Measuring engagement with music: development of an informant-report questionnaire

Emotional and musical factors combined with song-specific age predict the subjective autobiographical saliency of music in older adults

Music that evokes strong emotional responses is often experienced as autobiographically salient. Through emotional experience, the musical features of songs could also contribute to their subjective autobiographical saliency. Songs which have been popular during adolescence or young adulthood (ages 10-30) are more likely to evoke stronger memories, a phenomenon known as a reminiscence bump. In the present study, we sought to determine how song-specific age, emotional responsiveness to music, musical features, and subjective memory functioning contribute to the subjective autobiographical saliency of music in older adults. In a music listening study, 112 participants rated excerpts of popular songs from the 1950s to the 1980s for autobiographical saliency. Additionally, they filled out questionnaires about emotional responsiveness to music and subjective memory functioning. The song excerpts' musical features were extracted computationally using MIRtoolbox. Results showed that autobiographical saliency was best predicted by song-specific age and emotional responsiveness to music and musical features. Newer songs that were more similar in rhythm to older songs were also rated higher in autobiographical saliency. Overall, this study contributes to autobiographical memory research by uncovering a set of factors affecting the subjective autobiographical saliency of music.

Exploring the usability and feasibility of a mobile music listening application for people living in the community with post-stroke aphasia

PURPOSE

Language and communication disorders can inhibit participation in activities that have potential therapeutic benefits for recovery. This exploratory research examined the usability and feasibility of a purpose-built music listening mobile application for people living in the community with post-stroke aphasia, and examined relationships between useability and participant age, aphasia severity and time post-stroke.

METHODS

Nineteen participants with chronic aphasia tested the application for two weeks. Prior to use, music preferences, technology use and confidence, self-efficacy and music engagement questionnaires were completed. System usability scale, music listening data and a satisfaction rating were completed following use.

RESULTS

Overall, the application was perceived as being usable and feasible with a high system usability rating and moderate effectiveness, efficiency and satisfaction. The system usability scores were not associated with aphasia severity, age, years post-stroke, self-efficacy or music engagement. Technology confidence was positively associated with system usability.

CONCLUSION

The music listening application is a feasible and usable option for listening to music in people with chronic post-stroke aphasia. This study provides a foundation for the rigorous examination of the usability of music listening technology for people with post-stroke aphasia and the potential investigation of use in acute care facilities and other clinical populations.IMPLICATIONS FOR REHABILITATIONMusic listening has potential therapeutic benefits for people with post-stroke aphasia.Applications for music listening require customisation to enable people with post-stroke aphasia opportunity to listen to their preferred music.Music listening applications that are perceived as usable and feasible by people with post-stroke aphasia may have potential application within rehabilitation and community settings.

Online Singing Groups for People With Dementia: Adaptation and Resilience in the Face of the COVID-19 Pandemic

INTRODUCTION

At the start of the COVID-19 pandemic, people with dementia living in the community experienced the sudden loss of their usual activities, and videoconferencing was widely adopted by music groups whilst face-to-face sessions were not possible. This paper reports the findings of a proof-of-concept study of online singing for people living with dementia and their carers, focusing on the experiences of the participants.

METHOD

People with dementia and their care partners were invited to take part in 10 weeks of online singing sessions. Each session lasted 1 hour, and comprised time for talking, warming up and singing familiar songs. Participants completed standardised outcome measures at baseline and after 10 weeks. Dyads were invited to take part in a semi-structured interview.

RESULTS

In total, 16 pairs were recruited. The response to the online singing group was mostly positive. Participants were able to use the technology to join the sessions, and reported few technical problems. Despite the limitations of online singing, the experience was frequently reported to be enjoyable. Some participants described longer-term benefits, such as improved mood and better relationship between care partners. Some felt online sessions had advantages over face-to-face ones; for example, they were more accessible. However, participants who had previously been attending face-to-face sessions felt that the online singing was a "better than nothing" substitute.

CONCLUSIONS

Online singing cannot recreate the experience of group singing face-to-face, and it requires some technical knowledge, but it provides a worthwhile alternative in a time of need for some people with dementia and their carers. Furthermore, for some people online singing may be preferable due to its accessibility. Given the potential for online singing to include people who cannot go out for any reason and its relatively low cost, providers may wish to consider hybrid online/in-person singing groups in future.

