Music Improvisation for Cognitive Aging

(Music Training Trial)

Recruiting at 2 trial locations

Overseen By Julene Johnson, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, San Francisco

Must not be taking: Psychoactive, Antidepressants, Sleep medications

Disqualifiers: Dementia, Severe psychiatric disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 24

238 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine how music improvisation might help older adults improve self-regulation (the ability to manage thoughts and behaviors) and enhance brain engagement. Participants will join either group music listening sessions or group piano improvisation sessions, with some practice at home. The trial suits individuals over 60 who live independently, have mild cognitive impairment or normal cognitive function, and have little formal music training. As an unphased trial, this study offers a unique opportunity to explore innovative ways to enhance cognitive health through music.

Will I have to stop taking my current medications?

If you are currently taking psychoactive medications, antidepressants, or sleep medications that could affect cognitive abilities, you will need to stop taking them to participate in this trial.

What prior data suggests that these music interventions are safe for older adults?

Research shows that music improvisation and similar activities are generally safe for older adults. Studies have found that these activities can boost well-being and memory without causing serious side effects. Music activities might even improve health.

Although limited data exists on negative effects, music-making activities typically don't cause harm. Activities like playing the piano and creating music emphasize creativity and expression, which participants handle well. Overall, past research suggests these activities are safe to try. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using music as a tool for cognitive aging because it offers a non-invasive and engaging way to potentially enhance brain function. Unlike standard cognitive interventions, which might involve medications or brain training games, music listening and piano improvisation tap into the brain's natural ability to process and enjoy music, potentially boosting cognitive skills through creativity and enjoyment. This approach also encourages social interaction and emotional expression, aspects that are often overlooked in traditional treatments. By exploring these innovative techniques, researchers hope to uncover how musical activities can uniquely support cognitive health in aging adults.

What evidence suggests that this trial's treatments could be effective for cognitive aging?

Research has shown that activities like playing the piano can enhance thinking skills in older adults. In this trial, participants will join different treatment arms to explore these benefits. One arm involves Piano Improvisation, where participants engage in group piano improvisation training sessions. Some studies suggest that learning to improvise music may help people manage their thoughts and emotions better. Another arm involves Music Listening, where participants take part in group music listening sessions. While more evidence is needed, music activities have shown promise in slowing the progression from mild memory problems to more serious issues like dementia. Although further research is necessary, these early findings offer encouragement for those interested in maintaining mental sharpness. ^{1 2 3 6 7}

Who Is on the Research Team?

Julene Johnson, PhD

Principal Investigator

University of California, San Francisco

Are You a Good Fit for This Trial?

This trial is for older adults who are experiencing normal cognitive aging or have mild cognitive impairment, but not severe dementia. Participants should be interested in music and able to attend training sessions.

Inclusion Criteria

Less than three years of formal music training (as indicated by private music lessons does not include group or ensemble classes) and not currently reading or engaging in music performance

English fluency rated fairly well to well

MoCA score of 22-30 or diagnosis of 'mild cognitive impairment'

Exclusion Criteria

I have been diagnosed with dementia.

I cannot use my hands or all my fingers properly due to health issues.

Score < 22 on MoCA

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

R61 Phase - Intervention Development

Development of a music improvisation training intervention and a 2-arm randomized pilot study to examine feasibility and acceptability

12 weeks

12 visits (in-person, weekly)

R33 Phase - Mechanistic Trial

Randomized mechanistic trial to examine the effects of the intervention on self-regulation and cognitive engagement

12 weeks

12 visits (in-person, weekly)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Music Listening
• Piano Improvisation

Trial Overview The study looks at how learning to improvise on the piano affects self-regulation and brain function in older adults, compared with just listening to music. It tests if this activity can improve mental engagement.

How Is the Trial Designed?

Group I: Piano Improvisation Experimental Treatment 1 Intervention

This intervention will involve group piano improvisation training sessions once a week for 12 weeks, in addition to daily in-home practice for 4-5 days.

Group II: Music Listening Active Control 1 Intervention

The music listening condition will involve group music listening sessions (led by a trained instructor) once a week for 12 weeks and daily in-home music listening practice.

Music Listening is already approved in United States, European Union for the following indications:

Approved in United States as Music Therapy for:

• Cognitive impairment in multiple sclerosis
• Depression
• Anxiety
• Stress management
• Improvement in mood and emotional well-being

Approved in European Union as Music Therapy for:

• Cognitive rehabilitation in neurological disorders
• Emotional and behavioral disturbances in multiple sclerosis
• Improvement in motor skills and coordination

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials

2,636

Recruited

19,080,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Published Research Related to This Trial

Musical improvisation significantly enhances neutral verbal memory in older adults, as shown by improved word recall compared to control conditions, indicating its potential as a cognitive intervention.

Musicians, with five or more years of training, demonstrated better memory performance than non-musicians, suggesting that musical experience may further amplify the cognitive benefits of music-based interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of music-based intervention on verbal memory: an experimental behavioral study with older adults. Diaz Abrahan, V., Shifres, F., Justel, N.[2021]

This meta-analysis reviewed 10 studies involving older adults (60+) and found that playing musical instruments can improve cognitive functioning, with different types of instrument playing affecting various cognitive domains.

