Music Improvisation Training on Cognitive Function in Older Adults

NCT ID: NCT06721390

Last Updated: 2025-10-31

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 238 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-03-05
• Study Completion Date: 2026-05-31

Brief Summary

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.

Detailed Description

Approximately 5.8 million adults age 60 and over in the United States live with Alzheimer disease and related dementias (AD/ADRD) at a cost of $290 billion per year. Older adults with mild cognitive impairment (MCI), an intermediate stage between typical aging and dementia, are 3-5 times more likely to progress to AD than those with normal cognition. Late-life engagement in cognitively challenging activities is associated with decreased risk of cognitive decline, and there is a need to address cognitive inactivity. Music interventions are a promising strategy to address late-life cognitive inactivity. Music training can change brain structure and function in non-musician adults, thereby leading to cognitive, perceptual, and psychosocial advantages. These changes in cognitive function are thought to occur because the multimodal, complex nature of music facilitates training-induced neural plasticity. However, the mechanisms are not yet understood, and most studies used traditional or rote keyboard training techniques. Music training based on improvisation principles-the spontaneous generation of musical melodies and rhythms-will likely have more potent effects on cognition and brain function. Improvisation facilitates cognitive flexibility, self-monitoring, novel idea generation, execution of unplanned motor sequences and entrance into a state of flow. Biologically, improvisation is associated with distinct neural patterns involving activation of prefrontal networks and other brain networks that are affected by aging. As a mechanism of behavior change, it is likely that improvisation training will uniquely improve self-regulation (the ability to monitor and control one's own behavior, emotions, or thoughts and modify to situational demands). Yet, no research has tested whether improvisation training can improve self-regulation and facilitate maintenance of cognitively challenging activities among older adults with and without MCI. This project will develop and test the effects and mechanisms of a music improvisation training intervention on self-regulation of older adults with and without MCI. Our 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. Our project has two phases. In the R61 phase, the study will develop a music improvisation training intervention that aims to improve self-regulation among older adults with and without MCI and conduct a 2-arm randomized pilot study to (i) examine feasibility and acceptability of the intervention and study methods and (ii) determine its effects on the hypothesized mechanism of self-regulation. If milestones are met, the study will proceed to the R33 phase and conduct a randomized mechanistic trial to examine the effects of the intervention, compared to an attention control, on self-regulation and cognitive engagement among older adults with and without MCI. The findings from this study will improve our understanding of the underlying mechanisms of how music training interventions can facilitate behavior change to maintain health of older adults.

Conditions

Aging; Cognitive Aging; Cognitive Impairment; Cognitive Training; Mild Cognitive Impairment; Cognitively Normal Older Adults

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: SINGLE

Study Groups

Piano Improvisation

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 Type: EXPERIMENTAL

Piano Improvisation

Intervention Type: BEHAVIORAL

Piano Improvisation taught by a professional instructor for 12 weeks.

Music Listening

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.

Group Type: ACTIVE_COMPARATOR

Music Listening

Intervention Type: BEHAVIORAL

Music Listening facilitated by a professional instructor for 12 weeks.

Interventions

Piano Improvisation

Piano Improvisation taught by a professional instructor for 12 weeks.

Intervention Type: BEHAVIORAL

Music Listening

Music Listening facilitated by a professional instructor for 12 weeks.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Age 60 and over
• Living independently in the community
• Sufficient visual and hearing acuity (age-related to normal hearing loss, with assistive devices) as measured by audiometer
• 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
• English fluency rated fairly well to well
• MoCA score of 22-30 or diagnosis of "mild cognitive impairment
• Not currently taking psychoactive medications, antidepressants, or sleep medications that could adversely affect cognitive abilities.

Exclusion Criteria

• Medical diagnosis of dementia (any etiology)
• Inability to move the hands or use all 10 digits (extensive arthritis, neuropathy, missing digits)
• Score < 22 on MoCA
• Current (but not prior) severe psychiatric disorder, serious medical condition (e.g., stroke, TIA) that would interfere with participation in the study
• Poor English fluency
• Musician or previously trained in jazz improvisation, more than three years of formal music instruction or training and/or currently engaged in musical performance
• Plans to move out of the area within six months

• Minimum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Institute on Aging (NIA)

NIH

Sponsor Role: collaborator

University of California, San Francisco

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Julene Johnson, PhD

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

The study is taking place at community sites in San Francisco.

San Francisco, California, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Julene Johnson, PhD

Role: CONTACT

Julene.Johnson@ucsf.edu

415-476-1109

Other Identifiers

R33AG073669

Identifier Type: NIH

Identifier Source: secondary_id

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4R33AG073669-03

Identifier Type: NIH

Identifier Source: org_study_id

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