Journal Article

The Effect of a Music-Movement Intervention on Arousal and Cognitive Flexibility in Older Adults With and Without Mild Neurocognitive Disorder

Carolyn Moore and Teresa Lesiuk

in Music Therapy Perspectives

Published on behalf of American Music Therapy Association

Volume 36, issue 1, pages 127-128
Published in print April 2018 | ISSN: 0734-6875
Published online January 2018 | e-ISSN: 2053-7387 | DOI: https://dx.doi.org/10.1093/mtp/mix025
The Effect of a Music-Movement Intervention on Arousal and Cognitive Flexibility in Older Adults With and Without Mild Neurocognitive Disorder

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Abstract

Background

While cognitive decline is typically associated with Alzheimer’s disease and related disorders, changes in various cognitive skills are observed in most individuals as they age (American Psychological Association, 2008). Declines in executive functioning skills such as cognitive flexibility are especially common as one ages, and deficits in this area can interfere with older adults’ ability to live and function independently (Glisky, 2007).

Related Literature

Both physical exercise and music training are cognitively engaging methods of enhancing cognitive functioning in older adults (Harada, Love, & Triebel, 2013). Recent research suggests that multimodal interventions that simultaneously combine aspects of physical activity and cognitive training may be effective in enhancing older adults’ cognition (Law, Barnett, Yau, & Gray, 2013, 2014). Music instrument playing is an inherently multimodal activity because it involves both physical movement and various levels of cognitive complexity. Moreover, listening to music can induce a temporary state of pleasure and increased arousal that is necessary to attend to and participate in cognitively engaging tasks (Berlyne, 1971; North & Hargreaves, 1997). Despite the potential of music playing–based interventions to address age-related cognitive decline, particularly as a preventative intervention for “well elderly” populations, a paucity of research exists exploring the outcomes of such interventions.

Objective

To examine the effects of a music-movement intervention on arousal and cognitive flexibility in older adults with and without symptoms of mild neurocognitive disorder (MND).

Methods

Forty-eight older adults between the ages of 65 and 84 (8 male, 40 female) with (n = 24) and without (n = 24) symptoms of MND took part in this study. Participants met with the researcher individually to take part in either the Music-Movement Intervention (MMI) or an identical intervention without music (i.e., music-only intervention, or MOI). The MMI is a researcher-developed, single-session, combined cognitive-movement intervention consisting of playing musical instruments in time with familiar, recorded instrumental music. The various musical instrument–playing tasks involve performing various functional movements in a cognitively challenging manner such as alternating or moving extremities together, midline crossing, or in various movement sequences. Participant assessments included: 1) heart rate as a measure of physiological arousal measured at pre-, mid-, and posttest; 2) the Perceived Arousal Scale (PAS; Anderson, 1995), measured at pre- and posttest; 3) the Borg Rating of Perceived Exertion (RPE; Borg, 1982), measured at pre-, mid-, and posttest; and 4) Trail Making Test Part B (TMT-B; Reitan & Wolfson, 1985), to measure cognitive flexibility at pre- and posttest.

Results

A three-way repeated measures analysis of variance (ANOVA) (intervention x cognitive status x time) indicated that the two-way interaction of intervention and time was significant. In other words, regardless of cognitive status, participants who took part in the MMI significantly improved their cognitive flexibility over time, while participants who took part in the MOI did not experience comparable results; the effect size was medium to large ([F1, 44] = 4.64, p < .05, ηp2 = .095). By contrast, a series of the three-way ANOVAS for physiological arousal, perceived arousal, or perceived exertion showed that no significant interaction effects emerged for these variables. Changes in the arousal and exertion variables over time did not significantly correlate with changes in cognitive flexibility over time, implying that the significant changes in cognitive flexibility observed in MMI participants were not due to alterations in arousal or exertion. Participant feedback suggested that differences in intervention-induced motivation and state mood might have played a role in changes in cognitive flexibility.

Conclusions

The MMI was effective in immediately improving participants’ cognitive flexibility. However, these results do not appear to be due to differences in the two interventions’ arousal or exertion potential. MMI participants appeared to enjoy the combination of familiar music and novel instrument playing tasks, which led to improved mood and greater attention to task. By contrast, MOI participants shared that they felt bored, unmotivated by, and disengaged from the movement intervention. Overall, while both the MMI and MOI included completing an identical series of functional movements and the researcher assumed that both engaged the same cognitive skills, the MMI appeared to do so to a greater extent.

Implications for Clinical Practice

Combining music listening and musical instrument playing tasks into a multimodal music therapy intervention may be a novel and effective way to immediately impact older adults’ cognitive flexibility. The addition of music tasks to a combined movement-cognitive intervention may increase the cognitive demand necessary to complete the movements and contribute an affective-motivational component to the experience. If older adults are offered the opportunity to participate in interventions such as the MMI and enjoy doing so, they may be more likely to regularly take part in the training and potentially experience lasting benefits.

Implications for Future Research

Future research should explore the potential relationships between the affective-motivational and cognitive outcomes that arise from participation in MMI and related music therapy interventions. Further studies should also explore the outcomes associated with longer-term participation in the MMI or similar interventions in order to help clarify dose-response relationships, and how group participation and/or utilization of live versus recorded music affects the MMI’s effectiveness.

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Subjects: Applied Music ; Music Therapy ; Music Psychology

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