Participating in Creative and Performing Arts: Research Shows the Health Benefits

1. Linda S. Noelker, Ph.D Benjamin Rose Institute, Cleveland, Ohio This study was made possible by a grant from the Cleveland Foundation. Presented at the Western Reserve Area Agency on Aging’s Conference on Independent Living, June 10, 2010. PLEASE DO NOT CITE, QUOTE, DUPLICATE, OR DISTRIBUTE THIS DOCUMENT WITHOUT THE AUTHORS’ PERMISSION Participating in Creative and Performing Arts: Research Shows the Health Benefits

2. Objectives To review research on the documented health benefits of creative and performing arts programs for older adults. To discuss some resources for making arts programs more available to older adults and adults with disabilities.

3. Why is evidence of health benefits important? • To attract support from funders: evidence that expected outcomes will be achieved • To attract participants: a good alternative and/or supplement to medical treatments to achieve better health • To strengthen communities: arts programs can produce a living community legacy created by cultural groups and generations

4. Methods • Systematic review of the research using health literature data bases • Keywords used: creative*, health promotion, arts, program*, aging, perform*, and health *denotes the derivatives and variations of the word

5. Methods Inclusion criteria for articles • Had to include creative activities that either exclusively targeted or included older adults • Activity was not a therapy or arts & crafts • Activity had to be participatory, not observant • Had to document at least one health-related benefit (physical, mental, emotional) reported

6. Methods Search began June 2009 and ended November 2009 No existing meta-analysis or review articles found on health benefits of professionally-led participatory arts programs for older adults

7. Results • 2,205 articles identified using search terms (publication dates 1978 through 2009) • 42 were retained for review • 11 met inclusion criteria and were retained to include in the analysis

8. Types of Arts Program & Health Benefits • Creative drama classes: decrease in anxiety and one measure of hostility • Reminiscence & creative expression: significant decrease in depression and increase in mastery • Comparative effectiveness of art program (Memories in the Making): high levels of well-being for day care participants with dementia • Individualized piano instruction: better performance on two cognitive tests (perceptual speed and memory)

9. Types of Art Programs & Health Benefits • Jazz Dance Instruction: improved balance; fewer falls • Acting Classes: improved cognition • Theatrical Training: higher scores on recall and problem-solving skills and a mental health measure

10. Cohen et al., 2006 • Impact of 30 week participation in a chorale group on overall health & mental health of older adults in intervention (n=77) and comparison groups (n=64) • Mostly female and Caucasian subjects • Pre-test and post-test after 12 months. • Findings showed intervention subjects reported better overall health, fewer over-the-counter medications, fewer falls, fewer physician visits, and higher morale and decreased loneliness scores.

11. Cohen et al., 2007 • 24-month follow up of participants in the chorale and comparison groups • Findings showed intervention subjects had a smaller increase in use of over-the-counter and prescription drugs and reported fewer health problems

12. Limitations of the Studies • General lack of random assignment to treatment and comparison/control groups • Small, homogeneous samples • Convenience sampling • Short duration of the intervention • Lack of attention to longer term effects (sustained impact) • Lack of attention to variations in the frequency and length of the intervention

13. Conclusions • Limited number of studies that met inclusion criteria • Findings suggest that participatory creative and performing arts programs have a range of physical and mental health benefits for older adults

14. Resources • National Center for Creative Aging Website www.creativeaging.org • American Society on Aging webinars on creative aging programs www.asaging.org • Museum of Modern Art (NYC) Program in Arts and Dementia for those with Alzheimer’s and their Caregivers www.moma.org/learn/programs/alzheimers

15. Resources • Timeslips Storytelling Project (training manual, DVD and story kit) for those with memory loss www.timeslips.org • Elders Share the Arts: A Guide to the Living History Theater Program; integrating personal reminiscence, oral history, and art making; uses visual arts, theater arts, writing, and storytelling. www.elderssharethearts.org/coreprograms/livinghistory.php

16. Resources • Science of Creativity and Cognitive Enhancement: learn how to keep the aging brain fit through creative engagement www.mindramp.org • Songwriting Works: helps families and artists to bring music to older relatives through song composition and performance www.songwritingworks.org • Stagebridge Senior Theater: oldest senior theater in the US brings performance arts training (theater, storytelling, and music) to older adults who perform for younger generations www.stagebridge.org

17. Some Local Resources • Photocoloring (Carolina Martin, Art on Wheels) • Journaling for Health (Sarah G. Sieradzki, OT, UH) • Creative Card Making (Deena Baenen, MS, LSW, COTA) • Drumming (Cindy Hill, BA, Rhythm Culture)

18. Other Resources • The Creative Age: Awakening Human Potential in the Second Half of Life, Gene D. Cohen, M.D., Ph.D, Avon Books, New York, 2000. • Creativity Matters: The Arts and Aging Toolkit, J. M. Boyer, National Guild of Community Schools of the Arts, New York, 2007. • Cultivating Demand for the Arts: Arts Learning, Arts Engagement, and State Arts Policy, L. Zakaras & J. F. Lowell, Rand Corporation, 2008.

19. References Alpert, P. T., Miller, S. K., Wallmann, H., Havey, R., Cross, C., Chevalia, T., et al. (2009). The effect of modified jazz dance on balance, cognition, and mood in older adults. Journal of the American Academy of Nurse Practitioners, 21, 2, 108-115. Bohlmeijer, E., Valenkamp, M., Wsterhof, G., Smit, F., & Cuijpers, P. (2005). Creative reminiscence as an early intervention for depression: Results of a pilot project. Aging & Mental Health, 9, 4, 302-304. Bugos, J. A., Perlstein, W. M., McCrae, C. S., Brophy, T. S. & Bedenbaugh, P. H. (2007). Individualized piano instruction enhances executive functioning and working memory in older adults. Aging and Mental Health, 11, 4, 464-471. Cohen, G. D., Perlstein, S., Chapline, J., Kelly, J., Firth, K. M., & Simmens, S.  (2006)  The impact of professionally conducted cultural programs on the physical health, mental health, and social functioning of older adults.  The Gerontologist, 46, 6, 726-734.

20. References Cohen, G. D., Perlstein, S, Chapline, J., Kelly, J., Firth, K. M., Simmens, S. (2007). Impact of professionally conducted cultural programs on the physical health, mental health, and social functioning of older adults--2-year results. Journal of Aging, Humanities and the Arts, 1, 1-2, 5-22. Davis, B. W. (1985). Impact of creative drama training on psychological states of older adults: an exploratory study. The Gerontologist, 25, 3, 315-321. Kinney, J. M. & Rentz, C. A. (2005). Observed well-being among individuals with dementia: Memories in the Making, an art program, versus other structured activity. American Journal of Alzheimer's Disease and Other Dementias, 20, 4, 220-227. Noice, H., & Noice, T. (2006). Theatrical intervention to improve cognition in intact residents of long term care facilities. Clinical Gerontologist, 3, 59-76.

21. References Noice, H. & Noice, T. (2009). An Arts intervention for older adults living in subsidized retirement homes. Aging, neuropsychology & cognition, 16, 1, 56-79. Noice, H., Noice, T., Perrig-Chiello, P., Perrig, W. (1999). Improving memory in older adults by instructing them in professional actors' learning strategies. Applied Cognitive Psychology, 13, 4, 315-328. Noice, H., Noice, T., & Staines, G. (2004). Short-term intervention to enhance cognitive and affective functioning in older adults. Journal of Aging and Health, 16, 4, 562-585.

22. Thank you! Questions or comments? lnoelker@benrose.org www.benrose.org