Recent and past musical activity predicts cognitive aging variability: direct comparison with general lifestyle activities

Musical and Cognitive Abilities in Older Adults with Mild Cognitive Impairment

The objective of this cross-sectional study was to determine the extent and nature of self-reported musical abilities in persons with mild cognitive impairment (MCI). We recruited 60 older adults with a diagnosis of MCI from the Alzheimer's disease Core Center. We evaluated self-reported musical abilities using the Goldsmiths General Musical Sophistication Index. We examined correlations between musical abilities and neuropsychological measures of verbal learning and memory, processing speed, executive function, verbal fluency, naming and visuoconstructive abilities, while controlling for key demographic and participant characteristics. Older adults with MCI reported varying degrees of musical abilities. Nearly half of participants reported that they did not engage in regular, daily practice of a musical instrument. When adjusting for key demographic and participant characteristics, we found modest associations between four musical ability subfactors (active engagement, perceptual abilities, musical training and emotional engagement with music) with three cognitive abilities: verbal fluency, executive function and verbal naming. Except for the emotional engagement with music subfactor, none of the remaining musical ability subfactors correlated with any demographic or participant characteristics. While our study findings provided further support for the relationship between musical and cognitive abilities in older adults with MCI, this relationship warrants further investigation.

Reaching Out, Helping Hands Helping Minds: A Hawai'ian Model for Aiding Friends Coping With Dementia

Reaching a certain age places one in a particular landscape in which dementia may be part of the scenery. This costly public health problem is personally devastating not only for dementia sufferers but for their surrounding interpersonal circle, which is not limited to immediate family. Indeed, friends often become the family you choose; their issues become, at some level, shared issues. In this setting the impulse of a life scientist to offer knowledgeable assistance to a friend fits naturally into a cornerstone of culture in present-day Hawai'i for mobilizing relevant aid from all corners. This model, called "forming a hui", comprises a network of not only formal professional relationships but potentially even more importantly, the informal ones: friendships, serendipitous contacts, someone who knows someone who knows someone, the essence of connectedness on behalf of friends coping with dementia. Storytelling as a means of communication holds a place of prominence in Hawai'ian culture; exchange of ideas, as well as reminiscence, is called "talk story." In this article, lives now built around coping with dementia are woven into a story fabric as into a Hawai'ian quilt.

Cognitive Benefits From a Musical Activity in Older Adults

The aging population is growing rapidly. Proposing interventions that enhance the cognitive functions or strategies that delay the onset of disabilities associated with age is a topic of capital interest for the biopsychosocial health of our species. In this work, we employed musical improvisation as a focal environmental activity to explore its ability to improve memory in older adults. We present two studies: the first one evaluated neutral memory using the Rey Complex Figure (RCF) and the second one evaluated emotional memory using International Affective Picture System (IAPS). A group of 132 volunteers, between the ages of 60 and 90, participated in this investigation. Fifty-one of them were musicians with more than 5 years of formal musical training. After acquisition of neutral (Study 1) or emotional (Study 2) information, the groups of older adults were exposed to music improvisation (experimental intervention) or music imitation (control intervention) for 3 min. We then evaluated memory through two tasks (free recall and recognition), by means of immediate and deferred measures (after a week). We found a significant improvement in memory among participants involved in music improvisation, who remembered more items of the RCF and images from IAPS than the imitation group, both in the immediate and deferred evaluation. On the other hand, participants who had musical knowledge had a better performance in neutral visual memory than non-musicians. Our results suggest that a focal musical activity can be a useful intervention in older adults to promote an enhancement in memory.

Music and Visual Art Training Modulate Brain Activity in Older Adults

Cognitive decline is an unavoidable aspect of aging that impacts important behavioral and cognitive skills. Training programs can improve cognition, yet precise characterization of the psychological and neural underpinnings supporting different training programs is lacking. Here, we assessed the effect and maintenance (3-month follow-up) of 3-month music and visual art training programs on neuroelectric brain activity in older adults using a partially randomized intervention design. During the pre-, post-, and follow-up test sessions, participants completed a brief neuropsychological assessment. High-density EEG was measured while participants were presented with auditory oddball paradigms (piano tones, vowels) and during a visual GoNoGo task. Neither training program significantly impacted psychometric measures, compared to a non-active control group. However, participants enrolled in the music and visual art training programs showed enhancement of auditory evoked responses to piano tones that persisted for up to 3 months after training ended, suggesting robust and long-lasting neuroplastic effects. Both music and visual art training also modulated visual processing during the GoNoGo task, although these training effects were relatively short-lived and disappeared by the 3-month follow-up. Notably, participants enrolled in the visual art training showed greater changes in visual evoked response (i.e., N1 wave) amplitude distribution than those from the music or control group. Conversely, those enrolled in music showed greater response associated with inhibitory control over the right frontal scalp areas than those in the visual art group. Our findings reveal a causal relationship between art training (music and visual art) and neuroplastic changes in sensory systems, with some of the neuroplastic changes being specific to the training regimen.

