Individualized piano instruction enhances executive functioning and working memory in older adults

Inhibitory control and working memory predict rhythm production abilities in patients with neurocognitive deficits

Deficits in rhythm perception and production have been reported in a variety of psychiatric, neurodevelopmental and neurologic disorders. Since correlations between rhythmic abilities and cognitive functions have been demonstrated in neurotypical individuals, we here investigate whether and how rhythmic abilities are associated with cognitive functions in 35 participants with neurocognitive deficits due to acquired brain lesions. We systematically assessed a diverse set of rhythm perception and production abilities including time and beat perception and finger-tapping tasks. Neuropsychological tests were applied to assess separable cognitive functions. Using multiple regression analyses we show that lower variability in aligning movements to a pacing sequence was predicted by better inhibitory control and better working memory performance. Working memory performance also predicted lower variability of rhythmic movements in the absence of an external pacing sequence and better anticipatory timing to sequences with gradual tempo changes. Importantly, these predictors remained significant for all regression models when controlling for other cognitive variables (i.e., cognitive flexibility, information processing speed, and verbal learning ability) and potential confounders (i.e., age, symptom strength of depression, manual dexterity, duration of illness, severity of cognitive impairment, and musical experience). Thus, all rhythm production abilities were significantly predicted by measures of executive functions. In contrast, rhythm perception abilities (time perception/beat perception) were not predicted by executive functions in this study. Our results, enhancing the understanding of cognitive underpinnings of rhythmic abilities in individuals with neurocognitive deficits, may be a first mandatory step to further potential therapeutic implications of rhythm-based interventions in neuropsychological rehabilitation.

Attention, working memory, and inhibitory control in aging: Comparing amateur singers, instrumentalists, and active controls

Despite the ubiquity of musical activities, little is known about the specificity of their association with executive functions. In this cross-sectional study, we examined this relationship as a function of age. Our main hypotheses were that executive functions would decline in older age, that this relationship would be reduced in singers and instrumentalists compared to nonmusician active controls, and that the amount of musical experience would be more strongly associated with executive functions compared to the specific type of activity. A sample of 122 cognitively healthy adults aged 20-88 years was recruited, consisting of 39 amateur singers, 43 amateur instrumentalists, and 40 nonmusician controls. Tests of auditory processing speed, auditory selective attention, auditory and visual inhibitory control, and auditory working memory were administered. The results confirm a negative relationship between age and executive functions. While musicians' advantages were found in selective attention, inhibitory control, and auditory working memory, these advantages were specific rather than global. Furthermore, most of these advantages were independent of age and experience. Finally, there were only limited differences between instrumentalists and singers, suggesting that the relationship between music-making activities and executive functions may be, at least in part, general as opposed to activity-specific.

Cognitive Stimulation with Music in Older Adults with Cognitive Impairment: A Scoping Review

BACKGROUND

The use of music in cognitive interventions represents a possibility with potential worthy of further investigation in the field of aging, both in terms of prevention from dementia, in the phase of mild cognitive impairment, and in the treatment of overt dementia.

OBJECTIVES

Currently, the types of music-based interventions proposed in the literature are characterized by wide heterogeneity, which is why it is necessary to clarify which interventions present more evidence of effectiveness in stimulating different cognitive domains.

METHOD

The study was conducted in accordance with PRISMA guidelines for scoping reviews. By searching two different databases, PubMed and the Web of Science, all studies evaluating the cognitive effects of music-based interventions on people at early stages of cognitive decline (MCI or mild-to-moderate dementia) were selected.

RESULTS

The study selection included a total of 28 studies involving n = 1612 participants (mean age ranged from 69.45 to 85.3 years old). Most of the studies analyzed agree with the observation of an improvement, or at least maintenance, of global cognitive conditions (mainly represented by the results of the MMSE test) following music-based interventions, together with a series of other positive effects on verbal fluency, memory, and executive processes.

CONCLUSIONS

The results of this review suggest the introduction of music-based interventions as complementary approaches to usual cognitive treatments. Also, the use of standardized and well-defined protocols, in addition to strong methodological research approaches, is suggested. Music-based interventions are recommended in the early stages of dementia, in MCI, and in a preventive sense in healthy older adults.

The effects of language learning on cognitive functioning and psychosocial well-being in cognitively healthy older adults: A semi-blind randomized controlled trial

This study investigated the impact of language learning in comparison to other complex learning activities on cognitive functioning and psychosocial well-being in cognitively healthy, community-dwelling older adults. In a randomized controlled trial, 43 Dutch functionally monolinguals aged 65-78 completed a three-month English course (n = 15), music training (n = 13), or a lecture series (n = 15). Cognitive functioning (global cognition, cognitive flexibility, episodic memory, working memory, verbal fluency, and attention) and psychosocial well-being were assessed before and immediately after the intervention, and at a four-month follow-up. The language learners significantly improved on episodic memory and cognitive flexibility. However, the magnitude of cognitive change did not significantly differ between the language learning and music training conditions, except for a larger positive change in cognitive flexibility for the language learners from pretest to follow-up. Our results suggest that language learning in later life can improve some cognitive functions and fluency in the additional language, but that its unique effects seem limited.

Can Music Enhance Working Memory and Speech in Noise Perception in Cochlear Implant Users? Design Protocol for a Randomized Controlled Behavioral and Electrophysiological Study

BACKGROUND

A cochlear implant (CI) enables deaf people to understand speech but due to technical restrictions, users face great limitations in noisy conditions. Music training has been shown to augment shared auditory and cognitive neural networks for processing speech and music and to improve auditory-motor coupling, which benefits speech perception in noisy listening conditions. These are promising prerequisites for studying multi-modal neurologic music training (NMT) for speech-in-noise (SIN) perception in adult cochlear implant (CI) users. Furthermore, a better understanding of the neurophysiological correlates when performing working memory (WM) and SIN tasks after multi-modal music training with CI users may provide clinicians with a better understanding of optimal rehabilitation.

METHODS

Within 3 months, 81 post-lingual deafened adult CI recipients will undergo electrophysiological recordings and a four-week neurologic music therapy multi-modal training randomly assigned to one of three training focusses (pitch, rhythm, and timbre). Pre- and post-tests will analyze behavioral outcomes and apply a novel electrophysiological measurement approach that includes neural tracking to speech and alpha oscillation modulations to the sentence-final-word-identification-and-recall test (SWIR-EEG). Expected outcome: Short-term multi-modal music training will enhance WM and SIN performance in post-lingual deafened adult CI recipients and will be reflected in greater neural tracking and alpha oscillation modulations in prefrontal areas. Prospectively, outcomes could contribute to understanding the relationship between cognitive functioning and SIN besides the technical deficits of the CI. Targeted clinical application of music training for post-lingual deafened adult CI carriers to significantly improve SIN and positively impact the quality of life can be realized.

Short communication: Lifetime musical activity and resting-state functional connectivity in cognitive networks

BACKGROUND

Participation in multimodal leisure activities, such as playing a musical instrument, may be protective against brain aging and dementia in older adults (OA). Potential neuroprotective correlates underlying musical activity remain unclear.

OBJECTIVE

This cross-sectional study investigated the association between lifetime musical activity and resting-state functional connectivity (RSFC) in three higher-order brain networks: the Default Mode, Fronto-Parietal, and Salience networks.

METHODS

We assessed 130 cognitively unimpaired participants (≥ 60 years) from the baseline cohort of the DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE) study. Lifetime musical activity was operationalized by the self-reported participation in musical instrument playing across early, middle, and late life stages using the Lifetime of Experiences Questionnaire (LEQ). Participants who reported musical activity during all life stages (n = 65) were compared to controls who were matched on demographic and reserve characteristics (including education, intelligence, socioeconomic status, self-reported physical activity, age, and sex) and never played a musical instrument (n = 65) in local (seed-to-voxel) and global (within-network and between-network) RSFC patterns using pre-specified network seeds.

