Cognitive Stimulation with Music in Older Adults with Cognitive Impairment: A Scoping Review
Abstract
:1. Introduction
2. Materials and Methods
- (1)
- Are there any differences in outcomes in participants with mild onset of cognitive decline (MCI) compared to participants with an already existing dementia diagnosis? What are the outcome differences between mild and moderate stages of dementia?
- (2)
- Which types of music-based interventions are the most effective for cognitive stimulation, and how well defined are they in research articles?
- (3)
- Do specific music-based protocols designed for the training of certain cognitive functions depending on the specific cognitive deficits of patients exist?
- (4)
- Are there any assessment tools used in the majority of studies, and how far do they go in assessing the effects of an intervention on a specific cognitive function?
2.1. Search Strategy and Identification of Relevant Studies
2.2. Inclusion and Exclusion Criteria
- -
- Population: people with cognitive impairment related to aging, MCI, or dementia. Participants could be experiencing a range of disease stages, from MCI to moderate stages of dementia (the sample could include patients with Alzheimer’s disease-type dementia or any other defined type), but the severity should be clearly defined.
- -
- Intervention: Music-based interventions (i.e., music therapy or other music-based activities): the idea was to select only interventions based on the use of music, characterized by group or individual sessions conducted by a professional figure according to a process idea, not single exposures to sound–musical stimuli.
- -
- Comparison: the selection of interventions without the presence of a control group but with relevant results could be considered, keeping in mind, however, the greater reliability of studies comparing music-based treatments with a control group. In this regard, control groups treated with both standard care and other interventions based on other music-based or other non-pharmacological interventions were accepted in the selection process.
- -
- Outcomes: test scores evaluating the global cognitive situation or performance tasks linked to specific cognitive areas or neuroimaging studies showing the effects of the intervention on a cortical activation level.
- -
- Study design: given the nature of the review, no restrictions on study designs to be taken into consideration were placed. RCTs and CCTs were favored, but crossover, observational, cohort, and case studies could also be included in the review. Literature reviews and meta-analyses were additionally used as resources for selecting further relevant studies.
2.3. Study Selection
2.4. Data Extraction
3. Results
3.1. Search Results
3.2. Studies Characteristics and Outcomes
4. Discussion
4.1. Implications for Practice
4.2. Limits and Future Research
5. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Study and Year [Ref.] | Study Design | Country | No. of Participants | Mean Age | Female | Severity of Cognitive Impairment | Type of Music-Based Intervention | Control Type | Intervention Period | Intervention Frequency | Intervention Duration | Cognitive Outcomes | Cognitive Results |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Biasutti and Mangiacotti 2021 [52] | 1 RCT | Italy | 45 | 84.5 | 29/64.4% | 2 MCI and mild dementia | Music training (improvisation exercises) | Gymnastic activity | 6 weeks | 2 per week | 70 min | 3 MMSE | Improvement |
Biasutti and Mangiacotti 2018 [53] | RCT | Italy | 35 | 83.57 | 23/65.7% | MCI and mild dementia | Music training (improvisation exercises) | Gymnastic activity (45 min) | 6 weeks | 2 per week | 70 min | MMSE, 4 VFT, 5 TMT-A, attentional matrices, 6 CDT | Improvement in MMSE, VFT, CDT |