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

The aim of this meta-analysis was to review studies that applied musical instrument playing as an intervention to improve cognitive functioning of older adults with and without cognitive impairment. English-language articles published between 1990 and 2018 were searched using electronic databases. Music therapy journals were also hand searched for relevant research. Inclusion criteria for participants were older adults, ages 60 years and older, and any clinical diagnosis of cognitive impairment had to be due to aging. Searches used combinations of the following keywords: older adults, instrument playing, and cognitive outcomes measures. A total of 10 studies that met the inclusion criteria were included in the final analysis: five studies with healthy older adults, two with older adults with mild cognitive impairment (MCI), two studies with older adults with dementia, and one study with both healthy older adults and older adults with MCI. The results of this meta-analysis demonstrated that different types of cognitive involvement were demanded from instrument playing. Furthermore, depending on the type of involvement, a target cognitive domain was found to be differentially impacted by the instrument playing intervention. This study supports using different types of instrument playing for interventions targeting specific cognitive domains of older adults with varying levels of cognitive aging.

Musical auditory processing, cognition, and psychopathology in 22q11.2 deletion syndrome

Chromosome 22q11.2 deletion syndrome (22q11DS) is associated with impairment in multiple domains of cognition and risk for several psychiatric disorders. Musical auditory processing is highly heritable, and is impaired in individuals with schizophrenia and other neurodevelopmental disorders, but has never been studied in 22q11DS, notwithstanding anecdotal evidence of its sparing. We aimed to characterize musical auditory processing in 22q11DS and explore potential relationships with other cognitive domains, musical engagement, and psychiatric disorders. The Distorted Tunes Task and Global Musical Sophistication Index were used to assess pitch discrimination and general musical engagement in 58 individuals with 22q11DS aged 8-29 years. Psychopathology was assessed with sections from the modified Schedule for Affective Disorders and Schizophrenia for School-Age Children and the Structured Interview for Prodromal Syndromes. The Penn computerized neurocognitive battery (CNB) examined four domains of cognition (executive functioning, episodic memory, complex cognition, and social cognition). Significant musical auditory processing impairment and reduced musical engagement were found in individuals with 22q11DS. However, deficits in musical auditory processing were not associated with reduced musical engagement. After covarying for age and sex, episodic memory and overall CNB performance accuracy were significantly related to performance in musical auditory processing. There were no relationships between musical auditory processing and presence of any psychiatric diagnoses. Individuals with 22q11DS experience significant deficits in musical auditory processing and reduced musical engagement. Pitch discrimination is associated with overall cognitive ability, but appears to be largely independent of psychiatric illness.

Musical practice as an enhancer of cognitive function in healthy aging - A systematic review and meta-analysis

Aging is accompanied by cognitive decline, although recent research indicates that the rate of decline depends on multiple lifestyle factors. One of such factors is musical practice, an activity that involves several sensory and motor systems and a wide range of high-level cognitive processes. This paper describes the first systematic review and meta-analysis, to our knowledge, of the impact of musical practice on healthy neurocognitive aging. The inclusion criteria for the review required that studies were empirical works in English or Spanish that they explored the effects of musical practice on older people; they included an assessment of cognitive functions and/or an assessment of brain status; and they included a sample of participants aged 59 years or older with no cognitive impairment or brain damage. This review led to the selection of 13 studies: 9 correlational studies involving older musicians and non-musicians and 4 experimental studies involving short-term musical training programs. The results of the meta-analysis showed cognitive and cerebral benefits of musical practice, both in domain-specific functions (auditory perception) and in other rather domain-general functions. Moreover, these benefits seem to protect cognitive domains that usually decline with aging and boost other domains that do not decline with aging. The origin of these benefits may reside, simultaneously, in the specific training of many of these cognitive functions during musical practice (specific training mechanism), in the improvement of compensatory cognitive processes (specific compensatory mechanism), and in the preservation of general functions with a global influence on others, such as perceptual capacity, processing speed, inhibition and attention (general compensatory mechanism). Therefore, musical practice seems to be a promising tool to reduce the impact of cognitive problems associated to aging.

