The year has barely started, but it is a fairly safe bet that one of the stand-out albums of 2012 will be Leonard Cohen’s Old Ideas. For the many (including me!) allergic to the bedsit misery of his early work, there is reassurance about what old age can bring us in the drollery, bite, and deft characterisation of his late albums. Adversity was the trigger for this late outpouring: after his manager absconded with his savings, an older, wiser, (and mercifully wittier) Leonard set out on the road again.

For his new album, the 77 year old enmeshed himself with a handful of seasoned musicians. The textures combine a paradoxical mix of economy and lushness, particularly through the contrast between the ethereal voices of his regular collaborators (back-up singer seems an ungenerous and insufficient descriptor here) and the gravelly-voiced poet.

Verging to within an ace of self-parody or willful obscurity at times, we journey with him though romance, death, change (and reluctance to change!) to the maturing synthesis of the perspectives and richness of later life. The images are often striking—the vision of the artist as a “broken banjo bobbing on a dark-infested sea” evokes both instant recognition and wry smile—and the album can be recommended without reservation.

In teaching, I often use artists like Cohen as examples of the longevity dividend to those new to the concepts of ageing—other examples include Matisse, Verdi, Frank Lloyd Wright, and Juliette Greco—but students and others will often revert by saying that’s all very well for the great artists, but what is the relevance to me and other ordinary punters?

As actions speak louder than words, I would have directed their attention to a vivid example of the broader remit of late life creativity at a concert in Dublin last week. The remarkable Blow off the Dust Orchestra is part of the public engagement programme of the ever-inventive national symphony orchestra of Ireland, the RTE National Symphony Orchestra.

Members of the general public, and especially senior citizens, were invited to “blow off the dust” on their instruments and join up in a semi-impromptu musical ensemble linked to one of the orchestra’s regular Friday evening concerts. The symphony orchestra provided a skillful leader for the project, the energetic music educator and composer Paul Rissman, a handful of their musicians as a resource, and generous rehearsal time and space.

The final result including the creation and performance of a new work related to the central item of the concert, Shostakovich’s epic Leningrad Symphony. It was refreshing and fun but also effective in delivering not only stimulating music but also a strong message that it is never too late to re-engage with our own creativity and capabilities.

In this we are often our own worst enemies: denigrating our skills, not making time and not seeking opportunities for continuing to develop the things we once enjoyed doing, from knitting to drawing, from singing to dancing. Indeed one of the losses of adolescence and early adulthood is a withering of our belief in our own creativity and the onset of the deadly phrase “I’m no good at art/music/dancing…”

This point was beautifully illustrated to me at an American gerontology meeting a few years ago. A keynote speaker was about to engage in a Rolf Harris-like painting of a picture while speaking. Looking for an assistant, he asked us who was good at drawing: not a single member of the large audience put up a hand. Yet when he asked us what our answer would have been when we were five years old, ruefully we nearly all put up our hands.

Reclaiming this self-belief in the worth of our capabilities and creativity is one of the key challenges of adult life, and indeed the insights of later life are such that older people might actually be more open to this than those of us in earlier adulthood. The enthusiasm, skill, and bonhomie that I witnessed at the rehearsal of the Blow Off the Dust Orchestra were healthy antidotes to the self-doubt and timid dismissiveness that we permit to circumscribe our own creative impulses.

In particular the experience reinforced the key principle of preventive medicine of later life: start early, but it’s never too late.  If only Leonard Cohen could put that to music, I mused. Then I realized that he has done just precisely that: sometimes Old Ideas are indeed the best!

Desmond O’Neill is a consultant physician in geriatric and stroke medicine