Aim: To explore how changed participation in painting pictures or playing a musical instrument is related to change in physical and mental health in older women. Method: Women enrolled in the 1921–1926 birth cohort of the Australian Longitudinal Study on Women’s Health were surveyed in 2005 and 2008. Changed participation in painting pictures or playing a musical instrument was considered in relation to changes in social activity, social support, health status and health-related quality of life. Results: Data were available for 5058 women. Improvements in instrumental activities of daily living (odds ratio (OR) 1.1, 95% confidence interval (CI) 1.0–1.2; P = 0.004) and role limitations due to emotional factors (OR 1.6, 95% CI 1.0–2.5; P = 0.002) were associated with starting participation. Decline in mental health-related quality of life (OR 4.1, 95% CI 2.3–7.2; P < 0.0001) was associated with stopping. Conclusion: Changed participation was associated with change in functional capacity and tied to emotional well-being.