The Arts and Aging: Building the Science

Prepared by Mary Kent and rose Li, rose Li and Associates, Inc.

36 pages, February 2013. National Endowment for the Arts, 1100 Pennsylvania Avenue NW, Washington, D.C., 20506. (202) 682-5400. http://arts.gov/

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Recent and ongoing research suggests exciting possibilities for the therapeutic use of art to improve the health and well-being of older adults. As this population grows in number and as a proportion of all Americans, it will experience dramatic increases in the number of people with aging-related health conditions, including cognitive decline and dementia. Given the arts’ potential to treat, prevent, or ameliorate those conditions, additional research is needed to clarify the relationship between the arts and the health and well-being of older adults.

As part of a Federal Interagency Task Force on the Arts and Human Development, the National Endowment for the Arts and three units within the National Institutes of Health (NIH)—the National Institute on Aging (NIA), the Office of Behavioral and Social Sciences Research (OBSSR), and the National Center for Complementary and Alternative Medicine (NCCAM)—joined in requesting the National Academy of Sciences (NAS) to convene a public workshop around this research need. The NAS workshop subsequently aimed to identify research gaps and opportunities to foster greater investment in promising arts-related research that can seed interventions to improve quality of life for older adults.

So far, participation in arts interventions has been linked with improving cognitive function and memory, general self-esteem and well-being, as well as reducing stress and other common symptoms of dementia, such as aggression, agitation, and apathy. Some interventions promote social interaction, which has multiple psychosocial benefits.

Music is the most common participatory art studied, but theater, dance, and creative writing also hold promise as effective health interventions for older people. Lifelong music training is associated with many effects among older people, including improved memory and hearing. However, people who began singing or other music activities when older also derived benefits in many areas, as did older people who took acting classes or participated in creative writing programs for the first time. Design and visual arts play an important role in the well-being and quality of life for older people. The design of residential buildings for older people can affect the amount and quality of social interaction, physical activity, cognitive stimulation, and emotional well-being of residents. The landscaping, traffic flow, building materials, and design of activity hubs all contribute to the success or failure of a residential facility as a thriving community.

In addition, the increasing use of universal design can help older people participate more fully in normal activities. Universal design embraces the integration of “places, things, information, and communication” to expand accessibility to the widest spectrum of users in the widest range of situations.

Visual arts have been used in healthcare for centuries and are now a staple in hospitals, assisted living facilities, and long-term care facilities. But more research is needed to understand the situations in which different art forms are most suitable. For example, dementia patients might be affected negatively by art that might prove relaxing to others.

Although arts interventions show promise, most studies documenting these beneficial effects do not meet the rigorous standards of scientific research and few include a cost-benefit analysis (CBA)— necessary elements for securing funding for future programs and research. Further, arts interventions are less likely to be adopted in the wider community unless they can demonstrate effectiveness and cost advantage.

There was broad agreement among the workshop participants about the need for more rigorous research as well as the need for new or alternative research designs and measurements that are more appropriate for the multimodal aspects of arts interventions.