RESULTS

Older participants with lifetime musical activity showed significantly higher local RSFC between the medial prefrontal cortex (Default Mode Network seed) and temporal as well as frontal regions, namely the right temporal pole and the right precentral gyrus extending into the superior frontal gyrus, compared to matched controls. There were no significant group differences in global RSFC within or between the three networks.

CONCLUSION

We show that playing a musical instrument during life relates to higher RSFC of the medial prefrontal cortex with distant brain regions involved in higher-order cognitive and motor processes. Preserved or enhanced functional connectivity could potentially contribute to better brain health and resilience in OA with a history in musical activity.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS00007966, 04/05/2015).

What Does It Take to Play the Piano? Cognito-Motor Functions Underlying Motor Learning in Older Adults

The acquisition of skills, such as learning to play a musical instrument, involves various phases that make specific demands on the learner. Knowledge of the cognitive and motor contributions during learning phases can be helpful in developing effective and targeted interventions for healthy aging. Eighty-six healthy older participants underwent an extensive cognitive, motoric, and musical test battery. Within one session, one piano-related and one music-independent movement sequence were both learned. We tested the associations between skill performance and cognito-motor abilities with Bayesian mixed models accounting for individual learning rates. Results showed that performance was positively associated with all cognito-motor abilities. Learning a piano-related task was characterized by relatively strong initial associations between performance and abilities. These associations then weakened considerably before increasing exponentially from the second trial onwards, approaching a plateau. Similar performance-ability relationships were detected in the course of learning a music-unrelated motor task. Positive performance-ability associations emphasize the potential of learning new skills to produce positive cognitive and motor transfer effects. Consistent high-performance tasks that demand maximum effort from the participants could be very effective. However, interventions should be sufficiently long so that the transfer potential can be fully exploited.

Generalization of auditory expertise in audio engineers and instrumental musicians

From auditory perception to general cognition, the ability to play a musical instrument has been associated with skills both related and unrelated to music. However, it is unclear if these effects are bound to the specific characteristics of musical instrument training, as little attention has been paid to other populations such as audio engineers and designers whose auditory expertise may match or surpass that of musicians in specific auditory tasks or more naturalistic acoustic scenarios. We explored this possibility by comparing students of audio engineering (n = 20) to matched conservatory-trained instrumentalists (n = 24) and to naive controls (n = 20) on measures of auditory discrimination, auditory scene analysis, and speech in noise perception. We found that audio engineers and performing musicians had generally lower psychophysical thresholds than controls, with pitch perception showing the largest effect size. Compared to controls, audio engineers could better memorise and recall auditory scenes composed of non-musical sounds, whereas instrumental musicians performed best in a sustained selective attention task with two competing streams of tones. Finally, in a diotic speech-in-babble task, musicians showed lower signal-to-noise-ratio thresholds than both controls and engineers; however, a follow-up online study did not replicate this musician advantage. We also observed differences in personality that might account for group-based self-selection biases. Overall, we showed that investigating a wider range of forms of auditory expertise can help us corroborate (or challenge) the specificity of the advantages previously associated with musical instrument training.

The effects of musical instrument training on fluid intelligence and executive functions in healthy older adults: A systematic review and meta-analysis

Intervention studiescombiningcognitive and motor demands have reported far-transfer cognitive benefits in healthy ageing. This systematic review and meta-analysis evaluated the effects of music and rhythm intervention on cognition in older adulthood. Inclusion criteria specified: 1) musical instrument training; 2) healthy, musically-naïve adults (≥60 years); 3) control group; 4) measure of executive function. Ovid, PubMed, Scopus and the Cochrane Library online databases were searched in August 2023. Data from thirteen studies were analysed (N = 502 participants). Study quality was assessed using the Cochrane Risk of Bias tool (RoB 2; Sterne et al., 2019). Random effects models revealed: a low effect on inhibition (d = 0.27,p = .0335); a low-moderate effect on switching (d = -0.39, p = .0021); a low-moderate effect on verbal category switching (d =0.39,p = .0166); and a moderate effect on processing speed (d = 0.47,p < .0001). No effect was found for selective visual attention, working memory, or verbal memory. With regards to overall bias, three studies were rated as "high", nine studies were rated as having "some concerns" and one was rated "low". The meta-analysis suggests that learning to play a musical instrument enhances attention inhibition, switching and processing speed in ageing.

The transformative power of music: Insights into neuroplasticity, health, and disease

Music is a universal language that can elicit profound emotional and cognitive responses. In this literature review, we explore the intricate relationship between music and the brain, from how it is decoded by the nervous system to its therapeutic potential in various disorders. Music engages a diverse network of brain regions and circuits, including sensory-motor processing, cognitive, memory, and emotional components. Music-induced brain network oscillations occur in specific frequency bands, and listening to one's preferred music can grant easier access to these brain functions. Moreover, music training can bring about structural and functional changes in the brain, and studies have shown its positive effects on social bonding, cognitive abilities, and language processing. We also discuss how music therapy can be used to retrain impaired brain circuits in different disorders. Understanding how music affects the brain can open up new avenues for music-based interventions in healthcare, education, and wellbeing.

An Examination of the Non-linear Relationship Between Cognition and Total Hemoglobin Among the Cognitively Normal Older Adults by Gender

Objectives: This exploratory study aimed to identify the potential non-linear relationship between hemoglobin (Hgb) and cognition among cognitively normal older adults and how this relationship differs in terms of gender in generalized additive models (GAM). Methods: This is a secondary data analysis using Wave II (2010-2011) data from the National Social Life, Health, and Aging Project. A generalized additive model was used to understand the non-linear relationship between Hgb and cognition, and to identify critical Hgb point related to cognition. Results: While both genders had a non-linear association between Hgb and cognition, the degree of non-linearity was more pronounced in male older adults with EDF value close to 2. The inflection point of 15.10 g/dL for male older adults and inflection point of 11.72 g/dL for female older adults were obtained. Conclusion: Further studies are needed to validate these results and develop precision medicine approaches to integrate these results into clinical practice.

Increased functional connectivity in the right dorsal auditory stream after a full year of piano training in healthy older adults

Learning to play an instrument at an advanced age may help to counteract or slow down age-related cognitive decline. However, studies investigating the neural underpinnings of these effects are still scarce. One way to investigate the effects of brain plasticity is using resting-state functional connectivity (FC). The current study compared the effects of learning to play the piano (PP) against participating in music listening/musical culture (MC) lessons on FC in 109 healthy older adults. Participants underwent resting-state functional magnetic resonance imaging at three time points: at baseline, and after 6 and 12 months of interventions. Analyses revealed piano training-specific FC changes after 12 months of training. These include FC increase between right Heschl's gyrus (HG), and other right dorsal auditory stream regions. In addition, PP showed an increased anticorrelation between right HG and dorsal posterior cingulate cortex and FC increase between the right motor hand area and a bilateral network of predominantly motor-related brain regions, which positively correlated with fine motor dexterity improvements. We suggest to interpret those results as increased network efficiency for auditory-motor integration. The fact that functional neuroplasticity can be induced by piano training in healthy older adults opens new pathways to countervail age related decline.

Feasibility and acceptability of a group music creativity intervention for adults with varying cognitive function

Maintaining healthy cognitive functioning and delaying cognitive decline in cognitively intact and cognitive impaired adults are major research initiatives for addressing dementia disease burden. Music interventions are promising, non-pharmaceutical treatment options for preserving cognitive function and psychological health in older adults with varying levels of cognitive function. While passive, music interventions have attracted considerable attention in the abnormal cognitive aging literature, active, music interventions such as music creativity are less well-studied. Among 58 older adults with different levels of cognitive function (cognitively healthy to mild cognitive impairment), we examined the feasibility and acceptability of Project CHROMA, a Stage 1 clinical trial developed to assess the effects of a novel, music creativity curriculum on various health outcomes. Music intervention participation (93%), overall study retention (78%), and intervention satisfaction (100%) rates were comparable to other similarly designed clinical trials. Exploratory analyses using mixed-level modeling tested the efficacy of the intervention on cognitive and psychological outcomes. Compared to those in the control condition, participants in the music condition showed some improvements in cognitive functioning and socioemotional well-being. Findings suggest that a 6-week music creativity clinical trial with several multi-modal health assessments can be feasibly implemented within a sample of varying cognitive ability.