Novel associative processing and aging: effect on creative production

Creative production has been reported to decline with age. This study investigated age-related differences in creative verbal production. Participants were 30 younger and 30 older adults. Study testing included language and cognitive assessments and the experimental task wherein participants created short stories incorporating words that are not commonly related, semantically or associatively. The resulting stories were rated by independent blinded judges for originality, cohesion, appropriateness, and organization. Younger adults' stories were rated as being significantly more original and more appropriate. Integrating unrelated words to create original stories requires activating widely distributed lexical-semantic networks to develop novel associations. Potential decreased neural network connectivity due to white matter degradation, commonly seen in normal aging, as well as decrements in front-executive disengagement may have affected older adults' performance on this story creation task. Future research using neuroimaging may elucidate possible neuroanatomic correlates of age-related changes in associative creative production..

The association between singing and/or playing a musical instrument and cognitive functions in older adults

OBJECTIVES

Cognitive decline happens to everyone when aging, but to some more than others. Studies with children, adults, and professional musicians suggest that making music could be associated with better cognitive functioning. In older adults however, this association is less well investigated, which is therefore the aim of this study.

METHODS

In this cross-sectional study data from 1101 participants aged 64 and older from the Longitudinal Aging Study Amsterdam were used. Multivariable linear regression analyses were performed to test the association between making music and cognitive functioning and time spent making music and cognitive functioning. ANCOVA analyses were performed to differentiate between participants who made no music, only sang, only played an instrument or both sang and played an instrument in terms of cognitive functioning.

RESULTS

Making music was significantly positively associated with letter fluency, learning and attention/short-term memory. Time spent making music yielded no significant results. The ANCOVA analyses showed higher scores for participants who only played an instrument compared to participants who made no music on learning, working memory and processing speed. For processing speed the instrument only group also had a higher score than participants who only sang.

DISCUSSION

Making music at least once every two weeks and especially playing a musical instrument, is associated with better attention, episodic memory and executive functions. The results suggest that making music might be a potential protective factor for cognitive decline; however, to support this notion a longitudinal study design is needed.

The effects of drumming on working memory in older adults

Our study investigated the effect of a music training program on working memory (verbal memory, visual memory, and as a part of central executive processing working memory) in older adults. The experimental group was musically trained (drumming and singing), whereas one control group received a literature training program and a second control group was untrained. We randomly assigned 24 participants (all females; M = 77 years and 3 months) to the music group, the literature group, and the untrained group. The training groups were trained for 15 weeks. The three groups did not differ significantly in age, socioeconomic status, music education, musical aptitude, cognitive abilities, or depressive symptoms. We did not find differences in the music group in central executive function. However, we found a potential effect of music training on verbal memory and an impact of music training on visual memory. Musically trained participants remembered more words from a word list than both control groups, and they were able to remember more symbol sequences correctly than the control groups. Our findings show a possible effect of music training on verbal and visual memory in older people.

Musical training, bilingualism, and executive function: working memory and inhibitory control

The current study investigated whether long-term experience in music or a second language is associated with enhanced cognitive functioning. Early studies suggested the possibility of a cognitive advantage from musical training and bilingualism but have failed to be replicated by recent findings. Further, each form of expertise has been independently investigated leaving it unclear whether any benefits are specifically caused by each skill or are a result of skill learning in general.

To assess whether cognitive benefits from training exist, and how unique they are to each training domain, the current study compared musicians and bilinguals to each other, plus to individuals who had expertise in both skills, or neither. Young adults (n = 153) were categorized into one of four groups: monolingual musician; bilingual musician; bilingual non-musician; and monolingual non-musician. Multiple tasks per cognitive ability were used to examine the coherency of any training effects. Results revealed that musically trained individuals, but not bilinguals, had enhanced working memory. Neither skill had enhanced inhibitory control.

The findings confirm previous associations between musicians and improved cognition and extend existing evidence to show that benefits are narrower than expected but can be uniquely attributed to music compared to another specialized auditory skill domain. The null bilingual effect despite a music effect in the same group of individuals challenges the proposition that young adults are at a performance ceiling and adds to increasing evidence on the lack of a bilingual advantage on cognition.

Auditory and cognitive performance in elderly musicians and nonmusicians

Musicians represent a model for examining brain and behavioral plasticity in terms of cognitive and auditory profile, but few studies have investigated whether elderly musicians have better auditory and cognitive abilities than nonmusicians. The aim of the present study was to examine whether being a professional musician attenuates the normal age-related changes in hearing and cognition. Elderly musicians still active in their profession were compared with nonmusicians on auditory performance (absolute threshold, frequency intensity, duration and spectral shape discrimination, gap and sinusoidal amplitude-modulation detection), and on simple (short-term memory) and more complex and higher-order (working memory [WM] and visuospatial abilities) cognitive tasks. The sample consisted of adults at least 65 years of age. The results showed that older musicians had similar absolute thresholds but better supra-threshold discrimination abilities than nonmusicians in four of the six auditory tasks administered. They also had a better WM performance, and stronger visuospatial abilities than nonmusicians. No differences were found between the two groups' short-term memory. Frequency discrimination and gap detection for the auditory measures, and WM complex span tasks and one of the visuospatial tasks for the cognitive ones proved to be very good classifiers of the musicians. These findings suggest that life-long music training may be associated with enhanced auditory and cognitive performance, including complex cognitive skills, in advanced age. However, whether this music training represents a protective factor or not needs further investigation.