Measuring music engagement in older adults: the UNE music in aging wellness scale (MAWS)

OBJECTIVES

Engagement with music (i.e. listening, moving to the beat, joining in, performance) is documented to enhance cognition, mood, socialization, and a host of other wellness indicators in advancing age. A number of comprehensive scales measure this engagement, but a brief, accessible scale designed for general use with older adults is lacking. This project was undertaken to create and offer preliminary validation of the 7-item Music in Aging Wellness Scale (MAWS).

METHOD

Seven items reflecting aspects of music engagement (ME) were developed by expert opinion (e.g. 'I always tap my foot or sway my body to good music') for completion on a 1-7, strongly disagree to strongly agree, Likert scale. These were subject to exploratory factor analysis (EFA) (n = 349 cases) along with a set of six experimental items on ageism. It was hypothesized these items would cluster by content, thus showing separation into distinct factors.

RESULTS

This was achieved and the resulting measure showed sound internal consistency (0.82), split-half reliability (0.71), and one-year test-retest (0.83). The MAWS total score was found to correlate significantly in expected directions with common gerontological measures. High scorers reported less depression, more mastery, less loneliness, and larger social networks. No association was found for worry-based anxiety and self-reported cognitive decline.

CONCLUSION

This preliminary reliability and validity study suggests that the MAWS may be an appropriate outcome and tracking measure for older adults involved in music-wellness interventions. Future research will further validate MAWS characteristics and associations with other established measures in this important field.

Creativity in lockdown: Understanding how music and the arts supported mental health during the COVID-19 pandemic by age group

Recent research has indicated that many people around the world turned to artistic creative activities (ACAs) to support their mental health during COVID-19 lockdowns. However, studies have also shown that the negative psychosocial impacts of the pandemic have disproportionately affected young people, suggesting that the use of ACAs to support mental health in lockdown may have varied across age groups. This study investigated how Australians in four different age groups (18–24, 25–34, 35–54, and 55+) engaged in ACAs to support their mental health during the 2020 pandemic lockdowns. Participants (N = 653) recruited from the general public completed an online survey between May and October 2020, in which they reported which ACAs they had undertaken during the pandemic using an established list. Participants subsequently ranked undertaken ACAs in terms of effectiveness at making them “feel better,” and those who had engaged in musical ACAs also completed the Musical Engagement Questionnaire (MusEQ). Additionally, ratings of anxiety (GAD7) and depression (PHQ9) symptoms were obtained and examined for potential variations across four diverse variables: age, exercise, gender and state/territory of residence. ACA rankings showed that younger participants overwhelmingly rated musical activities as most effective, while, with the exception of singing, those aged 55+ rated non-musical activities as being most effective. These differences were further supported by ratings for all six MusEQ subscales, with responses strongly indicating that the youngest participants (aged 18–24) used music in significantly different ways during the pandemic than participants in all other age groups. Specifically, these youngest participants were more likely to integrate music into daily life, use music for emotion regulation, respond to music in embodied ways, and use music to perform a social identity. In line with prior research, further analyses indicated that symptoms of anxiety and depression were lessened for older participants, as well for those who reported exercising more during the lockdowns. These findings provide insight into how ACAs can support mental health during a pandemic crisis for specific age groups, which may inform future policy directions, and suggestions for how this can be done are provided.

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.

The Role of Artistic Creative Activities in Navigating the COVID-19 Pandemic in Australia

During the COVID-19 pandemic some Australians turned to artistic creative activities (ACAs) as a way of managing their own mental health and well-being. This study examined the role of ACAs in regulating emotion and supporting mental health and well-being during the COVID-19 pandemic, and also attempted to identify at-risk populations. We proposed that (1) participants would use ACAs as avoidance-based emotion regulation strategies; and (2) music engagement would be used for emotion regulation. Australian participants (N = 653) recruited from the general public completed an online survey, which included scales targeting anxiety (GAD7 scale), depression (PHQ9 scale) and loneliness (two UCLA Loneliness Scales, referring to "Before" and "Since" COVID-19). Participants reported which ACAs they had undertaken and ceased during the pandemic using an established list and ranked their undertaken ACAs in terms of effectiveness at making them "feel better." For their top-ranked ACA, participants then completed the Emotion Regulation Scale for Artistic Creative Activities (ERS-ACA), and if participants had undertaken any musical ACAs, also the Musical Engagement Questionnaire (MusEQ). The results supported both hypotheses. ANOVAs indicated that participants ranked significantly higher on the "avoidance" ERS-ACA subscale than the other subscales, and that participants ranked significantly higher on the emotion regulation and musical preference MusEQ subscales than the other subscales. Additionally, while ACAs such as "Watching films or TV shows" and "Cookery or baking" were common, they ranked poorly as effective methods of emotion regulation, whereas "Listening to music" was the second-most frequently undertaken ACA and also the most effective. "Singing" and "Dancing" were among the most ceased ACAs but also ranked among the most effective for emotion regulation, suggesting that support for developing pandemic-safe approaches to these ACAs may provide well-being benefits in future crises. Additionally, correlation analyses showed that younger participants, those who took less exercise during the pandemic, and those with the highest musical engagement reported the poorest well-being. We conclude that ACAs provided an important resource for supporting mental health and well-being during the COVID-19 pandemic in Australia and could potentially support mental health and well-being in future crises.