One-year cognitive outcomes from a multiple real-world skill learning intervention with older adults

OBJECTIVES

Novel skill learning has been shown to have cognitive benefits in the short-term (up to a few months). Two studies expanded on prior research by investigating whether learning multiple novel real-world skills simultaneously (e.g. Spanish, drawing, music composition), for a minimum of six hours a week, would yield 1-year cognitive gains.

METHOD

Following a 3-month multi-skill learning intervention, Study 1 (N = 6, Mage = 66 years, SDage = 6.41) and Study 2 (N = 27, Mage = 69 years, SDage = 7.12) participants completed follow-up cognitive assessments 3 months, 6 months, and one year after the intervention period. Cognitive assessments tested executive function (working memory and cognitive control) and verbal episodic memory.

RESULTS

Linear mixed-effects models revealed improvements in multiple cognitive outcomes from before the intervention to the follow-up timepoints. Specifically, executive function increased from pre-test to the 1-year follow-up for both studies (an effect driven mostly by cognitive control scores).

DISCUSSION

Our findings provide evidence that simultaneously learning real-world skills can lead to long-term improvements in cognition during older adulthood. Future work with diverse samples could investigate individual differences in gains. Overall, our findings promote the benefits of lifelong learning, namely, to improve cognitive abilities in older adulthood.

Active music making and leisure activities for people with intellectual disabilities: A cluster randomized pilot study

AIM

A pilot cluster randomized controlled trial was performed to evaluate the effects of a music group intervention and a leisure activities group intervention on well-being, self-esteem, social acceptance, challenging behaviour and three components of executive functions (inhibitory control, cognitive flexibility and visual working memory) of adults with intellectual disabilities (ID).

METHOD

Twenty-nine participants living in four residential facilities for people with ID were randomized into a music or a leisure activities group intervention. Sixteen weekly sessions of one hour were performed with six to eight participants per group. Measurements were carried out at baseline, post-intervention and 11 weeks follow- up. Results were analysed with linear mixed models.

RESULTS

The leisure activities group intervention improved more than the music group intervention on internalizing behaviour overall and on inhibitory control at post-intervention. However, further analyses showed that this improvement was only significant in one of the two leisure activities facilities.

CONCLUSION

A leisure activities group intervention seems a promising intervention to improve internalizing behaviour and inhibitory control of younger adults with mild ID. Implications for the delivery of leisure activities group interventions and especially music group interventions are discussed.

WHAT THIS PAPER ADDS

Involvement in leisure activities of people with ID is associated with better well-being, an improvement in social skills and a reduction in emotional and behavioural problems. Active music making, as a specific form of leisure activities, seems to improve well-being, social acceptance and challenging behaviour (CB) as well. Moreover, in different (non-clinical) groups a significant effect of active music making has been found on self-esteem and executive functioning (EF). So far, little attention has been paid to the possible positive effects of active music making on adults with ID. In the current paper, a randomized controlled trial (RCT) was conducted to compare the post-intervention and follow-up measurements with baseline measurements between a music group intervention and a leisure activities group intervention on well-being, self-esteem, social acceptance, CB and EF in adults with ID. Multilevel models were used to detect possible intervention effects of 16 weekly sessions. Overall, inhibitory control and internalizing behaviour improved more amongst the participants of the leisure activities group than amongst the participants of the music group. This was mainly the case for younger participants who had mild ID. These effects are discussed and recommendations regarding the improvement of a music intervention for people with ID are presented.

Effects of a 10-week musical instrument training on cognitive function in healthy older adults: implications for desirable tests and period of training

Introduction

Previous studies have shown that musical instrument training programs of 16 or more weeks improve verbal memory (Logical Memory Test delayed recall), processing speed (Digit Symbol Coding Test), and executive function (Trail Making Test Part B) of musically untrained healthy older adults. However, it is unclear whether shorter-period instrument training can yield similar effects. We sought to (1) verify those results and (2) clarify if intervention effects could be detected using other measures such as reaction time.

Methods

Healthy older adults (mean age = 73.28 years) were pseudo-randomly assigned to an untrained control group (n = 30) or an intervention group (n = 30) that received a weekly 10-session musical instrument training program (using melodica). We conducted neuropsychological tests on which intervention effects or association with musical training were reported in previous studies. We newly included two reaction time tasks to assess verbal working memory (Sternberg task) and rhythm entrainment (timing task). Intervention effects were determined using a "group × time" analysis of variance (ANOVA).

Results

The intervention effects were detected on the reaction time in Sternberg task and phonological verbal fluency. Although intervention effects had been reported on Logical Memory test, Digit Symbol Coding Test and Trail Making Test in previous studies with longer training periods, the present study did not show such effects. Instead, the test-retest practice effect, indicated by significant improvement in the control group, was significant on these tests.

Discussion

The present results indicated the usefulness of working memory assessments (Verbal Fluency Test and Sternberg task) in detecting the effects of short-term melodica training in healthy older adults. The practice effect detected on those three tasks may be due to the shorter interval between pre- and post-intervention assessments and may have obscured intervention effects. Additionally, the findings suggested the requirement for an extended interval between pre- and post-tests to capture rigorous intervention effects, although this should be justified by a manipulation of training period.

The Impact of Learning Multiple Real-World Skills on Cognitive Abilities and Functional Independence in Healthy Older Adults

OBJECTIVES

The natural learning experience from infancy to emerging adulthood, when considerable cognitive and functional growth is observed, mandates learning multiple real-world skills simultaneously. The present studies investigated whether learning multiple real-world skills simultaneously is possible in older adults and also whether it improves both their cognitive abilities (working memory, episodic memory, and cognitive control) and functional independence.

METHODS

Over two studies (15 and 27 participants), older adults learned at least three new skills (e.g., Spanish, drawing, music composition) simultaneously for 3 months. Participants completed cognitive and functional assessments before, during, and after the intervention in both studies. Participants were recruited sequentially for an intervention or no-contact control group in Study 1, and Study 2 included only an intervention group, who also completed assessments 4-6 weeks prior to the start of the intervention (i.e., they served as their own control group).

RESULTS

Results from both studies show that simultaneously learning multiple skills is feasible and potentially beneficial for healthy older adults. Learning multiple skills simultaneously increased cognitive abilities in older adults by midpoint of the intervention, to levels similar to performance in a separate sample of middle-aged adults.

DISCUSSION

Our findings demonstrate the feasibility and potential of conducting a real-world skill-learning intervention involving learning three novel skills with older adults. Our multiskill intervention may provide broad cognitive gains, akin to the benefits experienced earlier in the life span.

Longitudinal effects of choir singing on aging cognition and wellbeing: a two-year follow-up study

Introduction

While increasing evidence points toward the benefits of musical activities in promoting cognitive and emotional well-being in older adults, more longitudinal studies are needed to establish their long-term effects and uncover the mechanisms through which musical activities affect well-being. Most previous research has focused on instrumental musical activities, but little is currently known about the long-term effects of singing, even though neuroimaging evidence suggests that it is a versatile activity for the brain, involving a multitude of neural processes that are potentially beneficial for well-being.