Age-Related Changes in Bimanual Instrument Playing with Rhythmic Cueing

Deficits in bimanual coordination of older adults have been demonstrated to significantly limit their functioning in daily life. As a bimanual sensorimotor task, instrument playing has great potential for motor and cognitive training in advanced age. While the process of matching a person’s repetitive movements to auditory rhythmic cueing during instrument playing was documented to involve motor and attentional control, investigation into whether the level of cognitive functioning influences the ability to rhythmically coordinate movement to an external beat in older populations is relatively limited. Therefore, the current study aimed to examine how timing accuracy during bimanual instrument playing with rhythmic cueing differed depending on the degree of participants’ cognitive aging. Twenty one young adults, 20 healthy older adults, and 17 older adults with mild dementia participated in this study. Each participant tapped an electronic drum in time to the rhythmic cueing provided using both hands simultaneously and in alternation. During bimanual instrument playing with rhythmic cueing, mean and variability of synchronization errors were measured and compared across the groups and the tempo of cueing during each type of tapping task. Correlations of such timing parameters with cognitive measures were also analyzed. The results showed that the group factor resulted in significant differences in the synchronization errors-related parameters. During bimanual tapping tasks, cognitive decline resulted in differences in synchronization errors between younger adults and older adults with mild dimentia. Also, in terms of variability of synchronization errors, younger adults showed significant differences in maintaining timing performance from older adults with and without mild dementia, which may be attributed to decreased processing time for bimanual coordination due to aging. Significant correlations were observed between variability of synchronization errors and performance of cognitive tasks involving executive control and cognitive flexibility when asked for bimanual coordination in response to external timing cues at adjusted tempi. Also, significant correlations with cognitive measures were more prevalent in variability of synchronization errors during alternative tapping compared to simultaneous tapping. The current study supports that bimanual tapping may be predictive of cognitive processing of older adults. Also, tempo and type of movement required for instrument playing both involve cognitive and motor loads at different levels, and such variables could be important factors for determining the complexity of the task and the involved task requirements for interventions using instrument playing.

Musicians have better memory than nonmusicians: A meta-analysis

BACKGROUND

Several studies have found that musicians perform better than nonmusicians in memory tasks, but this is not always the case, and the strength of this apparent advantage is unknown. Here, we conducted a meta-analysis with the aim of clarifying whether musicians perform better than nonmusicians in memory tasks.

METHODS

Education Source; PEP (WEB)-Psychoanalytic Electronic Publishing; Psychology and Behavioral Science (EBSCO); PsycINFO (Ovid); PubMed; ScienceDirect-AllBooks Content (Elsevier API); SCOPUS (Elsevier API); SocINDEX with Full Text (EBSCO) and Google Scholar were searched for eligible studies. The selected studies involved two groups of participants: young adult musicians and nonmusicians. All the studies included memory tasks (loading long-term, short-term or working memory) that contained tonal, verbal or visuospatial stimuli. Three meta-analyses were run separately for long-term memory, short-term memory and working memory.

RESULTS

We collected 29 studies, including 53 memory tasks. The results showed that musicians performed better than nonmusicians in terms of long-term memory, g = .29, 95% CI (.08-.51), short-term memory, g = .57, 95% CI (.41-.73), and working memory, g = .56, 95% CI (.33-.80). To further explore the data, we included a moderator (the type of stimulus presented, i.e., tonal, verbal or visuospatial), which was found to influence the effect size for short-term and working memory, but not for long-term memory. In terms of short-term and working memory, the musicians' advantage was large with tonal stimuli, moderate with verbal stimuli, and small or null with visuospatial stimuli.

CONCLUSIONS

The three meta-analyses revealed a small effect size for long-term memory, and a medium effect size for short-term and working memory, suggesting that musicians perform better than nonmusicians in memory tasks. Moreover, the effect of the moderator suggested that, the type of stimuli influences this advantage.