Feasibility of a Music System Intervention to Affect Mental Stress and Strain of Employees in Inpatient Dementia Care

OBJECTIVES

If family caregivers participate with people with dementia in group music therapies, their mental stress can be reduced. The interventions investigated this context are often limited to active music therapies in groups, which do not consider the inclusion of formal caregivers. In the presented study, a music system was implemented in the routine nursing care of a dementia residential community. Aiming to investigate the use and the effects of the music system on employees' mental stress and strain, hypotheses were derived, which, for the first time, qualitatively describe this connection.

METHODS

A controlled feasibility study with pretests and posttests was conducted. Two residential areas of an inpatient care facility for people with dementia participated as an intervention and control groups-these included 28 residents and 18 employees. In the intervention phase, the employees of the intervention group used the music systems during nursing activities and the operations were saved in log files. Mental stress and strain were recorded six times using the BGWmiab questionnaire. In the questionnaire part on mental stress, typical stress factors were assessed, while the part on mental strain records the extent of seven typical symptoms of overstrain.

RESULTS

The music systems were used 1.6 (±1.3) times per day and per resident, dependent on the residents (P < 0.05, n = 13). Changes in total mental stress and strain scores could not be determined. Regarding the strain symptoms, scores of work motivation, fatigue, and aversions decreased. Seventy-one percent of the employees stated an improved daily work routine. The strain changes in employees of the intervention group correlated significantly with their work experience (r = 0.73, P = 0.04, n = 8).

CONCLUSIONS

Eight hypotheses on the usage and effect of music systems were generated. These did not represent an additional stress factor and affected single strain symptoms. In addition, the study highlighted a positive impact that the music systems had on the employees' perception of stress. This is the first time that the positive effects of receptive music interventions on mental stress and strain of formal caregivers are described. Further investigations with an increased frequency of use of the music systems should validate and specify the findings and hypotheses.

Exploring Changes in Musical Behaviors of Caregivers and Children in Social Distancing During the COVID-19 Outbreak

The coronavirus disease 2019 (COVID-19) pandemic has had profound effects on all aspects of society. Families were among those directly impacted by the first measures imposed by health authorities worldwide to contain the spread of the Sars-CoV-2 virus, where social distancing and mandatory quarantine were the main approaches implemented. Notably, little is yet known about how social distancing during COVID-19 has altered families' daily routines, particularly regarding music-related behaviors. The aim of this study was 2-fold: (i) to explore changes in families' daily routine and caregivers' levels of well-being and stress during the COVID-19 outbreak in Brazil and (ii) to investigate whether musical behaviors of caregivers and the children under their care (aged from 3 to 6 years old) changed during social distancing. One hundred and eighty-eight caregivers residing in Brazil participated in an online cross-sectional study conducted between July and August 2020. Our findings suggest significant changes in families' dynamics during the COVID-19 outbreak, with parents (especially mothers) spending more time on childcare and a substantial decrease in caregiver's well-being. Regarding music-related behaviors, our results revealed considerable changes in caregivers' and children's musical activities at home during social distancing, including an increase in child-only musical behaviors and shared caregiver-child activities. Moreover, sociodemographic factors such as caregiver background and well-being as well as the child's disability status significantly influenced musical engagement at home during social distancing. This study captured some features of the home musical environment of middle-class families in Brazil in the first stages of social distancing restrictions during the pandemic and caregivers' role in providing an environment where musical experiences are nurtured. Further research is needed to better understand aspects such as the long-term impact of the changes of musical behaviors at home on musical parenting and families' well-being.