Methods

We conducted a 2-year follow-up study to assess aging-related changes in cognitive functioning and emotional and social well-being with self-report questionnaires and standardized tests in 107 older adult choir singers and 62 demographically matched non-singers. Data were collected at baseline (T1), and at 1-year (T2) and 2-year (T3) follow-ups using questionnaires on subjective cognitive functioning, depression, social engagement, and quality of life (QOL) in all participants and neuropsychological tests in a subgroup of participants (45 choir singers and 41 non-singers).

Results

The results of linear mixed model analysis showed that in verbal flexibility (phonemic fluency task), the choir singers had higher scores already at T1 and showed no change over time, whereas the non-singers showed enhancement from T1 to T3. Furthermore, active retrieval of word knowledge (WAIS-IV Vocabulary task) showed significantly different changes from T1 to T2 between the groups (enhancement in choir singers and decline in non-singers), however lacking significant change within groups. Similar opposite trajectories of QOL related to social inclusion and safety of the environment (WHOQOL-Bref Environmental subscale) were significant from T1 to T3, but these changes were not significant within groups or at each timepoint. Within the choir singers, shorter experience in choir singing was associated with greater improvement in the vocabulary task over the follow-up period, suggesting that initiation of choir singing at older age induces some verbal benefits. There were no group differences in any other questionnaire or neuropsychological measure over time.

Discussion

In conclusion, our results suggest that choir singing at older age is associated with a sustained enhancement of phonemic fluency, while the effects on other verbal skills and quality of life are less clear.

Cognitive and Functional Improvement via Novel Skill Learning for Low-Income Minoritized Middle-Aged and Older Adults

Prior research has demonstrated beneficial outcomes for learning new skills in older adulthood, including increased cognitive and functional abilities, which help prevent age-related declines and foster healthy aging. However, these studies largely have included participants not typically considered at risk for cognitive and functional decline (i.e., White, highly educated, higher income). Cognitive and functional disparities exist among minoritized racial and ethnic individuals, particularly Black and Latinx populations, because of a lifetime of inequalities associated with low socioeconomic status, low education, and discrimination. This theoretical paper proposes a potential pathway in which such disparities could be mitigated by increasing cognitive and functional abilities via novel skill learning in these at-risk populations in middle and later life to prevent decline. We also discuss indirect barriers (e.g., financial and health issues), direct barriers (e.g., limited learning opportunities), and motivational barriers (e.g., self-beliefs, values) that these adults may encounter. We further highlight that addressing these barriers to novel skill learning by providing appropriate resources is necessary to maximize the feasibility and potential effectiveness of this pathway. Lastly, we encourage future research to test this pathway and help inform policymakers and existing learning programs to implement better ways of promoting lifelong learning in an inclusive and equitable manner to prevent decline.

Music alleviates cognitive impairments in an animal model of autism

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by core symptoms including impairment in social communication and restrictive and repetitive behaviors and interests. Music has emerged in the past decade as an intervention therapy for children with ASD. The aim of the present study was to evaluate the effects of music on cognition impairments in the valproic acid (VPA) rat model of autism. The VPA was administered for animal modeling of autism on embryonic day 12.5 (E12.5) (600 mg/kg). Male and female pups were sub divided into four main groups (Saline.Non-music, VPA.Non-music, Saline.Music, and VPA.Music). The rats in the music groups were exposed to Mozart's piano sonata K.448 for 30 days (4 h/day), from postnatal day (PND) 21 to 50. Autistic-like behaviors were tested using a social interaction, the Morris water maze (MWM), and a passive avoidance tasks at the end of the PND 50. Our results demonstrated that VPA-exposed rat pups had significantly lower sociability and social memory performance compared with the saline-exposed rats in both sexes. VPA-exposed rat pups exhibited learning and memory impairments in the MWM and passive avoidance tasks. Our results demonstrated that music improved sociability in VPA-exposed rats, especially in males. Furthermore, our findings revealed that music improved learning impairments in VPA-exposed male rats in MWM task. In addition, music improved spatial memory impairments in VPA-exposed rats of both sexes. We also found that music improved passive avoidance memory impairments in VPA-exposed rats of both sexes, especially in females. More investigation in future studies are needed.

The Relationship between Formal Music Training and Conflict Control: An ERP Study

Music training involves manifolds of sensorimotor processes that tie closely with executive functions, including conflict control. Past studies have found consistent evidence in children of the link between music learning and executive functions. However, the same relationship has not been found in adult populations, and conflict control has yet to be studied in a focused manner. Via the Stroop task and event-related potentials (ERPs), the present study examined the association between musical training and conflict control ability among Chinese college students. The findings exhibited that individuals with music training outperformed individuals without music training by demonstrating higher accuracy and faster reaction times on the Stroop task and exhibiting greater N2 and smaller P3 amplitudes compared to the control group. The results support our hypothesis that people who received music training demonstrate advantages in their capacity for conflict control. The findings also provide scope for future research.

Musical and psychomotor interventions for cognitive, sensorimotor, and cerebral decline in patients with Mild Cognitive Impairment (COPE): a study protocol for a multicentric randomized controlled study

BACKGROUND

Regular cognitive training can boost or maintain cognitive and brain functions known to decline with age. Most studies administered such cognitive training on a computer and in a lab setting. However, everyday life activities, like musical practice or physical exercise that are complex and variable, might be more successful at inducing transfer effects to different cognitive domains and maintaining motivation. "Body-mind exercises", like Tai Chi or psychomotor exercise, may also positively affect cognitive functioning in the elderly. We will compare the influence of active music practice and psychomotor training over 6 months in Mild Cognitive Impairment patients from university hospital memory clinics on cognitive and sensorimotor performance and brain plasticity. The acronym of the study is COPE (Countervail cOgnitive imPairmEnt), illustrating the aim of the study: learning to better "cope" with cognitive decline.

METHODS

We aim to conduct a randomized controlled multicenter intervention study on 32 Mild Cognitive Impairment (MCI) patients (60-80 years), divided over 2 experimental groups: 1) Music practice; 2) Psychomotor treatment. Controls will consist of a passive test-retest group of 16 age, gender and education level matched healthy volunteers. The training regimens take place twice a week for 45 min over 6 months in small groups, provided by professionals, and patients should exercise daily at home. Data collection takes place at baseline (before the interventions), 3, and 6 months after training onset, on cognitive and sensorimotor capacities, subjective well-being, daily living activities, and via functional and structural neuroimaging. Considering the current constraints of the COVID-19 pandemic, recruitment and data collection takes place in 3 waves.

DISCUSSION

We will investigate whether musical practice contrasted to psychomotor exercise in small groups can improve cognitive, sensorimotor and brain functioning in MCI patients, and therefore provoke specific benefits for their daily life functioning and well-being.

TRIAL REGISTRATION

The full protocol was approved by the Commission cantonale d'éthique de la recherche sur l'être humain de Genève (CCER, no. 2020-00510) on 04.05.2020, and an amendment by the CCER and the Commission cantonale d'éthique de la recherche sur l'être humain de Vaud (CER-VD) on 03.08.2021. The protocol was registered at clinicaltrials.gov (20.09.2020, no. NCT04546451).

Effect of 3D-MOT training on the execution of manual dexterity skills in a population of older adults with mild cognitive impairment and mild dementia

Computerized cognitive training tools are an alternative to preventive treatments related to cognitive impairment and aging. In this study, the transfer of 3D multiple object tracking (3D-MOT) training on manual dexterity concerning fine and gross motor skills in 38 elderly participants, half of them with mild cognitive impairment (MCI) and the other half with mild dementia (MD) was explored. A total of 36 sessions of the 3D-MOT training program were administered to the subjects. The Montreal Cognitive Assessment (MoCA) test was used to assess the baseline cognitive status of the participants. Two batteries of manual motor skills (GPT and MMDT) were applied before and after the 3D-MOT training program. The results showed an interaction effect of training and improvement in manual dexterity tests, from the first training session until the fifteenth session, and after this range of sessions, the interaction effect was lost. However, the training effect continued to the end of the thirty-six-session program. The experimental results show the effect of cognitive training on the improvement of motor skills in older adults. This type of intervention could have a broad impact on the aging population in terms of their attention, executive functions, and therefore, their quality of life.