The research suggests that tailored music interventions can be beneficial for older adults with and without cognitive impairments, highlighting the importance of specific cognitive engagement in enhancing cognitive outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Instrument Playing as a Cognitive Intervention Task for Older Adults: A Systematic Review and Meta-Analysis. Kim, SJ., Yoo, GE.[2020]

In a study involving 11 elderly clients at a retirement center, player piano music therapy significantly improved rhythmic and extremity responses, indicating positive physical engagement with the music.

Participants reported enhanced well-being, enjoyment of the music, and the ability to retrieve long-term memories, suggesting that player piano music can be an effective therapeutic tool for improving quality of life in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Player piano music as therapy for the elderly. Olson, BK.[2019]

In a study involving 132 older adults aged 60 to 90, musical improvisation significantly improved both neutral and emotional memory compared to a control group that engaged in music imitation.

Participants with more than 5 years of musical training performed better in memory tasks, indicating that musical knowledge may enhance memory retention in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive Benefits From a Musical Activity in Older Adults. Diaz Abrahan, V., Shifres, F., Justel, N.[2020]

A study involving 35 older adults with mild to moderate cognitive impairment showed that cognitive training using rhythm-music and improvisation significantly improved executive functions, as evidenced by better scores on tests like the Mini-Mental State Examination and verbal fluency test.

In contrast, the control group participating in gymnastic activities did not show any significant cognitive improvements, highlighting the potential effectiveness of music-based cognitive training for enhancing mental functions in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessing a cognitive music training for older participants: a randomised controlled trial. Biasutti, M., Mangiacotti, A.[2022]

A systematic review and meta-analysis of 234 older participants showed that while individual studies suggested music therapy could improve cognitive function, the overall analysis did not find significant short-term benefits when combining results from all studies.

The pooled mean difference for music therapy's effect on cognitive function was 0.73, indicating no statistically significant improvement, suggesting that future research should focus on higher quality methodologies and longer-term studies to better assess the impact of music therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of music therapy on cognitive functioning among older adults: a systematic review and meta-analysis. Li, HC., Wang, HH., Chou, FH., et al.[2018]

In a study involving 126 mechanically ventilated patients in intensive care units, preferred music playlists were analyzed to understand their impact on managing anxiety through patient-directed music listening interventions.

The findings highlight the importance of music selection in therapeutic interventions, suggesting that involving a board-certified music therapist can enhance the effectiveness of music listening protocols in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Analysis of Preferred Music of Mechanically Ventilated Intensive Care Unit Patients Enrolled in a Randomized Controlled Trial. Heiderscheit, A., Johnson, K., Chlan, LL.[2023]

Older adults, including those with complex needs, show a strong interest and capability in using music technologies to engage with music, whether through listening, creating, or performing.

The review of 18 studies indicates that music technologies can provide significant social and emotional benefits for seniors, highlighting the potential for these tools to enhance their quality of life through creative musical opportunities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Music Technology Creatively to Enrich Later-Life: A Literature Review. Creech, A.[2020]

Older adults with cognitive impairments showed significantly lower responsiveness to music excerpts compared to caregivers and college students, indicating challenges in attention and recognition related to cognitive decline.

After participating in music therapy sessions, the same older adults demonstrated significant improvements in their responses to both music and silence excerpts, suggesting that music interventions can enhance attention and engagement in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Music listening for maintaining attention of older adults with cognitive impairments. Gregory, D.[2019]

In an 8-week randomized control trial with 28 elderly cognitively-impaired psychiatric inpatients, music therapy significantly improved cognitive function, as measured by the Mini-Mental State Exam (MMSE), particularly in dementia-diagnosed subjects.

Dementia patients who received music therapy showed an average improvement of 3.69 points in MMSE scores the next morning compared to those in a control group, indicating that music therapy can provide immediate cognitive benefits, although these effects did not persist beyond a week.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The temporal limits of cognitive change from music therapy in elderly persons with dementia or dementia-like cognitive impairment: a randomized controlled trial. Bruer, RA., Spitznagel, E., Cloninger, CR.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11965234/

Neurobiological effects of music-making interventions for ... Evidence on music-making interventions and neuroplasticity in older adults remains inconclusive due to limited studies, high risk of bias, and methodological ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT05980286

Impact of Musical Improvisation Training on Cognitive ... This project will develop and test the effects and mechanisms of a music improvisation training intervention on self-regulation of older adults with and ...

3. withpower.com withpower.com/trial/music-improvisation-for-cognitive-aging-d5958

Music Improvisation for Cognitive Aging (Music Training Trial) This project will study the effects and mechanisms of a music improvisation training intervention on self-regulation of older adults with and without MCI.

4. sciencedirect.com sciencedirect.com/science/article/pii/S002239562200231X

A systematic review of music interventions for the cognitive ... Music interventions may represent an effective approach to improving symptoms and delaying progression of MCI to dementia.

5. bmcgeriatr.biomedcentral.com bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-024-05600-2

Acquisition of musical skills and abilities in older adults ... The PP group demonstrated moderate improvements in piano articulation and dynamics, while the MC group achieved higher scores in the music quiz.

6. clinicaltrials.ucsf.edu clinicaltrials.ucsf.edu/trial/NCT06721390

Music Improvisation Training on Cognitive Function in ... This study studies music improvisation training's effect on self-regulation in older adults, with and without MCI, to improve cognitive ...

7. journals.lww.com journals.lww.com/md-journal/fulltext/2023/12010/music_intervention_for_older_adults__evidence_map.77.aspx

Music Intervention for older adults: Evidence Map of... The study revealed that music interventions for older adults can have positive or potentially positive effects on health outcomes.