Preference–participation mismatch in later-life cultural engagement and depressive symptoms: Longitudinal evidence from ELSA

Background Cultural participation is increasingly promoted within healthy-ageing and social-prescribing agendas, yet low participation may reflect either limited interest or unmet desire. We examined whether this preference–participation mismatch identifies a distinct mental health risk state in later life. Methods Using self-completion data from Waves 2–8 of the English Longitudinal Study of Ageing, supplemented by Wave 9 outcomes where available, we classified 54,523 person-waves from 14,600 adults aged ≥ 50 years into four profiles across cinema, museums/galleries, and theatre/concerts/opera. Unmet cultural need was defined as low participation in at least one domain combined with a desire for greater participation in that same domain. Lagged models predicted next-wave depressive symptoms, fixed-effects models assessed within-person associations, and incident depression was analysed among transitions from a non-depressed state. Results Unmet cultural need was present in 29.2% of person-waves. Compared with active satisfaction, unmet cultural need was associated with higher next-wave CES-D scores (β = 0.296, 95% CI 0.259–0.334), with larger differences than those observed for low/no stated demand (contrast β = 0.177, 95% CI 0.131–0.224) or active high demand (contrast β = 0.115, 95% CI 0.073–0.156). Fixed-effects estimates were smaller but directionally consistent. Among 40,870 transitions from a non-depressed state, unmet cultural need showed the largest risk difference for incident depression (3.08 percentage points, 95% CI 2.39–3.76). Conclusions Low cultural participation is heterogeneous. Combining participation with stated desire may help identify older adults who need further assessment of cultural access, mobility, and social or psychological support.