Auditory cognitive aging in amateur singers and non-singers

The notion that lifestyle factors, such as music-making activities, can affect cognitive functioning and reduce cognitive decline in aging is often referred to as the mental exercise hypothesis. One ubiquitous musical activity is choir singing. Like other musical activities, singing is hypothesized to impact cognitive and especially executive functions. Despite the commonness of choir singing, little is known about the extent to which singing can affect cognition in adulthood. In this cross-sectional group study, we examined the relationship between age and four auditory executive functions to test hypotheses about the relationship between the level of mental activity and cognitive functioning. We also examined pitch discrimination capabilities. A non-probabilistic sample of 147 cognitively healthy adults was recruited, which included 75 non-singers (mean age 52.5 ± 20.3; 20-98 years) and 72 singers (mean age 55.5 ± 19.2; 21-87 years). Tests of selective attention, processing speed, inhibitory control, and working memory were administered to all participants. Our main hypothesis was that executive functions and age would be negatively correlated, and that this relationship would be stronger in non-singers than singers, consistent with the differential preservation hypothesis. The alternative hypothesis - preserved differentiation - predicts that the difference between singers and non-singers in executive functions is unaffected by age. Our results reveal a detrimental effect of age on processing speed, selective attention, inhibitory control and working memory. The effect of singing was comparatively more limited, being positively associated only with frequency discrimination, processing speed, and, to some extent, inhibitory control. Evidence of differential preservation was limited to processing speed. We also found a circumscribed positive impact of age of onset and a negative impact of singing experience on cognitive functioning in singers. Together, these findings were interpreted as reflecting an age-related decline in executive function in cognitively healthy adults, with specific and limited positive impacts of singing, consistent with the preserved differentiation hypothesis, but not with the differential preservation hypothesis.

An RCT study showing few weeks of music lessons enhance audio-visual temporal processing

Music involves different senses and is emotional in nature, and musicians show enhanced detection of audio-visual temporal discrepancies and emotion recognition compared to non-musicians. However, whether musical training produces these enhanced abilities or if they are innate within musicians remains unclear. Thirty-one adult participants were randomly assigned to a music training, music listening, or control group who all completed a one-hour session per week for 11 weeks. The music training group received piano training, the music listening group listened to the same music, and the control group did their homework. Measures of audio-visual temporal discrepancy, facial expression recognition, autistic traits, depression, anxiety, stress and mood were completed and compared from the beginning to end of training. ANOVA results revealed that only the music training group showed a significant improvement in detection of audio-visual temporal discrepancies compared to the other groups for both stimuli (flash-beep and face-voice). However, music training did not improve emotion recognition from facial expressions compared to the control group, while it did reduce the levels of depression, stress and anxiety compared to baseline. This RCT study provides the first evidence of a causal effect of music training on improved audio-visual perception that goes beyond the music domain.

Playing a musical instrument and the risk of dementia among older adults: a systematic review and meta-analysis of prospective cohort studies

BACKGROUND

Engaging in leisure activities was suggested to protect older adults from dementia. However, the association between playing a musical instrument and the risk of dementia is not well-established. This study aimed to investigate this association in older adults using a systematic review and meta-analysis of prospective cohort studies.

METHODS

Pooled hazard ratio (HR) and 95% confidence interval (CI) of having dementia for older adults playing a musical instrument were calculated using the random-effects model. We performed the I2 statistic to detect heterogeneity across studies and the test for funnel plot asymmetry to assess publication bias. The risk of bias assessment was conducted using the modified Newcastle-Ottawa Scale.

RESULTS

A total of three prospective cohort studies were found eligible: two from the U.S. and one from Japan. Playing a musical instrument, in the meta-analysis, was significantly associated with a decreased risk of dementia (HR = 0.64; 95% CI: 0.41, 0.98) among older adults. No signs of significant heterogeneity across studies (I2 = 23.3% and p-heterogeneity = 0.27) or publication bias (z= -1.3 and p-publication bias = 0.18) were identified.

CONCLUSION

Playing a musical instrument was associated with a decreased risk of dementia among older adults. Older adults should be encouraged to engage in leisure activities, especially playing musical instruments.

Music training modulates theta brain oscillations associated with response suppression

There is growing interest in developing training programs to mitigate cognitive decline associated with normal aging. Here, we assessed the effect of 3-month music and visual art training programs on the oscillatory brain activity of older adults using a partially randomized intervention design. High-density electroencephalography (EEG) was measured during the pre- and post-training sessions while participants completed a visual GoNoGo task. Time-frequency representations were calculated in regions of interest encompassing the visual, parietal, and prefrontal cortices. Before training, NoGo trials generated greater theta power than Go trials from 300 to 500 ms post-stimulus in mid-central and frontal brain areas. Theta power indexing response suppression was significantly reduced after music training. There was no significant difference between pre- and post-test for the visual art or the control group. The effect of music training on theta power indexing response suppression was associated with reduced functional connectivity between prefrontal, visual, and auditory regions. These results suggest that theta power indexes executive control mechanisms in older adults. Music training affects theta power and functional connectivity associated with response suppression. These findings contribute to a better understanding of inhibitory control ability in older adults and the neuroplastic effects of music interventions.

Enhanced Short-Term Memory Function in Older Adults with Dementia Following Music-Feedback Physical Training: A Pilot Study

Prior research demonstrates that music making, physical exercise, and social activity have unique, positive effects on cognition and mood. One intervention, “Jymmin^®”, was developed incorporating these approaches and found effective for decreased pain perception and increased endurance, self-efficacy, mood, and muscle efficiency. Previously, Jymmin was not piloted with older adults with dementia. The current study is a randomized pilot study of the Jymmin^® with an older adult population in a long-term care facility (n = 38), evaluated across dementia levels (mild, moderate, or severe). Results found significant improvements in scores on a confrontation naming task across all conditions (p = 0.047) and a significant interaction effect for short-term memory scores (p = 0.046), suggesting higher scores at Time 2 for the experimental group and at Time 3 for the control group. There were no significant changes in mood ratings. Findings are discussed in the context of neural activity and musical agency.

Cognitive efficacy and neural mechanisms of music-based neurological rehabilitation for traumatic brain injury

Traumatic brain injury (TBI) causes lifelong cognitive deficits, most often in executive function (EF). Both musical training and music-based rehabilitation have been shown to enhance EF and neuroplasticity. Thus far, however, there is little evidence for the potential rehabilitative effects of music for TBI. Here, we review the core findings from our recent cross-over randomized controlled trial in which a 10-week music-based neurological rehabilitation (MBNR) protocol was administered to 40 patients with moderate-to-severe TBI. Neuropsychological testing and structural/functional magnetic resonance imaging were collected at three time points (baseline, 3 months, and 6 months); one group received the MBNR between time points 1 and 2, while a second group received it between time points 2 and 3. We found that both general EF and set shifting improved after the intervention, and this effect was maintained long term. Morphometric analyses revealed therapy-induced gray matter volume changes most consistently in the right inferior frontal gyrus, changes that correlated with better outcomes in set shifting. Finally, we found changes in the between- and within-network functional connectivity of large-scale resting-state networks after MBNR, which also correlated with measures of EF. Taken together, the data provide evidence for concluding that MBNR improves EF in TBI; also, the data show that morphometric and resting-state functional connectivity are sensitive markers with which to monitor the neuroplasticity induced by the MBNR intervention.