Chen 2018 [54] | RCT | Taiwan | 28 | 77.3 | 14/50% | Mild–moderate dementia | Musical dual-task training (7 NMT) | Dual-task training | 8 weeks | 1 per week | 60 min | TMT-A | Improvement |
Chéour 2023 [55] | RCT | Tunisia | 28 | 72.8 | 12/42.85% | Mild 8 AD | Music listening | Physical rehabilitation PR + ML, control | 4 months | 3 times per week | 60 min | MMSE, 9 ADAS- Cog | Improvement (in ML, PR, and PR + ML) |
Cheung 2018 [56] | RCT | China | 165 | 85.3 | 125/75.75% | Moderate dementia | Movement music Therapy (MM) | Music listening (ML), Social activity | 6 weeks | 2 per week | 40 min | MMSE; 10 FOME; Mod-VFT; Digit Span | Improvement (MM, ML) in MMSE; memory storage and recall; VFT improvement in MM group |
Doi 2017 [57] | RCT | Japan | 201 | 76 | 104/51.7% | MCI | Playing instrument (percussions) | Dance, control | 10 months | 1 per week | 60 min | MMSE, TMT-A, TMT-B, story, and word memory | MMSE improvement (music group); improvement memory recall (dance group only) |
Feng 2020 [58] | RCT | Malaysia | 93 | 70 | 73/78.5% | At risk of dementia (early cognitive impairment in 5/10 cognitive tests) | Choral singing | Health education | 2 years | 1 per week | 60 min | 11 CCTS, 12 SM-MMSE 13 MRI, oxidative damage/ immunosenescence | Improvement without intergroup difference; no difference in bio- markers |
Fraile 2019 [59] | 14 CCT | France | 12 | 83.83 | 7/60% | Mild–moderate AD | Learning an individualized song (lyrics writing) | Control | 5 weeks + 5 weeks (Waitlist) | 2 per week | 20 min | Cued autobiographical recall, phonological, and semantic fluency; 15 EFCL (verbal, memory, executive process) | Improvement in autobio- graphical memory retrieval and general cognitive abilities |
Giovagnoli 2017 [60] | RCT | Italy | 39 | 73.6 | 24/61.5% | Mild–moderate AD | Active music therapy | Active control (cognitive training CT, neuro- education NE) | 12 weeks | 2 per week | 45 min | TMT, 16 DSST | No significant changes; clinically significant improvement rates = CT: (62%) AMT: (8%) NE: (none) |
Gómez- Gallego 2021 [61] | Quasi- experi- mental design (Randomization of nursing homes) | Spain | 90 | 80.9 | 55/61.1% | Mild–moderate dementia (probable AD) | Active music intervention (AMI); receptive music Intervention (RMI) | Control pharmacological therapy, cognitive stimulation | 12 weeks | 2 per week | 45 min | MMSE | Improve- ment in AMI (higher than in RMI) |
Han 2020 [62] | RCT, pilot | Korea | 24 | 73.12 | 11/45.8% | MCI | Song-based cognitive stimulation protocol | Control | 10 weeks | 2 per week | 60 min | MMSE-DS 17 MoCA-K | Improvement |
Kim and Kang 2021 [63] | RCT, pilot | South Korea | 49/40 | 81.6 | 31/77.5% | Mild–moderate dementia | Active music intervention (rhythmic exercises) | Control (usual care) | 12 weeks | 2 per week | 50 min | MMSE- Korean version | Improvement |
Li 2015 [64] | Quasi- experi- mental trial design | Taiwan | 41 | 78.75 | 28/68.29% | Mild AD | Music listening (2 different pieces) | Control | 6 months | 2 daily | 30 min | 18 CASI, CASI- estimated MMSE | No improvement (less decreased score than controls) |
Liu 2024 [65] | RCT | China | 24 | 69.45 | 12/50% | Mild–moderate Dementia | Group music therapy (activities change across sessions) | Control (usual care) | 5 months | 1 per week | 40 min | MMSE | Improved scores (without statistics) |
Lyu 2018 [66] | RCT | China | 298 | 69.7 | 173/58.1% | 10 AD (mild, moderate, severe) | Singing (S) | Reading (R), control | 12 weeks | 2 per week (2 per day) | 30–40 min | VFT, 19 AVLT, MMSE | Improvement in VFT (S and R groups) and in immediate recall (singing) |