A Qualitative Exploration of Aged-Care Residents' Everyday Music Listening Practices and How These May Support Psychosocial Well-Being

Strategies to support the psychosocial well-being of older adults living in aged-care are needed; and evidence points toward music listening as an effective, non-pharmacological tool with many benefits to quality of life and well-being. Yet, the everyday listening practices (and their associated specific psychosocial benefits) of older adults living in residential aged-care remain under-researched. The current study explored older adults' experiences of music listening in their daily lives while living in residential aged-care and considered how music listening might support their well-being. Specifically, what might go into autonomous listening activities? 32 Australian residents (aged 73-98) living in two Australian care facilities participated in semi-structured interviews. The results of a qualitative thematic analysis revealed three themes pertaining to "previous music experiences and interest," "current music listening," and "barriers to listening." While an interest in and access to music did not necessarily result in everyday listening practices, of those participants who did listen to music, perceived benefits included outcomes such as entertainment, enjoyment, relaxation, and mood regulation. Drawing on Ruud's notion of music as a "cultural immunogen" supporting well-being and Self-Determination Theory, theoretical implications of the findings are addressed, relating to how to create and support music activities in aged-care facilities so that they are engaging, meaningful, and promote emotional regulation, community, and well-being.

Beneficial effects of choir singing on cognition and well-being of older adults: Evidence from a cross-sectional study

Background and objectives

Choir singing has been associated with better mood and quality of life (QOL) in healthy older adults, but little is known about its potential cognitive benefits in aging. In this study, our aim was to compare the subjective (self-reported) and objective (test-based) cognitive functioning of senior choir singers and matched control subjects, coupled with assessment of mood, QOL, and social functioning.

Research design and methods

We performed a cross-sectional questionnaire study in 162 healthy older (age ≥ 60 years) adults (106 choir singers, 56 controls), including measures of cognition, mood, social engagement, QOL, and role of music in daily life. The choir singers were divided to low (1–10 years, N = 58) and high (>10 years, N = 48) activity groups based on years of choir singing experience throughout their life span. A subcohort of 74 participants (39 choir singers, 35 controls) were assessed also with a neuropsychological testing battery.

Results

In the neuropsychological testing, choir singers performed better than controls on the verbal flexibility domain of executive function, but not on other cognitive domains. In questionnaires, high activity choir singers showed better social integration than controls and low activity choir singers. In contrast, low activity choir singers had better general health than controls and high activity choir singers.

Discussion and implications

In healthy older adults, regular choir singing is associated with better verbal flexibility. Long-standing choir activity is linked to better social engagement and more recently commenced choir activity to better general health.

Pilot Randomised Evaluation of Singing in Dementia (PRESIDE): protocol for a two-arm, parallel-group randomised controlled feasibility study with waiting-list control

Background

As the number of people living with dementia grows, so does the need to provide them with adequate psychosocial support. Many people with dementia live at home with family carers, who also require social and emotional support to cope with their role. Community group singing has received attention for its potential to support people with dementia and their carers. It is postulated that singing can improve cognitive function, strengthen the bonds between care partners and help to establish social support networks. However, there is a lack of rigorous evidence of singing’s benefits for this population. This study aims to test the feasibility of a randomised controlled trial of community singing in dementia, to pave the way for a larger, conclusive study.

Methods

The PRESIDE study is designed as a two-arm, parallel-group randomised trial with a waiting list control. Dyads consisting of a person with dementia (n = 80) and their carer (n = 80) will be recruited. Each dyad will be randomised either to attend 10 weeks of community group singing sessions straight away or to wait for 3 months before attending the sessions. The singing sessions will be led by experienced professional musicians and will last about 90 min, including time for socialising. The primary outcome of this study is the attainment of feasibility criteria around recruitment, retention and the acceptability of the waiting list control. Secondary outcomes include the quality of life, mood, cognition, and musical engagement of the person with dementia, and quality of life, mood, and experiences/challenges of the carer. These data will be collected during home visits at baseline, and 3 and 6 months post-baseline.

Discussion

Despite growing public interest in the positive effects of singing, and encouraging findings from qualitative and non-randomised quantitative studies, there is a lack of rigorous evidence. This is the first randomised controlled trial of community group singing for people with dementia in Europe, to our knowledge. If the results favour a full trial, conclusively demonstrating the effectiveness of group singing could positively affect the opportunities available to community-dwelling people with dementia and their carers.