Musical Activity During Life Is Associated With Multi-Domain Cognitive and Brain Benefits in Older Adults

Regular musical activity as a complex multimodal lifestyle activity is proposed to be protective against age-related cognitive decline and Alzheimer’s disease. This cross-sectional study investigated the association and interplay between musical instrument playing during life, multi-domain cognitive abilities and brain morphology in older adults (OA) from the DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE) study. Participants reporting having played a musical instrument across three life periods (n = 70) were compared to controls without a history of musical instrument playing (n = 70), well-matched for reserve proxies of education, intelligence, socioeconomic status and physical activity. Participants with musical activity outperformed controls in global cognition, working memory, executive functions, language, and visuospatial abilities, with no effects seen for learning and memory. The musically active group had greater gray matter volume in the somatosensory area, but did not differ from controls in higher-order frontal, temporal, or hippocampal volumes. However, the association between gray matter volume in distributed frontal-to-temporal regions and cognitive abilities was enhanced in participants with musical activity compared to controls. We show that playing a musical instrument during life relates to better late-life cognitive abilities and greater brain capacities in OA. Musical activity may serve as a multimodal enrichment strategy that could help preserve cognitive and brain health in late life. Longitudinal and interventional studies are needed to support this notion.

Long-Term Impacts of Early Musical Abilities on Academic Achievement: A Longitudinal Study

Numerous neurological, psychological, and transfer studies confirmed the role of learning music in cognitive development and education. However, exploring the long-term impacts of early musical abilities on academic achievement has gained relatively little attention thus far. In a seven-year longitudinal study, we examined the predictive role of musical abilities in future success in school. The sample consisted of 76 Hungarian students. The independent variables were mothers’ education and the tests administered to Grade-1 students, which included Raven’s Progressive Matrices and tests on word reading, mathematics, and musical abilities. The dependent variable was GPA in Grade 7. All tests demonstrated adequate reliability. In the regression model with the most significant predictive role, the independent variables explained 46% of GPA in Grade 7 when taken together. We established the long-term predictive role of musical abilities in later success in school. Rhythm perception and reproduction demonstrated the most significant explanatory power (11%) of variance for GPA. Mathematics and mothers’ education each explained 10% of the variance. The findings shed light on the positive impacts that early musical training may play in later academic achievement, even in the long run.

The effect of learning to drum on behavior and brain function in autistic adolescents

This current study aimed to investigate the impact of drum training on behavior and brain function in autistic adolescents with no prior drumming experience. Thirty-six autistic adolescents were recruited and randomly assigned to one of two groups. The drum group received individual drum tuition (two lessons per week over an 8-wk period), while the control group did not. All participants attended a testing session before and after the 8-wk period. Each session included a drumming assessment, an MRI scan, and a parent completing questionnaires relating to the participants’ behavioral difficulties. Results showed that improvements in drumming performance were associated with a significant reduction in hyperactivity and inattention difficulties in drummers compared to controls. The fMRI results demonstrated increased functional connectivity in brain areas responsible for inhibitory control, action outcomes monitoring, and self-regulation. In particular, seed-to-voxel analyses revealed an increased functional connectivity in the right inferior frontal gyrus and the right dorsolateral prefrontal cortex. A multivariate pattern analysis demonstrated significant changes in the medial frontal cortex, the left and right paracingulate cortex, the subcallosal cortex, the left frontal pole, the caudate, and the left nucleus accumbens. In conclusion, this study investigates the impact of a drum-based intervention on neural and behavioral outcomes in autistic adolescents. We hope that these findings will inform further research and trials into the potential use of drum-based interventions in benefitting clinical populations with inhibition-related disorders and emotional and behavioral difficulties.

Music experience predicts episodic memory performance in older adult instrumental musicians

OBJECTIVE

Previous research suggests that there is a relationship between music lessons early in life and cognitive functioning in late life. The current study examined 1) how lifestyle factors, including music lessons, physical and social activity, and health predict late life cognition and 2) how unique music training variables (e.g., hours practiced, years in lessons, age of acquisition) predicted cognitive scores for older adults.

METHODS

Participants completed a neuropsychological battery examining major cognitive domains, and completed questionnaires on music experience, physical and social activity, and physician diagnosed health factors.

RESULTS

Results suggested that belonging to the musician group predicted scores on executive functioning, language, and visual spatial ability. Among instrumental musicians, number of years in formal training and current number of hours playing per week predicted scores on verbal memory. Age of acquisition was not a significant predictor of cognitive functioning.

CONCLUSIONS

Music training significantly predicted scores on tests of executive function, visual spatial ability, and language, above and beyond other variables, including current age and health and lifestyle factors. The number of years of formal training predicted scores on verbal learning and memory, with significant implications for aging. The results are discussed in the context of cognitive aging and music education.

The importance of the motor system in the development of music-based forms of auditory rehabilitation

Hearing abilities decline with age, and one of the most commonly reported hearing issues in older adults is a difficulty understanding speech when there is loud background noise. Understanding speech in noise relies on numerous cognitive processes, including working memory, and is supported by numerous brain regions, including the motor and motor planning systems. Indeed, many working memory processes are supported by motor and premotor cortical regions. Interestingly, lifelong musicians and nonmusicians given music training over the course of weeks or months show an improved ability to understand speech when there is loud background noise. These benefits are associated with enhanced working memory abilities, and enhanced activity in motor and premotor cortical regions. Accordingly, it is likely that music training improves the coupling between the auditory and motor systems and promotes plasticity in these regions and regions that feed into auditory/motor areas. This leads to an enhanced ability to dynamically process incoming acoustic information, and is likely the reason that musicians and those who receive laboratory-based music training are better able to understand speech when there is background noise. Critically, these findings suggest that music-based forms of auditory rehabilitation are possible and should focus on tasks that promote auditory-motor interactions.

Working-Memory, Alpha-Theta Oscillations and Musical Training in Older Age: Research Perspectives for Speech-on-speech Perception

During the normal course of aging, perception of speech-on-speech or “cocktail party” speech and use of working memory (WM) abilities change. Musical training, which is a complex activity that integrates multiple sensory modalities and higher-order cognitive functions, reportedly benefits both WM performance and speech-on-speech perception in older adults. This mini-review explores the relationship between musical training, WM and speech-on-speech perception in older age (> 65 years) through the lens of the Ease of Language Understanding (ELU) model. Linking neural-oscillation literature associating speech-on-speech perception and WM with alpha-theta oscillatory activity, we propose that two stages of speech-on-speech processing in the ELU are underpinned by WM-related alpha-theta oscillatory activity, and that effects of musical training on speech-on-speech perception may be reflected in these frequency bands among older adults.

A person-centered framework for designing music-based therapeutic studies in dementia: current barriers and a path forward

Objectives: Music-based interventions have received growing attention to improve quality of life for people diagnosed with dementia. Results of randomized controlled trials and meta-analytic reviews to date, however, reveal a lack of conclusive evidence for or against the effectiveness of such interventions. Herein, we critically review the basic assumptions and methodological issues ingrained in the cultures of research and care as they relate to evaluating music-based treatments for people with dementia, and propose a shift in the methodology by which music interventions are empirically evaluated.Method: We begin by reviewing existing barriers to achieving clarity on the effectiveness of music interventions, and we highlight methodological and sociocultural constraints that have limited our ability to reach concrete conclusions in research studies to-date. We then consider several key factors that have demonstrated relevance in matching people to specific music-based interventions. Based on these key factors, we developed a person-centered framework integrating elements from precision-medicine methodology to guide intervention studies.Results: Our organizing framework systematically integrates the following factors to inform the design of intervention studies: 1) person-centered goals and desired outcomes; 2) differences among individuals in clinical, cognitive, and historical attributes; and 3) the context of intervention and access to resources.Conclusion: Integration of the proposed framework into empirical investigations of music interventions for people living with dementia will inform precise and tailored interventions that will bring clarity to this growing body of research. Another aim of this framework is to foster a more humane, person-centered approach to our culture of care.