Maguire 2015 [67] | No rando- mization (voluntary partici- pation) | USA | 45 | 70–99 | 38/85% | MCI and mild–moderate dementia | Singing (vocal training) | Music listening | 16 weeks | 3 times per week | 50 min | MMSE, CDT | Improvement in MMSE (both groups, larger effect in singing group) |
Mahendran 2018 [68] | RCT, pilot | Malaysia | 68 | 71.1 | 38/55.9% | MCI | Music listening ML (reminiscence) | Art therapy, control | 12 weeks | 1 per week | 65 min | AVLT | Improvement in ML group |
Moreira 2023 [69] | RCT | Brazil | 43 | 76.49 | 39/91% | MCI and mild–moderate dementia | Neurologic music therapy | Control | 6 weeks | 2 per week | 30–40 min | 20 WAIS-III Digit subtest; Corsi block-tapping test; 21 FMT; 22 SASMET; CDT; MMSE | Improvement in episodic memory tests only |
Murabayashi 2019 [70] | CCT | Japan | 115 | 81.3 | 109/93.6% | Frail elderlies (with dementia or other care needs) | Music listening and singing | Control | 12 weeks +12 weeks (Waitlist) | 1 per week | 45–50 min | VFT: 23 YKSST | No significant difference observed either in the period- effect or treatment for cognition |
Perez-Ros 2019 [71] | RCT | Spain | 119 | 80.52 | 61/51.26% | Mild–moderate dementia | Preferred music listening + occupational therapy | Occupatio- nal therapy | 8 weeks | 5 days per week | 60 min | MMSE | Mainte- nance (worse- ning in controls) |
Pongan 2017 [72] | RCT | France | 59 | 79.5 | 39/66.1% | Mild AD | Singing | Paint | 12 weeks | 1 per week | 120 min | TMT-A, 24 FAB | Improvement (digit, inhibitory processes) in both groups; singing group: verbal memory stable |
Särkämö 2016 [73] | RCT | Finland | 89 | 78.3 | 55/51.4% | Mild–moderate dementia | Singing groups, music listening groups (ML) | Standard Care | 10 weeks | 1 per week | 90 min | MMSE, 25 WMS-III FAB, WAIS-III, TMT-A, 26 BNT; 27 WAB | Singing: improvement in working memory; maintenance: executive function, orientation (mild dementia); ML-supported general cognition, working memory (moderate dementia) |
Särkämö 2014 [74] | RCT | Finland | 89 | 78.8 | 60/67.4% | Mild–moderate dementia | Singing groups, music listening groups | Standard Care | 10 weeks | 1 per week | 90 min | MMSE, WMS-III, FAB, WAIS-III, TMT-A, BNT, WAB | Experimental groups: improvement orientation, remote episodic memory; attention, executive function, general cognition slightly improved; effect of singing also in short-term and working memory |
Satoh 2015 [75] | CT | Japan | 20 | 77.55 | 14/70% | Mild–moderate AD | Singing training | Control | 6 months | 1 per week | 60 min | MMSE, 28 RCPM, 29 RBMT, FAB, fMRI assessment | Time for RCPM completion significant reduction; increased activity in the right angular gyrus and the left lingual gyrus (fMRI) |
Shimizu 2018 [76] | RCT | Japan | 45 | 74.64 | 38/84.4% | MCI | Movement music therapy (MMT) | Gymnastic activity | 12 weeks | 1 per week | 65 min | FAB, 30 CBF with 31 NIRS | Improvement (FAB) in MMT; significant increase in CBF |
Tang 2018 [77] | RCT | China | 77 | 75.88 | 38/49.4% | Mild–moderate AD | Listening, singing, and playing instruments | Control | 12 weeks | 3 times per week | 50 min | MMSE | Mainte- nance (decrease in controls) |
Wang 2018 [78] | RCT | China | 60 | 69.75 | 38/63.3% | Mild AD | Listening and singing familiar songs (+pharmacolo- gical therapy) | Pharmacological therapy only | 12 weeks | 3 times per day | 30–50 min | MMSE, MoCA | Improvement (MMSE); listening group. MoCA significant increase (both groups) |
Xue 2023 [79] | RCT | China | 80 | 74.93 | 62/77.5% | MCI | Receptive music therapy (RMT) | Standard Care | 8 weeks | 4 times per week | 20 min (+time for the last two session phases) | MoCA | Improvement in RMT (especially memory, attention, abstraction) |
