Does frequency or diversity of leisure activity matter more for epigenetic ageing? Analyses of arts engagement and physical activity in the UK Household Longitudinal Study

Over the past decade, ageing clocks have become widely adopted as important tools for understanding biological ageing and have been redefining notions of "pro-longevity" lifestyles. However, this work is still at an early stage. Some leisure activities, such as arts and cultural engagement (ACEng) have never been studied at all, while others such as physical activity (PA) have only received scant attention. In particular, there is little understanding of whether frequency of engagement or diversity (which provides access to more active ingredients) is more important. This study used data from 3,354 adults in the UK Household Longitudinal Study - a large, nationally-representative cohort study, which includes seven derived epigenetic clocks. We used a doubly robust estimation using the inverse-probability-weighted regression adjustment estimator adjusted for demographic, socioeconomic, behavioural and health covariates, data collection gaps and technical covariates of epigenetic clocks. ACEng and PA were related to slower biological ageing in the PhenoAge, DunedinPoAm and DunedinPACE clocks, although not to the other measured clocks PA (Lin, Horvath2018, Horvath2013 and Hannum), with comparable effect sizes between ACEng. For ACEng, diversity and frequency of engagement were related to DunedinPoAm and DunedinPACE, while for PhenoAge, there was a slightly clearer relationship for frequency than diversity. For PA, higher levels of frequency, diversity, and activeness were related to DunedinPoAm and DunedinPACE, while only the highest diversity and activeness were related to PhenoAge. These results were all stronger amongst middle-aged and older adults. Our findings support future exploration of whether lifestyle changes can slow epigenetic ageing. Translational significancePopulation ageing poses a major global challenge, underscoring the urgency of investigating how modifiable lifestyle factors influence ageing process and healthy lifespan. This is the first study to link arts and cultural engagement with epigenetic ageing. Analysing data from a nationally representative cohort study, we found comparable effect sizes between arts and cultural engagement and physical activities. These findings extend existing research beyond specific health conditions and mortality, advancing our understanding of potential impacts of leisure activities on biological hallmarks of ageing that underpin health and diseases. Our study provides important implications for developing evidence-based interventions to delay biological ageing and promote healthy longevity.