A group of older people are going to learn keyboard, take part in choral singing, or watch music-related films for a new clinical trial aiming to establish whether making music can reduce cognitive decline in older adults with memory difficulties.
Despite many reviews exploring music interventions, they often mix listening and music-making activities, involve small sample sizes, and include diverse populations, making it hard to draw definitive conclusions, says Dr Zoe Menczel Schrire, a postdoctoral research associate with the Healthy Brain Ageing Team at the Brain and Mind Centre at the University of Sydney.
“There’s limited robust clinical evidence on how making music may affect the brain structure and function in older adults,” Menczel Schrire tells Australian Ageing Agenda.
“Without strong evidence, recommending music-based interventions to older, vulnerable individuals who invest in them for cognitive improvement may not be ideal. These interventions should be co-designed with consumers and involve community consultation to ensure they are feasible and effective.”
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To address this lack of evidence, Menczel Schrire and a team of researchers at the University Sydney are running a clinical trial called the NeuroMusic study. Participants will meet once a week for three months at the Conservatorium of Music in Sydney to determine whether a training program that incorporates music-making can reduce cognitive decline, and improve neuroplasticity, mood, and daytime functioning in older adults with memory difficulties.
“The study is open to people aged between 60 and 90 years who are experiencing memory decline and have little to no prior musical experience,” Menczel Schrire says.
“If participants decide to participate, they will be screened for suitability and then randomly assigned to one of three groups: learning keyboard, choral singing, or watching music-related films and discussing them with a group.”
Learning music is a wonderful way for older adults to potentially stay “mentally sharp and socially connected,” Menczel Schrire tells AAA.
”Activities like choir singing and playing instruments are accessible, enjoyable, and can offer “significant cognitive and emotional benefits” improve overall wellbeing, social connectedness and reduce feelings of loneliness.
“While there are many anecdotal success stories, the scientific evidence supporting the effectiveness of music-based training programs is still growing, especially in older adults at risk of dementia,” she said.
“Since people invest their time and money into learning new musical instruments or engaging in choir, it is important that we have sound research supporting its use in older people with cognitive decline. While there is promising evidence supporting the notion that it may improve memory and other thinking skills, some studies lack consistency and robust methodologies.”
She adds: “Therefore, we need to do some more rigorous research before recommending it to the community, or within health and aged care settings.”
A paper published in the Australasian Journal of Ageing titled ‘It helps you forget your worries’: A pilot study exploring music therapy in the acute hospital aged care setting researchers explored music therapy through an eight-week program on an acute geriatric ward.
Brief receptive musical interventions up to twice-weekly were undertaken by all patients admitted to the aged care ward with 10 patients completing surveys; six were women and all had cognitive impairment.
The results showed that after each music therapy session, all patients reported feeling happy and staff respondents reported patients appeared relaxed with the musical sessions resulting in improved patient behaviour and mood.
Menczel Schrire tells AAA that when it comes to music interventions, many studies have explored them for older adults with dementia, or the early phases before dementia development but results vary due to differences in methods and populations.
“Some reviews of all the existing studies have found slight cognitive benefits from music-making activities, like playing instruments or singing, but the evidence isn’t strong enough to make definitive recommendations,” she says.
“More robust clinical trials are needed to understand the specific brain mechanisms involved. The largest study to date was conducted in Switzerland on 132 musically naïve healthy older adults and assessed the effect of six months of piano training on the brain and found increases in brain tissue and working memory.”
Menczel Schrire says their study aims to recruit 432 older adults with memory impairment, to assess the effects of both piano and choir singing on cognition and brain plasticity in a larger, more at risk sample. They are also assessing biomarkers of dementia through blood tests, and administering questionnaires assessing sleep, mood, and quality of life, to investigate a more holistic picture of the benefits of music training.
“Once we finish the trial, we hope to implement music interventions into aged care settings. Providers can help encourage participation in these interventions by helping to explain that it is never too late to start learning music, even if experiencing memory difficulties. They will need to create a safe space, where all participants feel comfortable to begin their musical journey” Menczel Schrire says.
“One day, I hope to see music interventions as a standard part of aged care, with more facilities integrating it into their daily routines. For this to happen, there needs to be improved government funding and resources so that aged care providers or external therapists can facilitate music programs according to evidence based practice.”
When the clinical trial is complete, Dr Schrire and her team aim to run an implementation study in aged care to see the efficacy in real-world settings.
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