Keeping brains young with making music

Music-making is a widespread leisure and professional activity that has garnered interest over the years due to its effect on brain and cognitive development and its potential as a rehabilitative and restorative therapy of brain dysfunctions. We investigated whether music-making has a potential age-protecting effect on the brain. For this, we studied anatomical magnetic resonance images obtained from three matched groups of subjects who differed in their lifetime dose of music-making activities (i.e., professional musicians, amateur musicians, and non-musicians). For each subject, we calculated a so-called BrainAGE score which corresponds to the discrepancy (in years) between chronological age and the "age of the brain", with negative values reflecting an age-decelerating brain and positive values an age-accelerating brain, respectively. The index of "brain age" was estimated using a machine-learning algorithm that was trained in a large independent sample to identify anatomical correlates of brain-aging. Compared to non-musicians, musicians overall had lower BrainAGE scores, with amateur musicians having the lowest scores suggesting that music-making has an age-decelerating effect on the brain. Unlike the amateur musicians, the professional musicians showed a positive correlation between their BrainAGE scores and years of music-making, possibly indicating that engaging more intensely in just one otherwise enriching activity might not be as beneficial than if the activity is one of several that an amateur musician engages in. Intense music-making activities at a professional level could also lead to stress-related interferences and a less enriched environment than that of amateur musicians, possibly somewhat diminishing the otherwise positive effect of music-making.

Leisure Activities and Change in Cognitive Stability: A Multivariate Approach

Aging is traditionally associated with cognitive decline, attested by slower reaction times and poorer performance in various cognitive tasks, but also by an increase in intraindividual variability (IIV) in cognitive performance. Results concerning how lifestyle activities protect from cognitive decline are mixed in the literature and all focused on how it affects mean performance. However, IIV has been proven to be an index more sensitive to age differences, and very little is known about the relationships between lifestyle activities and change in IIV in aging. This longitudinal study explores the association between frequency of physical, social, intellectual, artistic, or cultural activities and age-related change in various cognitive abilities, considering both mean performance and IIV. Ninety-six participants, aged 64-93 years, underwent a battery of cognitive tasks at four measurements over a seven-year period, and filled out a lifestyle activity questionnaire. Linear multilevel models were used to analyze the associations between change in cognitive performance and five types of activities. Results showed that the practice of leisure activities was more strongly associated with IIV than with mean performance, both when considering overall level and change in performance. Relationships with IIV were dependent of the cognitive tasks considered and overall results showed protective effects of cultural, physical and intellectual activities on IIV. These results underline the need for considering IIV in the study of age-related cognitive change.

Intense piano training on self-efficacy and physiological stress in aging

The aim of this study was to evaluate the effects of an intense piano training program on general self-efficacy, musical self-efficacy, and physiological stress in older adults. Self-efficacy refers to perceived beliefs regarding the performance of domain-specific tasks or activities, which contribute to psychological and physical health. A key challenge is to identify activities that promote self-efficacy in the aging population. Seventeen healthy community-dwelling older adults (60-85 years) with little to no previous musical training participated in a within subjects experimental design. Measures of self-efficacy and cortisol levels were administered over three time points: an initial pre-testing session, a second pre-testing following a two-week no treatment control period, and a post-testing session upon the completion of piano training. Intense piano training consisted of 30 hours of training (3 hours per day) in which high levels of achievement were required. Results of a three-way Repeated Measures ANOVA over all time points with pairwise comparisons revealed significantly (p < .05) enhanced musical self-efficacy post-training, F (2, 32) = 11.5, p < .001, d = .79. No significant changes in general self-efficacy or cortisol levels were found. These results suggest that domain-specific self-efficacy may increase as a result of short-term intense music training; however, short-term music training may not be sufficient to transfer to general self-efficacy.

Does music training facilitate the mnemonic effect of song? An exploration of musicians and nonmusicians with and without Alzheimer's dementia

INTRODUCTION

The efficacy of using sung words as a mnemonic device for verbal memory has been documented in persons with probable Alzheimer's dementia (AD), but it is not yet known whether this effect is related to music training. Given that music training can enhance cognitive functioning, we explored the effects of music training and modality (sung vs. spoken) on verbal memory in persons with and without AD.

METHOD

We used a mixed factorial design to compare learning (5 trials), delayed recall (30-min and, 24-hour), and recognition of sung versus spoken information in 22 healthy elderly (15 musicians), and 11 people with AD (5 musicians).

RESULTS

Musicians with AD showed better total learning (over 5 trials) of sung information than nonmusicians with AD. There were no significant differences in delayed recall and recognition accuracy (of either modality) between musicians with and without AD, suggesting that music training may facilitate memory function in AD. Analysis of individual performances showed that two of the five musicians with AD were able to recall some information on delayed recall, whereas the nonmusicians with AD recalled no information on delay. The only significant finding in regard to modality (sung vs. spoken) was that total learning was significantly worse for sung than spoken information for nonmusicians with AD. This may be due to the need to recode information presented in song into spoken recall, which may be more cognitively demanding for this group.