Case Report: Accessible Digital Musical Instrument Can Be Used for Active Music Therapy in a Person With Severe Dementia and Worsening Behavioral and Psychological Symptoms: A Case Study Over a Year and a Half

Despite the fact that accessible digital musical instruments can take into account the level of cognitive demands, previous studies have been conducted with patients with mild cognitive impairment (MCI), and it is not known whether they can be used by people with moderate to severe dementia or dementia with worsening behavioral and psychological symptoms of dementia (BPSD). The participant was an 88-year-old woman with vascular dementia (VaD) (Mini-Mental State Examination [MMSE] and Neuropsychiatric Inventory [NPI] scores: 8 and 20, respectively). Music therapy (MT) was provided twice a week for 15 min, and MT sessions spanned over 18 months. For the MT, we used the cyber musical instrument with score (Cymis), an accessible digital musical instrument; it could be played using a touch panel and switches. The cognitive function of the participant declined further, with MMSE scores of 4 after 1 year and 0 after 1.5 years. BPSD peaked with the NPI score of 54 at 1 year and declined thereafter, although only apathy remained. Despite these changes, during MT, she was able to play the accessible digital musical instrument and focus on the performance. These results suggest that even patients with severe VaD can play an accessible digital instrument and continue active music therapy even if their BPSD progress with cognitive decline.

Music affects functional brain connectivity and is effective in the treatment of neurological disorders

In a million years, under the pressure of natural selection, hominins have acquired the abilities for vocal learning, music, and language. Music is a relevant human activity, highly effective in enhancing sociality, is a universal experience common to all known human cultures, although it varies in rhythmic and melodic complexity. It has been part of human life since the beginning of our history, or almost, and it strengthens the mother-baby relation even within the mother's womb. Music engages multiple cognitive functions, and promotes attention, concentration, imagination, creativity, elicits memories and emotions, and stimulates imagination, and harmony of movement. It changes the chemistry of the brain, by inducing the release of neurotransmitters and hormones (dopamine, serotonin, and oxytocin) and activates the reward and prosocial systems. In addition, music is also used to develop new therapies necessary to alleviate severe illness, especially neurological disorders, and brain injuries.

Six Months of Piano Training in Healthy Elderly Stabilizes White Matter Microstructure in the Fornix, Compared to an Active Control Group

While aging is characterized by neurodegeneration, musical training is associated with experience-driven brain plasticity and protection against age-related cognitive decline. However, evidence for the positive effects of musical training mostly comes from cross-sectional studies while randomized controlled trials with larger sample sizes are rare. The current study compares the influence of six months of piano training with music listening/musical culture lessons in 121 musically naïve healthy elderly individuals with regard to white matter properties using fixel-based analysis. Analyses revealed a significant fiber density decline in the music listening/musical culture group (but not in the piano group), after six months, in the fornix, which is a white matter tract that naturally declines with age. In addition, these changes in fiber density positively correlated to episodic memory task performances and the amount of weekly piano training. These findings not only provide further evidence for the involvement of the fornix in episodic memory encoding but also more importantly show that learning to play the piano at an advanced age may stabilize white matter microstructure of the fornix.

Lifetime musical training and cognitive performance in a memory clinic population: A cross-sectional study

BACKGROUND

Music training has been found to be beneficial for young and healthy participants but the associations between musical training and the cognitive functioning of elderly participants have not been reported consistently. We examined whether lifetime musical training is associated with neuropsychological performance in a memory clinic population of older patients.

METHODS

A total of 478 patients (54.2% female, mean age 73.70 ± 6.22, mean Mini Mental State Examination score 25 ± 3) were included in the cross-sectional analyses. All patients were referred to the memory clinic due to cognitive impairments. During the course of diagnosis, all patients underwent neuropsychological tests using the CERAD neuropsychological assessment battery. Patients provided information on whether they ever learned to play an instrument for at least five years in their life.

RESULTS

Neuropsychological test results differed based on musical training (p = .042). Overall, there were no differences in any domains of cognitive functioning, other than that patients with musical training performed worse on word list memory (p = .008). However, this relationship varied based on the extent of cognitive impairments. Patients who were cognitively unimpaired (Mini Mental State Examination score 27-30) and had musical training showed better word list learning, whereas patients with cognitive impairments (Mini Mental State Examination score < 27) and musical training performed worse in word list learning (p = .042) and word list recall (p = .045).

DISCUSSION

Overall, there was little evidence of associations between specific neuropsychological test results and musical training. Only in cognitively unimpaired patients was there evidence that musical training had beneficial associations. In patients with cognitive impairment, there were suggestions of negative associations with verbal memory. Future research should longitudinally investigate the beneficial effects of musical training in people with and without cognitive impairments.

Music Training, and the Ability of Musicians to Harmonize, Are Associated With Enhanced Planning and Problem-Solving

Music training is associated with enhanced executive function but little is known about the extent to which harmonic aspects of musical training are associated with components of executive function. In the current study, an array of cognitive tests associated with one or more components of executive function, was administered to young adult musicians and non-musicians. To investigate how harmonic aspects of musical training relate to executive function, a test of the ability to compose a four-part harmony was developed and administered to musicians. We tested the working hypothesis that musicians would outperform non-musicians on measures of executive function, and that among musicians, the ability to harmonize would correlate positively with measures of executive function. Results indicate that musicians outperformed non-musicians on the Tower of London task, a measure of planning and problem-solving. Group differences were not detected on tasks more selective for inhibitory control, conflict resolution, or working memory. Among musicians, scores on the harmony assessment were positively correlated with performance of the Tower of London task. Taken together, the current results support a strong relationship between musicianship and planning and problem solving abilities, and indicate that the ability to harmonize is associated with components of executive function contributing to planning and problem solving.

Piano Training Enhances Executive Functions and Psychosocial Outcomes in Aging: Results of a Randomized Controlled Trial

Objectives

Preliminary evidence suggests piano training may enhance areas of executive functions and psychosocial outcomes in aging adults. However, little is known regarding specific cognitive outcomes affected and whether or not enhancements are sustainable. We conducted a randomized controlled trial to evaluate the effects of piano training on cognitive performance, psychosocial well-being, and physiological stress and immune-function, in older adults.

Methods

Older adults (N=155, 60-80 years) completed an initial three-hour assessment of standardized cognitive and psychosocial measures. Participants were randomly assigned to one of three groups: piano training, computer-assisted cognitive training, or a no treatment control group. Training groups completed a 16-week program with two group training sessions per week for 90 minutes each session. All participants completed a standard battery of executive functions (working memory, processing speed, verbal fluency), psychosocial measures (musical and general self-efficacy, mood), and physiological measures (cortisol and immune-function) at pretesting, posttesting, and at a three-month follow-up time point.

Results

Results showed that piano training and computer-assisted cognitive training enhanced working memory and processing speed as compared to controls. Piano training significantly increased verbal fluency skills in category switching, as compared to computer-assisted cognitive training and no treatment controls. Participants in piano training demonstrated enhanced general and musical self-efficacy post-training; however, no significant differences were found for physiological measures.

Discussion

Piano training resulted in a unique advantage in category switching as compared to computer-assisted cognitive training and no treatment controls. Music training programs may mitigate or prevent cognitive deficits in verbal skills.

Rhythm and Music-Based Interventions in Motor Rehabilitation: Current Evidence and Future Perspectives

Research in basic and clinical neuroscience of music conducted over the past decades has begun to uncover music’s high potential as a tool for rehabilitation. Advances in our understanding of how music engages parallel brain networks underpinning sensory and motor processes, arousal, reward, and affective regulation, have laid a sound neuroscientific foundation for the development of theory-driven music interventions that have been systematically tested in clinical settings. Of particular significance in the context of motor rehabilitation is the notion that musical rhythms can entrain movement patterns in patients with movement-related disorders, serving as a continuous time reference that can help regulate movement timing and pace. To date, a significant number of clinical and experimental studies have tested the application of rhythm- and music-based interventions to improve motor functions following central nervous injury and/or degeneration. The goal of this review is to appraise the current state of knowledge on the effectiveness of music and rhythm to modulate movement spatiotemporal patterns and restore motor function. By organizing and providing a critical appraisal of a large body of research, we hope to provide a revised framework for future research on the effectiveness of rhythm- and music-based interventions to restore and (re)train motor function.

