Impacts of participatory arts-based interventions on well-being of older adults without dementia : an umbrella review and a conceptual artistic participation framework

Abstract

Background and Objectives: While participatory arts are thought to benefit older adults’ well-being, evidence has focused on dementia. This umbrella review synthesizes evidence from systematic reviews (SRs) and meta-analyses (MAs) on the impacts of participatory arts for older adults without dementia, and conceptually organizes findings using the proposed “Aesthetic–Engagement–Creativity” (AEC) framework. Research Design and Methods: Following PRIOR guidelines, we searched MEDLINE, PubMed, PsycINFO, The Cochrane Library of Systematic Reviews and gray literature to September 2023, with an update in June 2025. Study characteristics and well-being outcomes were extracted. We used the AEC framework for conceptual categorization, assessed primary study overlap using the corrected covered area (CCA) and the methodological quality with the AMSTAR 2. Results: Eighteen reviews were included, with minimal study overlap (CCA = 1.96%). However, the evidence base was weak; 12 reviews were of low or critically low quality. A synthesis of the six moderate-to-high quality reviews revealed that dance was the most studied modality, associated with improved physical well-being. The benefits for other well-being domains and art modalities were mixed, and significant heterogeneity in study designs and measures complicated comparisons. Our retrospective application of the AEC framework suggests that considering participants’ aesthetic preferences and optimizing engagement and creativity levels may be important, but this link is speculative. Discussion and Implications: Participatory arts show potential for promoting well-being of older adults, but robust conclusions are constrained by the poor quality, underrepresented art modalities, and heterogeneity of the existing evidence. The AEC framework is offered as a conceptual tool requiring future empirical validation.