CONCLUSIONS

This is the first study to demonstrate that music training modulates memory of sung and spoken information in AD. The mechanism underlying these results is unclear, but may be due to music training, higher cognitive abilities, or both. Our findings highlight the need for further research into the potentially protective effect of music training on cognitive abilities in our aging population.

Life-long music practice and executive control in older adults: An event-related potential study

Recent research has indicated that music practice can influence cognitive processing across the lifespan. Although extensive musical experience may have a mitigating effect on cognitive decline in older adults, the nature of changes to brain functions underlying performance benefits remains underexplored. The present study was designed to investigate the underlying neural mechanisms that may support apparent beneficial effects of life-long musical practice on cognition. We recorded event-related potentials (ERPs) in older musicians (N=17; average age=69.2) and non-musicians (N=17; average age=69.9), matched for age and education, while they completed an executive control task (visual go/no-go). Whereas both groups showed similar response speed and accuracy on go trials, older musicians showed fewer no-go errors. ERP recordings revealed the typical N2/P3 complex, but the nature of these responses differed between groups in that (1) older musicians showed larger N2 and P3 effects ('no-go minus go' amplitude), with the N2 amplitude being correlated with behavioral accuracy for no-go trials and (2) the topography of the P3 response was more anterior in musicians. Moreover, P3 amplitude was correlated with measures of musical experience in musicians. In our discussion of these results, we propose that music practice may have conferred an executive control advantage for musicians in later life.

Music and dementia

There is an increasing incidence of dementia in our aging population, and consequently an urgent need to develop treatments and activities that may alleviate the symptoms of dementia. Accumulating evidence shows that persons with dementia enjoy music, and their ability to respond to music is potentially preserved even in the late or severe stages of dementia when verbal communication may have ceased. Media interest in this topic has contributed to the public perception that music abilities are an "island of preservation" in an otherwise cognitively impaired person with dementia. In this chapter, we review the current literature on music cognition in dementia and show that there has been very scarce rigorous scientific investigation of this issue, and that various types of music memory exist and are differentially impaired in the different types of dementia. Furthermore, we discuss the recent development of music activities as a nonpharmacological treatment for dementia and highlight the methodological limitations of the current literature on this topic. While it has been reported that music activities can improve behavior, (particularly agitation), mood, and cognition in persons with dementia, recent large-scale randomized control studies have questioned the specificity of the effect of music and found that it is no more beneficial than other pleasant activities. Nevertheless, music is unique in its powerful ability to elicit both memories and emotions. This can provide an important link to individual's past and a means of nonverbal communication with carers, which make it an ideal stimulus for persons with dementia.

Music training relates to the development of neural mechanisms of selective auditory attention

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Does music training shape the development of neural mechanisms of auditory attention?

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We compared cortical responses to attended speech in child and adult musicians and nonmusicians.

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Musician children and adults had less prefrontal auditory response variability during attention.

Selective attention decreases trial-to-trial variability in cortical auditory-evoked activity. This effect increases over the course of maturation, potentially reflecting the gradual development of selective attention and inhibitory control. Work in adults indicates that music training may alter the development of this neural response characteristic, especially over brain regions associated with executive control: in adult musicians, attention decreases variability in auditory-evoked responses recorded over prefrontal cortex to a greater extent than in nonmusicians. We aimed to determine whether this musician-associated effect emerges during childhood, when selective attention and inhibitory control are under development. We compared cortical auditory-evoked variability to attended and ignored speech streams in musicians and nonmusicians across three age groups: preschoolers, school-aged children and young adults. Results reveal that childhood music training is associated with reduced auditory-evoked response variability recorded over prefrontal cortex during selective auditory attention in school-aged child and adult musicians. Preschoolers, on the other hand, demonstrate no impact of selective attention on cortical response variability and no musician distinctions. This finding is consistent with the gradual emergence of attention during this period and may suggest no pre-existing differences in this attention-related cortical metric between children who undergo music training and those who do not.

Playing a Musical Instrument as a Protective Factor against Dementia and Cognitive Impairment: A Population-Based Twin Study

Increasing evidence supports that playing a musical instrument may benefit cognitive development and health at young ages. Whether playing an instrument provides protection against dementia has not been established. In a population-based cotwin control study, we examined the association between playing a musical instrument and whether or not the twins developed dementia or cognitive impairment. Participation in playing an instrument was taken from informant-based reports of twins' leisure activities. Dementia diagnoses were based on a complete clinical workup using standard diagnostic criteria. Among 157 twin pairs discordant for dementia and cognitive impairment, 27 pairs were discordant for playing an instrument. Controlling for sex, education, and physical activity, playing a musical instrument was significantly associated with less likelihood of dementia and cognitive impairment (odds ratio [OR] = 0.36 [95% confidence interval 0.13–0.99]). These findings support further consideration of music as a modifiable protective factor against dementia and cognitive impairment.