Can Dance and Music Make the Transition to a Sustainable Society More Feasible?

Transition to sustainability is a process that requires change on all levels of society from the physical to the psychological. This review takes an interdisciplinary view of the landscapes of research that contribute to the development of pro-social behaviors that align with sustainability goals, or what we call 'inner sustainability'. Engaging in musical and dance activities can make people feel trust and connectedness, promote prosocial behavior within a group, and also reduce prejudices between groups. Sustained engagement in these art forms brings change in a matter of seconds (such as hormonal changes and associated stress relief), months (such as improved emotional wellbeing and learning outcomes), and decades (such as structural changes to the brains of musicians and dancers and superior skills in expressing and understanding emotion). In this review, we bridge the often-separate domains of the arts and sciences by presenting evidence that suggests music and dance promote self-awareness, learning, care for others and wellbeing at individual and group levels. In doing so, we argue that artistic practices have a key role to play in leading the transformations necessary for a sustainable society. We require a movement of action that provides dance and music within a constructive framework for stimulating social sustainability.

Neural Advantages of Older Musicians Involve the Cerebellum: Implications for Healthy Aging Through Lifelong Musical Instrument Training

This study compared 30 older musicians and 30 age-matched non-musicians to investigate the association between lifelong musical instrument training and age-related cognitive decline and brain atrophy (musicians: mean age 70.8 years, musical experience 52.7 years; non-musicians: mean age 71.4 years, no or less than 3 years of musical experience). Although previous research has demonstrated that young musicians have larger gray matter volume (GMV) in the auditory-motor cortices and cerebellum than non-musicians, little is known about older musicians. Music imagery in young musicians is also known to share a neural underpinning [the supramarginal gyrus (SMG) and cerebellum] with music performance. Thus, we hypothesized that older musicians would show superiority to non-musicians in some of the abovementioned brain regions. Behavioral performance, GMV, and brain activity, including functional connectivity (FC) during melodic working memory (MWM) tasks, were evaluated in both groups. Behaviorally, musicians exhibited a much higher tapping speed than non-musicians, and tapping speed was correlated with executive function in musicians. Structural analyses revealed larger GMVs in both sides of the cerebellum of musicians, and importantly, this was maintained until very old age. Task-related FC analyses revealed that musicians possessed greater cerebellar-hippocampal FC, which was correlated with tapping speed. Furthermore, musicians showed higher activation in the SMG during MWM tasks; this was correlated with earlier commencement of instrumental training. These results indicate advantages or heightened coupling in brain regions associated with music performance and imagery in musicians. We suggest that lifelong instrumental training highly predicts the structural maintenance of the cerebellum and related cognitive maintenance in old age.

The Impact of Music Training and Working Memory on Speech Recognition in Older Age

Purpose Music training has been proposed as a possible tool for auditory training in older adults, as it may improve both auditory and cognitive skills. However, the evidence to support such benefits is mixed. The goal of this study was to determine the differential effects of lifelong musical training and working memory on speech recognition in noise, in older adults. Method A total of 31 musicians and nonmusicians aged 65-78 years took part in this cross-sectional study. Participants had a normal pure-tone average, with most having high-frequency hearing loss. Working memory (memory capacity) was assessed with the backward Digit Span test, and speech recognition in noise was assessed with three clinical tests (Quick Speech in Noise, Hearing in Noise Test, and Revised Speech Perception in Noise). Results Findings from this sample of older adults indicate that neither music training nor working memory was associated with differences on the speech recognition in noise measures used in this study. Similarly, duration of music training was not associated with speech-in-noise recognition. Conclusions Results from this study do not support the hypothesis that lifelong music training benefits speech recognition in noise. Similarly, an effect of working memory (memory capacity) was not apparent. While these findings may be related to the relatively small sample size, results across previous studies that investigated these effects have also been mixed. Prospective randomized music training studies may be able to better control for variability in outcomes associated with pre-existing and music training factors, as well as to examine the differential impact of music training and working memory for speech-in-noise recognition in older adults.

Use of Music Therapy as an Audiological Rehabilitation Tool in the Elderly Population: A Mini-Review

It is well known and documented that sensory perception decreases with age. In the elderly population, hearing loss and reduced vestibular function are among the most prevalently affected senses. Two important side effects of sensory deprivation are cognitive decline and decrease in social participation. Hearing loss, vestibular function impairment, and cognitive decline all lead to a decrease in social participation. Altogether, these problems have a great impact on the quality of life of the elderly. This is why a rehabilitation program covering all of these aspects would therefore be useful for clinicians. It is well known that long-term music training can lead to cortical plasticity. Behavioral improvements have been measured for cognitive abilities and sensory modalities (auditory, motor, tactile, and visual) in healthy young adults. Based on these findings, it is possible to wonder if this kind of multisensory training would be an interesting therapy to not only improve communication but also help with posture and balance, cognitive abilities, and social participation. The aim of this review is to assess and validate the impact of music therapy in the context of hearing rehabilitation in older adults. Musical therapy seems to have a positive impact on auditory perception, posture and balance, social integration, and cognition. While the benefits seem obvious, the evidence in the literature is scarce. However, there is no reason not to recommend the use of music therapy as an adjunct to audiological rehabilitation in the elderly when possible. Further investigations are needed to conclude on the extent of the benefits that music therapy could bring to older adults. More data are needed to confirm which hearing abilities can be improved based on the many characteristics of hearing loss. There is also a need to provide a clear protocol for clinicians on how this therapy should be administered to offer the greatest possible benefits.

How Do Music Activities Affect Health and Well-Being? A Scoping Review of Studies Examining Psychosocial Mechanisms

Background: This scoping review analyzed research about how music activities may affect participants' health and well-being. Primary outcomes were measures of health (including symptoms and health behaviors) and well-being. Secondary measures included a range of psychosocial processes such as arousal, mood, social connection, physical activation or relaxation, cognitive functions, and identity. Diverse music activities were considered: receptive and intentional music listening; sharing music; instrument playing; group singing; lyrics and rapping; movement and dance; and songwriting, composition, and improvisation. Methods: Nine databases were searched with terms related to the eight music activities and the psychosocial variables of interest. Sixty-three papers met selection criteria, representing 6,975 participants of all ages, nationalities, and contexts. Results: Receptive and intentional music listening were found to reduce pain through changes in physiological arousal in some studies but not others. Shared music listening (e.g., concerts or radio programs) enhanced social connections and mood in older adults and in hospital patients. Music listening and carer singing decreased agitation and improved posture, movement, and well-being of people with dementia. Group singing supported cognitive health and well-being of older adults and those with mental health problems, lung disease, stroke, and dementia through its effects on cognitive functions, mood, and social connections. Playing a musical instrument was associated with improved cognitive health and well-being in school students, older adults, and people with mild brain injuries via effects on motor, cognitive and social processes. Dance and movement with music programs were associated with improved health and well-being in people with dementia, women with postnatal depression, and sedentary women with obesity through various cognitive, physical, and social processes. Rapping, songwriting, and composition helped the well-being of marginalized people through effects on social and cultural inclusion and connection, self-esteem and empowerment. Discussion: Music activities offer a rich and underutilized resource for health and well-being to participants of diverse ages, backgrounds, and settings. The review provides preliminary evidence that particular music activities may be recommended for specific psychosocial purposes and for specific health conditions.