors concluded that theater training, even over a short time period, can help prevent cognitive decline associated with aging (J. Aging Health 2004;16:562-85).
Creative engagement also can improve the quality of life for adults with Alzheimer's disease and other age-related dementias. In an observational study published in 2005 in the American Journal of Alzheimer's Disease and Other Dementias, the well-being of 12 older adults with dementia improved while participating in an art program called Memories in the Making than they did during more-traditional adult day care activities.
Specifically, participants in the program, which encourages self-expression through the visual arts for adults in the early and middle stages of dementia, exhibited significantly more interest, sustained attention, pleasure, self-esteem, and normalcy during the intervention period (Am. J. Alzheimers Dis. Other Demen. 2005;20:220-7).
More recently, researchers from the University of Wisconsin's Center on Age and Community in Milwaukee reported that participation in a group storytelling program called TimeSlips, developed by the center's executive director Anne Basting, Ph.D., improved the alertness and level of engagement among individuals with dementia living in long-term care settings, compared with a control group of peers from nonparticipating facilities. The researchers also observed improved staff-resident interactions, social interactions, and social engagement in the participating centers (Gerontologist 2009;49:117-27).
Using the arts and creative engagement “gives us a way to focus on remaining strengths and even growth during a time that is perceived as an inevitable and total decline, which in turn brings meaning and hope to families and care providers alike,” Dr. Basting said in an interview.
The link between creative engagement and positive psychosocial outcomes in older adults can likely be attributed to multiple mechanisms. It is possible, according to Roberto Cabeza, Ph.D., professor of psychology and neuroscience in the Center for Cognitive Neuroscience at Duke University, Durham, N.C., that participating in activities that challenge the mind, such as artistic expression “stimulates the growth of new brain cells in the cerebral cortex.” Even as we age, he said, “the creation of new neuron networks continues.”