Trial registration

Unique identification number in ISRCTN registry: ISRCTN10201482. Date registered: 12 May 2020

Towards sustainable implementation of music in daily care of people with dementia and their spouses

Primary caregivers (PCs) of people with dementia deal with stressful daily living, especially spouses whose care recipient is at home. Several programs have been developed to aid caregiving by providing musical strategies, yet successful sustainable implementation of music in the daily lives of the couples awaits further research and development. To promote this, in this pilot study we proposed a music therapy program that included 12 weekly sessions with the couple in their home environment. In addition, there were bi-weekly phone counseling sessions with the PC, to reflect on the joint sessions and to help implement music in daily life. Findings based on the description, analysis, and interpretation of two cases showed that the proposed program provided a strong foundation upon which the treatment could succeed; it relied on natural forces such as the use of songs, which can empower each of the spouses individually, as well as together as a couple; and it included elements of ongoing support that enabled preservation of the accomplishments that were achieved during the sessions. Future research is required to examine whether this program is appropriate for couples in other housing contexts, and in different stages of dementia.

Music evoked autobiographical memories in people with behavioural variant frontotemporal dementia

Music is highly efficient at evoking autobiographical memories in both healthy and neurological populations. Music evoked autobiographical memories (MEAMs) are preserved in people with Alzheimer's Dementia (AD), and occur at the same frequency as in healthy people. To date there has been no investigation of the integrity of MEAMs in people with non-AD dementia. This study provides the first characterisation of the frequency and specificity of MEAMs and photo evoked autobiographical memories (PEAMs) in 6 people with Behavioural variant frontotemporal dementia (Bv-FTD). We found significantly reduced frequency and specificity of MEAMs and PEAMs in people with Bv-FTD compared with healthy elderly. This supports the known decline in autobiographical memory function in this population, and the integral role of medial frontal regions in the retrieval of MEAMs. Our findings highlight that the mnemonic effects of music vary between people with different types of dementia, which has implications for dementia care.

A Qualitative Exploration of Choral Singing in Community-dwelling Older Adults

Recent research has recognized the value of participatory arts, including choirs, as a strategy to engage older adults in the community. Less is known about the participation of minority older adults of low socioeconomic status (SES) in choirs. The purpose of this qualitative descriptive study was to explore the perceived benefits of choral singing among older adults from Program of All-Inclusive Care for the Elderly (PACE) day centers. We elicited perceptions from 19 choir participants from three focus groups, the majority of whom were Black or African American (N =17/19), each held at a different PACE center. One main theme emerged, "Something for us to do that we love," with two subthemes, "Joyful time together" and "Uplifting experience performing for others." These study findings have implications for promoting choir singing in older adults to serve as a place for engagement in social interactions in a lifelong activity they love.

Characterization of Music and Photograph Evoked Autobiographical Memories in People with Alzheimer's Disease

BACKGROUND

Music evoked autobiographical memories (MEAMs) have been documented in people with Alzheimer's disease (AD), but it is unclear whether music is more effective than other familiar stimuli at evoking memories.

OBJECTIVE

To explore the frequency and specificity of memories in response to famous songs compared with photographs of famous events (photograph evoked autobiographical memories, PEAMs), and whether stimuli from the period of the reminiscence bump (10-30 years of age) were more likely to elicit memories.

METHODS

10 participants with AD and 10 aged-matched healthy elderly people reported memories following exposure to 2 songs (longest time at number one in Australian music charts) and 2 photographs (of prominent famous events) from each decade from 1930 to 2010.

RESULTS

PEAMs were more frequent than MEAMs in healthy elderly (p < 0.05), but no such differences were observed among people with AD. There was no difference in the frequency of MEAMs between groups, but people with AD showed a significant decline in the frequency of PEAMs. In both groups, MEAMs were typically less specific than PEAMs and comprised semantic knowledge or repeated/extended events. Stimuli from when participants were aged 10-30 years triggered more frequent memories compared with stimuli from later decades, but this was only statistically significant for MEAMs.

CONCLUSION

Our findings indicate a preserved mnemonic effect of music relative to pictures in this patient population, corroborating suggestions that MEAMs represent an island of preservation during the progression of AD.

Short and long term representation of an unfamiliar tone distribution

We report on a study conducted to extend our knowledge about the process of gaining a mental representation of music. Several studies, inspired by research on the statistical learning of language, have investigated statistical learning of sequential rules underlying tone sequences. Given that the mental representation of music correlates with distributional properties of music, we tested whether participants are able to abstract distributional information contained in tone sequences to form a mental representation. For this purpose, we created an unfamiliar music genre defined by an underlying tone distribution, to which 40 participants were exposed. Our stimuli allowed us to differentiate between sensitivity to the distributional properties contained in test stimuli and long term representation of the distributional properties of the music genre overall. Using a probe tone paradigm and a two-alternative forced choice discrimination task, we show that listeners are able to abstract distributional properties of music through mere exposure into a long term representation of music. This lends support to the idea that statistical learning is involved in the process of gaining musical knowledge.