Music Improvisation for Cognitive Aging

(Music Training Trial)

Recruiting at 1 trial location

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

Trial Summary

What is the purpose of this 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. The investigator's overall hypothesis is that improvisation training will lead to improvements in self-regulation, compared to controls, and that improvisation training will be associated with specific changes in prefrontal brain networks and ultimately cognitive engagement.

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 data supports the effectiveness of the treatment Music Improvisation for Cognitive Aging?

Research shows that music therapy, including playing instruments and listening to music, can improve cognitive function in older adults. Studies have found that music therapy can enhance memory, attention, and overall mental well-being, making it a promising approach for addressing cognitive aging. ^{1 2 3 4 5}

Is music improvisation safe for older adults?

Music improvisation and related music interventions are generally safe for older adults. Studies have shown that these activities can improve well-being, memory, and cognitive function without any reported harmful effects. ^{1 5 6 7 8}

How does the treatment 'Music Improvisation for Cognitive Aging' differ from other treatments for cognitive aging?

Music improvisation is unique because it actively engages participants in creating music, which has been shown to improve memory and cognitive functions in older adults. Unlike passive music listening, this treatment involves active participation, which can enhance verbal and emotional memory, especially in those with musical experience. ^{1 3 6 9 10}

Research Team

Julene Johnson, PhD

Principal Investigator

University of California, San Francisco

Eligibility Criteria

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

I am 60 years old or older.

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

I live on my own and manage my daily activities.

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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 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]

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]

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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

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

2. England pubmed.ncbi.nlm.nih.gov

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

3. Switzerland pubmed.ncbi.nlm.nih.gov

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

4. England 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. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

The effect of music therapy on cognitive functioning among older adults: a systematic review and meta-analysis. [2018]

6. Germany pubmed.ncbi.nlm.nih.gov

Impact of music-based intervention on verbal memory: an experimental behavioral study with older adults. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Analysis of Preferred Music of Mechanically Ventilated Intensive Care Unit Patients Enrolled in a Randomized Controlled Trial. [2023]

8. Switzerland pubmed.ncbi.nlm.nih.gov

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

9. Switzerland pubmed.ncbi.nlm.nih.gov

Cognitive Benefits From a Musical Activity in Older Adults. [2020]

10. England pubmed.ncbi.nlm.nih.gov

Assessing a cognitive music training for older participants: a randomised controlled trial. [2022]