Leisure engagement, encompassing voluntary non-work activities pursued for pleasure, has been increasingly recognized for its potential to positively impact health and well-being across the lifespan. Numerous studies have demonstrated the benefits of leisure activities, ranging from improved child development to reduced cognitive decline in older adults. Despite the widespread benefits, leisure is often undervalued, viewed as secondary to work and often inaccessible due to economic factors. While international aging cohorts often include questions on leisure engagement, its impact on various aspects of aging remains unclear. This study addresses this gap by investigating how different domains of leisure engagement (physical, creative, cognitive, and community) influence a broad range of objective and subjective aging experiences. The study's importance stems from the growing need to understand how to support healthy aging, especially given the increasing prevalence of age-related chronic diseases and the challenges older adults face in maintaining healthy behaviors. Understanding the potential benefits of leisure engagement has significant implications for healthcare systems and the implementation of community-based programs, such as social prescribing, that aim to improve the health and well-being of older adults.

Existing research links leisure engagement to physical and mental health throughout life. Studies highlight the benefits of play in childhood development and community engagement in preventing cognitive decline and dementia. However, much of the research focuses on single leisure domains or specific health outcomes like depression, dementia, or well-being, often neglecting the broader impact on aging experiences. While some prior studies explored leisure and aging, these were typically small-scale and lacked nationally representative samples. Therefore, a comprehensive understanding of how different leisure activities independently influence multiple aspects of aging – both objective (e.g., physical fitness) and subjective (e.g., perceived health) – is needed. The current study aims to fill this research gap by employing an outcome-wide approach to comprehensively analyze the effects of diverse leisure activities on a wide range of aging-related outcomes.

This longitudinal study utilized data from the Health and Retirement Study (HRS), a nationally representative sample of over 37,000 individuals aged 50 and older in the US. The study included 8771 participants (55% female) with data from 2006 to 2018, whose ages ranged from 50 to 94 (mean = 63.18, SD = 8.45). Leisure engagement was assessed using the HRS Social Engagement questionnaire, which measured participation in 15 leisure activities categorized into four domains: physical, creative, cognitive, and community activities. Frequency of engagement ranged from 0 (never) to 6 (daily). Aging experiences were assessed eight years later (2016/2018) across 23 outcomes in seven domains: daily functioning, physical fitness, long-term physical health problems, heart health, weight, sleep, and subjective perceptions of health. An outcome-wide approach was employed, using various regression models (negative binomial, linear, logistic, and ordered logistic) selected based on the nature of each outcome variable. Models included all four leisure domains simultaneously and were adjusted for demographic, socioeconomic, and neighborhood covariates, as well as the baseline measure of each outcome. Multiple imputation by chained equations (MICE) was used to handle missing data. Sensitivity analyses were conducted to assess the robustness of the findings to unmeasured confounding, accounting for additional health and health behavior covariates, and exploring different levels of leisure engagement. The analyses accounted for the complex survey design using HRS sample weights. Statistical analyses were conducted using Stata 17.

The longitudinal analysis revealed that more frequent engagement in physical activities was associated with more positive experiences across all domains of aging except heart health. Strongest associations were observed for better static balance, less perceived balance difficulties, and lower odds of mobility difficulties and chronic health conditions. Creative activities were associated with positive outcomes in daily functioning, physical fitness, sleep, and subjective perceptions of health, but not long-term health problems, heart health, or weight. Cognitive activities showed a few weak positive associations, mainly with sleep and eyesight. Community engagement surprisingly lacked protective associations and was even linked to higher odds of chronic health conditions. Cross-sectional analyses revealed similar trends, with physical and creative activities displaying strong positive associations with various aging experiences, whereas cognitive and community activities showed more mixed results. Sensitivity analyses indicated that the longitudinal associations between physical and creative activities and aging were relatively robust to unmeasured confounding. Findings also suggested that weekly engagement in physical activity was strongly associated with many positive aging outcomes, whereas any level of creative activity may be beneficial.

This study's findings highlight the significant role of physical and creative activities in supporting healthy aging. The robust associations between physical activity and a broad spectrum of aging outcomes, independent of other leisure activities and confounding factors, confirm its substantial impact. The beneficial effects of creative activities, although less consistent than those of physical activities, also underscore its importance for maintaining physical functioning and fitness. The unexpected lack of consistent associations for cognitive and community activities might be attributed to various factors, including the possibility that these activities are more strongly linked to mental health than physical health, or that their benefits require sustained engagement over extended periods. The stronger associations between leisure engagement and subjective perceptions of health compared to objective health measures suggest that leisure activities may significantly influence older adults' attitudes toward their health, even if their actual physical health is less directly affected. The observed differences in the strength of relationships between different domains of aging and leisure engagement may reflect the bidirectional nature of these relationships, where better health facilitates participation in leisure activities, which in turn further supports health.

This large-scale study provides compelling evidence for the beneficial effects of physical and creative leisure activities on multiple dimensions of aging. These activities may help mitigate age-related decline and promote functional independence in older adults. The findings emphasize the need for strategies and policies that support and encourage older adults' participation in these activities, potentially reducing healthcare costs and promoting equitable aging. Future research could explore sustained engagement patterns, examine the specific mechanisms through which leisure impacts aging, and investigate potential interactions between leisure and other lifestyle factors. Furthermore, research addressing health disparities and inequalities in access to and participation in various types of leisure activities is warranted.

This study's main limitations include the reliance on baseline leisure engagement measures, limiting the assessment of the effects of changing engagement patterns over time; the relatively short follow-up period of eight years; and potential susceptibility to unmeasured confounding, despite extensive adjustment for known covariates. The study's focus on population-level associations may mask individual variations in experiences and outcomes, and the categorization of certain demographic variables (e.g., race/ethnicity) could have masked nuanced influences of diverse identities and experiences. Future studies addressing these limitations are essential to strengthen our understanding of the complex interplay between leisure engagement and successful aging.