Musical practice and cognitive aging: two cross-sectional studies point to phonemic fluency as a potential candidate for a use-dependent adaptation

Because of permanent use-dependent brain plasticity, all lifelong individuals' experiences are believed to influence the cognitive aging quality. In older individuals, both former and current musical practices have been associated with better verbal skills, visual memory, processing speed, and planning function. This work sought for an interaction between musical practice and cognitive aging by comparing musician and non-musician individuals for two lifetime periods (middle and late adulthood). Long-term memory, auditory-verbal short-term memory, processing speed, non-verbal reasoning, and verbal fluencies were assessed. In Study 1, measures of processing speed and auditory-verbal short-term memory were significantly better performed by musicians compared with controls, but both groups displayed the same age-related differences. For verbal fluencies, musicians scored higher than controls and displayed different age effects. In Study 2, we found that lifetime period at training onset (childhood vs. adulthood) was associated with phonemic, but not semantic, fluency performances (musicians who had started to practice in adulthood did not perform better on phonemic fluency than non-musicians). Current frequency of training did not account for musicians' scores on either of these two measures. These patterns of results are discussed by setting the hypothesis of a transformative effect of musical practice against a non-causal explanation.

Participatory arts for older adults: a review of benefits and challenges

This article reviews the scientific literature on the enhancement of healthy aging in older adults through active participation in the arts. Methodologies and conclusions are described for studies of dance, expressive writing, music (singing and instrumental), theatre arts, and visual arts including documentation of mental/physical improvements in memory, creativity, problem solving, everyday competence, reaction time, balance/gait, and quality of life. In addition to these gains in measures of successful aging, the article also provides (in a Supplementary Appendix) some selected examples of arts engagement for remedial purposes. Finally, it offers suggestions for expanding inquiry into this underinvestigated corner of aging research.

Early life instruction in foreign language and music and incidence of mild cognitive impairment

OBJECTIVE

To test the hypothesis that foreign language and music instruction in early life are associated with lower incidence of mild cognitive impairment (MCI) and slower rate of cognitive decline in old age.

METHOD

At enrollment in a longitudinal cohort study, 964 older persons without cognitive impairment estimated years of foreign language and music instruction by age 18. Annually thereafter they completed clinical evaluations that included cognitive testing and clinical classification of MCI.

RESULTS

There were 264 persons with no foreign language instruction, 576 with 1-4 years, and 124 with > 4 years; 346 persons with no music instruction, 360 with 1-4 years, and 258 with > 4 years. During a mean of 5.8 years of observation, 396 participants (41.1%) developed MCI. In a proportional hazards model adjusted for age, sex, and education, higher levels (> 4 years) of foreign language (hazard ratio [HR] = 0.687, 95% confidence interval [CI] [0.482, 0.961]) and music (HR = 0.708, 95% CI [0.539, 0.930]) instruction by the age of 18 were each associated with reduced risk of MCI. The association persisted after adjustment for other early life indicators of an enriched cognitive environment, and it was stronger for nonamnestic than amnestic MCI. Both foreign language and music instruction were associated with higher initial level of cognitive function, but neither instruction measure was associated with cognitive decline.

CONCLUSIONS

Higher levels of foreign language and music instruction during childhood and adolescence are associated in old age with lower risk of developing MCI but not with rate of cognitive decline.

Biological impact of auditory expertise across the life span: musicians as a model of auditory learning

Experience-dependent characteristics of auditory function, especially with regard to speech-evoked auditory neurophysiology, have garnered increasing attention in recent years. This interest stems from both pragmatic and theoretical concerns as it bears implications for the prevention and remediation of language-based learning impairment in addition to providing insight into mechanisms engendering experience-dependent changes in human sensory function. Musicians provide an attractive model for studying the experience-dependency of auditory processing in humans due to their distinctive neural enhancements compared to nonmusicians. We have only recently begun to address whether these enhancements are observable early in life, during the initial years of music training when the auditory system is under rapid development, as well as later in life, after the onset of the aging process. Here we review neural enhancements in musically trained individuals across the life span in the context of cellular mechanisms that underlie learning, identified in animal models. Musicians' subcortical physiologic enhancements are interpreted according to a cognitive framework for auditory learning, providing a model in which to study mechanisms of experience-dependent changes in human auditory function.

Do older professional musicians have cognitive advantages?

