NeuroMusic: A Randomised-Controlled Trial of a Music-Based Training Program for Memory Difficulties
NeuroMusic: A Randomised-Controlled Trial of a Music-Based Training Program for Older Adults with Memory Difficulties
The University of Sydney
432 participants
May 18, 2023
Interventional
Conditions
Summary
Early intervention to slow the onset of dementia is a crucial topic warranting investigation, however, to date there has been insufficient research in this field. There is evidence suggesting that older adults with memory difficulties are particularly vulnerable to developing dementia and that music training programs could have a positive effect on cognition and potentially harness the brain's ongoing ability to form new and/or reorganise existing neural pathways – 'neuroplasticity' – as well as contribute to increased wellbeing in this population. Nevertheless, there remains a paucity of research investigating the neuroprotective effects of music training in people with memory difficulties. The unique pairing of experts from the Brain and Mind Centre and the Sydney Conservatorium of Music perfectly position us to develop, pilot and translate a ground-breaking intervention to reduce risk of cognitive decline and dementia whilst improving quality of life for older people with MCI. Thus, the main objective of this NeuroMusic study is to evaluate the efficacy of keyboard and choral singing interventions in comparison to a control condition on improving verbal memory performance. We hypothesise that in older adults with memory difficulties, our music-based training program will improve memory performance, supported by structural and functional brain changes. This study is a 12-week, single blind, randomised-controlled trial in which 216 community dwelling older Australians (60-90 years), with memory difficulties. Participants will be randomised (1:1:1) to either the keyboard intervention, choral singing intervention or an active control condition (i.e. film-viewing sessions). Data collection points will be baseline (weeks 0-2), post-intervention (week 16) and 6 months after intervention completion (week 36).
Eligibility
Inclusion Criteria5
- 1. Memory decline as defined by 1SD or below the average on any memory test performed at screening (i.e. RAVLT 1-5, RAVLT 7, RAVLT 7/6, RAVLT 7/5 and/or Logical Memory I or Logical Memory II)
- Able to provide informed written consent.
- Fluent English literacy.
- Adults aged between 60-90 years.
- Appropriateness to be in a group setting.
Exclusion Criteria13
- Previous diagnosis of dementia, a score on the Montreal Cognitive Assessment – Audiovisual <25, a score of <21 on the Modified Telephone Interview for Cognitive Status (TICS-M) or as assessed by a clinician.
- Musical instrumental playing or singing in an organised group in the last 6 months and/or history of employment as a professional musician.
- Attended formal music lessons for over 3 years
- Problems affecting hand dexterity.
- Impaired or not-corrected visual or auditory accuracy.
- Previous major head injury, cerebrovascular events (stroke, TIA), or loss of consciousness equal to or greater than 30 minutes.
- Other health issues or medications that may have caused memory impairment at the discretion of the study team.
- Previous or current neurological disorder diagnosis (e.g. Parkinson’s, multiple sclerosis, epilepsy).
- Current illicit substance use or harmful alcohol intake (Alcohol Use Disorders Identification Test Consumption (AUDIT-C) score > 8).
- Current severe major depression diagnosis as defined by a score >20 on the Patient Health Questionnaire (PHQ-9) and/or suicidal ideation (score of >1 on Q9 of the PHQ-9) (39), or severe psychiatric or developmental disorders (e.g. schizophrenia, bipolar disorder, autism).
- Previously participating in any music training program or currently enrolled in another study.
- Currently participating in or has participated in a cognitive training intervention within 4 weeks of enrolment. Participants who are currently engaged in self-selected cognitive training applications (e.g. Luminosity or Brain HQ) are permitted to continue if they do not change the amount of time spent or level that they have been consistently completing for the duration of the trial.
- Have been prescribed an antidepressant medication for less than four weeks or if they are experiencing side effects related to this medication.
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Interventions
Music-based training programs: The goal for both music interventions is to complete 19 hours of group training over 12 weeks. All participants will be requested to attend a 2-hour training session, once a week (minimum request of 80% participation). Lessons will be delivered by professional musicians from the Sydney Conservatorium of Music. Each session has been structured with an initial 15-minute warm-up followed by a short review of material (10-min) and the remaining portion of the class will focus on learning and practising new skills and concepts. Participants will also have a 25-minute socialisation opportunity at the end of each session. Participants are expected to achieve some repertoire each week and to work progressively on a larger repertoire. There will be no overall pressure on perfection, rather encouragement to attempt activities and participate. Instructors will focus on gradual levels of short-term achievement. Each training program will take place at the Sydney Conservatorium of Music in groups of up to 12 for each intervention. The choir group may be supplemented with other participants from previous control groups after their 36 week follow up, if they choose to join. Progress will be recorded for each participant during each class session. Practice outside of the training session will be encouraged but will not be mandatory. If participants decide to practice at home, they will be provided with weekly guidance and given access to support resources. Participants will be asked to record their practice (e.g. time spent, type of activity) in a workbook provided by the instructor. At week 12, participants will be invited to be part of an optional group performance for the team and the other group. The first 90 participants will be invited to receive a 60 minute 3T MRI brain scan at baseline and a scan for 45 minutes 12 weeks post intervenion. a) Keyboard intervention (arm 1): Participants allocated to the keyboard intervention arm will receive keyboard lessons. Keyboard training will consist of basic piano technique and literature, music theory and dexterity exercises. At each training session, participants are expected to perform some piano repertoire and technique (finger dexterity exercises/ scales). Each lesson will include opportunities to alternate between skill development in a group setting or individual practice. To encourage practice outside of the training session, a keyboard will be provided to each participant. b) Choral singing intervention (arm 2): The choral singing sessions will involve different strategies to learn new songs, practice listening to other participants, synchronizing personal singing parts with the rest of the choir and review of previously learned songs. The repertoire will consist of various forms of canon and rounds. The songs are selected according to different degrees of popularity and difficulty to challenge participants to adapt to their level. The choir will be accompanied by the Conductor, but there will also be options for a cappella repertoire and backing tracks if needed. A subset of participants will be asked to attend semi-structured interviews and focus groups, via an 'opt-in' system. These will be conducted by trained members of the music team. Focus groups will be all together and interviews will be one-on-one. Focus groups and interviews will be held until thematic saturation.
Locations(1)
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ACTRN12623000407695