Study and Year [Ref.] | Music Intervention Provider | Group or Individual Intervention |
---|---|---|
Biasutti and Mangiacotti 2021 [52] | Music psychologist | Group |
Biasutti and Mangiacotti 2018 [53] | Music psychologist | Group |
Chen 2018 [54] | Music therapist | Individual |
Chéour 2023 [55] | Music therapist | Group (with caregivers) |
Cheung 2018 [56] | Health care professional | Group (4–6 people) |
Doi 2017 [57] | Music teacher | Group |
Feng 2020 [58] | Professional musicians | Group |
Fraile 2019 [59] | Language and speech therapist trainees | Individual |
Giovagnoli 2017 [60] | Music therapist | Individual |
Gómez-Gallego 2021 [61] | Art therapists (specialized in music therapy) | Group (6–9 people) |
Han 2020 [62] | Music therapist (and neurologist) | Group |
Kim and Kang 2021 [63] | Music therapist | Group |
Li 2015 [64] | Self-administration (with the help of caregivers) | Individual |
Liu 2024 [65] | Music therapist | Group |
Lyu 2018 [66] | Music therapist | Group (6 people) |
Maguire 2015 [67] | Vocal teacher (+DVD instructor) | Group |
Mahendran 2018 [68] | Art therapist (specialized in music) | Group |
Moreira 2023 [69] | Music therapist (and psychologist) | Individual (with caregiver presence) |
Murabayashi 2019 [70] | Music therapist | Group |
Perez-Ros 2019 [71] | Nurses | Group |
Pongan 2017 [72] | Choir conductor (with a psychologist) | Group |
Särkämö 2016 [73] | Music therapist and Vocal teacher | Group (10 people = 5 caregiver-patient dyads) |
Särkämö 2014 [74] | Music therapist and Vocal teacher | Group (10 people = 5 caregiver-patient dyads) |
Satoh 2015 [75] | Vocal teacher (+a pianist) | Group |
Shimizu 2018 [76] | Instructor (trained in protocol administration) | Group |
Tang 2018 [77] | Music therapist | Group (9 people) |
Wang 2018 [78] | Music therapist | Group |
Xue 2023 [79] | Music therapist | Group |
Cognitive Area | Cognitive Measures | No. of Studies |
---|---|---|
Global Cognition (or composite score cognitive test) | MMSE | 20 |
MoCA | 3 | |
AVLT | 2 | |
CASI | 2 | |
ADAS-Cog | 1 | |
CCTS | 1 | |
Memory | AVLT | 2 |
Digit Span | 2 | |
WMS | 2 | |
Corsi block-tapping test | 1 | |
Cued autobiographical recall | 1 | |
FMT | 1 | |
FOME | 1 | |
RBMT | 1 | |
SASMET | 1 | |
Story and word memory | 1 | |
Attention (Speed processing) | TMT-A | 7 |
Attentional matrices | 1 | |
DSST | 1 | |
YKSST | 1 | |
Executive Functions | FAB | 5 |
CDT | 3 | |
Digit Span Backward | 2 | |
TMT-B | 2 | |
Reasoning | WAIS | 3 |
RCPM | 1 | |
Language | VFT | 4 |
BNT | 2 | |
EFCL | 1 | |
Phonological and semantic fluency | 1 | |
WAB | 1 | |
Neuroimaging techniques | fMRI (cerebral activity, immunosenescence) | 2 |
CBF with NIRS | 1 |
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Raglio, A.; Figini, C.; Bencivenni, A.; Grossi, F.; Boschetti, F.; Manera, M.R. Cognitive Stimulation with Music in Older Adults with Cognitive Impairment: A Scoping Review. Brain Sci. 2024, 14, 842. https://doi.org/10.3390/brainsci14080842
Raglio A, Figini C, Bencivenni A, Grossi F, Boschetti F, Manera MR. Cognitive Stimulation with Music in Older Adults with Cognitive Impairment: A Scoping Review. Brain Sciences. 2024; 14(8):842. https://doi.org/10.3390/brainsci14080842
Chicago/Turabian StyleRaglio, Alfredo, Camilla Figini, Alice Bencivenni, Federica Grossi, Federica Boschetti, and Marina Rita Manera. 2024. "Cognitive Stimulation with Music in Older Adults with Cognitive Impairment: A Scoping Review" Brain Sciences 14, no. 8: 842. https://doi.org/10.3390/brainsci14080842