The current study investigates whether long-term music training and practice are associated with enhancement of general cognitive abilities in late middle-aged to older adults. Professional musicians and non-musicians who were matched on age, education, vocabulary, and general health were compared on a near-transfer task involving auditory processing and on far-transfer tasks that measured spatial span and aspects of cognitive control. Musicians outperformed non-musicians on the near-transfer task, on most but not all of the far-transfer tasks, and on a composite measure of cognitive control. The results suggest that sustained music training or involvement is associated with improved aspects of cognitive functioning in older adults.

Turning down the noise: the benefit of musical training on the aging auditory brain

Age-related decline in hearing abilities is a ubiquitous part of aging, and commonly impacts speech understanding, especially when there are competing sound sources. While such age effects are partially due to changes within the cochlea, difficulties typically exist beyond measurable hearing loss, suggesting that central brain processes, as opposed to simple peripheral mechanisms (e.g., hearing sensitivity), play a critical role in governing hearing abilities late into life. Current training regimens aimed to improve central auditory processing abilities have experienced limited success in promoting listening benefits. Interestingly, recent studies suggest that in young adults, musical training positively modifies neural mechanisms, providing robust, long-lasting improvements to hearing abilities as well as to non-auditory tasks that engage cognitive control. These results offer the encouraging possibility that musical training might be used to counteract age-related changes in auditory cognition commonly observed in older adults. Here, we reviewed studies that have examined the effects of age and musical experience on auditory cognition with an emphasis on auditory scene analysis. We infer that musical training may offer potential benefits to complex listening and might be utilized as a means to delay or even attenuate declines in auditory perception and cognition that often emerge later in life.

Auditory Training: Evidence for Neural Plasticity in Older Adults

Improvements in digital amplification, cochlear implants, and other innovations have extended the potential for improving hearing function; yet, there remains a need for further hearing improvement in challenging listening situations, such as when trying to understand speech in noise or when listening to music. Here, we review evidence from animal and human models of plasticity in the brain's ability to process speech and other meaningful stimuli. We considered studies targeting populations of younger through older adults, emphasizing studies that have employed randomized controlled designs and have made connections between neural and behavioral changes. Overall results indicate that the brain remains malleable through older adulthood, provided that treatment algorithms have been modified to allow for changes in learning with age. Improvements in speech-in-noise perception and cognition function accompany neural changes in auditory processing. The training-related improvements noted across studies support the need to consider auditory training strategies in the management of individuals who express concerns about hearing in difficult listening situations. Given evidence from studies engaging the brain's reward centers, future research should consider how these centers can be naturally activated during training.

A dynamic auditory-cognitive system supports speech-in-noise perception in older adults

Understanding speech in noise is one of the most complex activities encountered in everyday life, relying on peripheral hearing, central auditory processing, and cognition. These abilities decline with age, and so older adults are often frustrated by a reduced ability to communicate effectively in noisy environments. Many studies have examined these factors independently; in the last decade, however, the idea of an auditory-cognitive system has emerged, recognizing the need to consider the processing of complex sounds in the context of dynamic neural circuits. Here, we used structural equation modeling to evaluate the interacting contributions of peripheral hearing, central processing, cognitive ability, and life experiences to understanding speech in noise. We recruited 120 older adults (ages 55-79) and evaluated their peripheral hearing status, cognitive skills, and central processing. We also collected demographic measures of life experiences, such as physical activity, intellectual engagement, and musical training. In our model, central processing and cognitive function predicted a significant proportion of variance in the ability to understand speech in noise. To a lesser extent, life experience predicted hearing-in-noise ability through modulation of brainstem function. Peripheral hearing levels did not significantly contribute to the model. Previous musical experience modulated the relative contributions of cognitive ability and lifestyle factors to hearing in noise. Our models demonstrate the complex interactions required to hear in noise and the importance of targeting cognitive function, lifestyle, and central auditory processing in the management of individuals who are having difficulty hearing in noise.

Musical experience strengthens the neural representation of sounds important for communication in middle-aged adults

Older adults frequently complain that while they can hear a person talking, they cannot understand what is being said; this difficulty is exacerbated by background noise. Peripheral hearing loss cannot fully account for this age-related decline in speech-in-noise ability, as declines in central processing also contribute to this problem. Given that musicians have enhanced speech-in-noise perception, we aimed to define the effects of musical experience on subcortical responses to speech and speech-in-noise perception in middle-aged adults. Results reveal that musicians have enhanced neural encoding of speech in quiet and noisy settings. Enhancements include faster neural response timing, higher neural response consistency, more robust encoding of speech harmonics, and greater neural precision. Taken together, we suggest that musical experience provides perceptual benefits in an aging population by strengthening the underlying neural pathways necessary for the accurate representation of important temporal and spectral features of sound.