Impact of Music Improvisation Training on Brain Function and Cognition among Older Adults

音乐即兴训练对老年人大脑功能和认知的影响

• 批准号: 10925727
• 负责人: JULENE K JOHNSON
• 金额: $ 54.35万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10925727
• 关键词: Address; Adherence; Adult; Affect; Age; Aging; Alzheimer' s disease related dementia; Attention; Behavior; Behavioral; Behavioral Mechanisms; Biological Assay; Brain; Brain imaging; Cognition; Cognitive; Complex; Creativeness; Data; Dementia; Educational Intervention; Elderly; Emotions; Generations; Goals; Health; Health behavior; Impaired cognition; Informal Social Control; Intervention; Language; Lateral; Learning; Limb structure; Link; Maintenance; Measures; Memory; Methods; Monitor; Motor; Music; Nature; Neuronal Plasticity; Outcome; Patient Self-Report; Phase; Pilot Projects; Play; Randomized; Reading; Research; Risk; Risk Factors; Self Efficacy; Short-Term Memory; Site; Structure; Techniques; Testing; Thinking; Training; Training Technics; United States; United States National Institutes of Health; acceptability and feasibility; arm; attentional control; behavior change; cognitive control; cognitive function; comparison control; cost; executive function; experience; flexibility; improved; innovation; instrument; intervention effect; mild cognitive impairment; modifiable risk; multimodality; neural; neural patterning; novel; pre-clinical; processing speed; psychosocial; psychosocial wellbeing; randomized trial; resilience; verbal

ABSTRACT 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, we 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, we 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.

抽象的 在美国，大约有 580 万 60 岁及以上的成年人患有阿尔茨海默病及相关疾病 痴呆症 (AD/ADRD) 每年造成 2900 亿美元的损失。患有轻度认知障碍（MCI）的老年人 典型衰老和痴呆之间的中间阶段，进展为 AD 的可能性比那些人高 3-5 倍 具有正常的认知能力。晚年参与具有认知挑战性的活动与认知能力下降有关 认知能力下降的风险，并且需要解决认知不活动的问题。音乐干预是 解决晚年认知不活跃问题的有前途的策略。音乐训练可以改变大脑结构 功能在非音乐家成年人中发挥作用，从而导致认知、知觉和心理社会优势。这些 人们认为认知功能的变化是因为音乐的多模式、复杂性促进了 训练引起的神经可塑性。然而，其机制尚不清楚，大多数研究都使用 传统或死记硬背的键盘训练技术。基于即兴创作原则的音乐训练—— 音乐旋律和节奏的自发产生——可能会对认知产生更有效的影响 和大脑功能。即兴创作有助于认知灵活性、自我监控、新想法的产生， 执行计划外的运动序列并进入心流状态。从生物学上来说，即兴创作是 与不同的神经模式相关，涉及前额叶网络和其他大脑网络的激活 受到衰老的影响。作为行为改变的一种机制，即兴训练很可能会以独特的方式 提高自我调节能力（监控和控制自己的行为、情绪或思想的能力） 根据情况要求修改）。然而，还没有研究测试即兴训练是否可以提高自我能力。 调节并促进老年人维持具有或不具有认知挑战性的活动 MCI。该项目将开发和测试音乐即兴训练的效果和机制 对患有和不患有 MCI 的老年人进行自我调节干预。我们的总体假设是即兴创作 与对照相比，培训将导致自我调节的改善，并且即兴训练将 与前额叶大脑网络的特定变化以及最终的认知参与相关。我们的 项目分为两个阶段。在R61阶段，我们将开发音乐即兴训练干预措施，旨在 提高患有和不患有 MCI 的老年人的自我调节能力，并进行 2 组随机试验 研究目的是 (i) 审查干预措施和研究方法的可行性和可接受性，以及 (ii) 确定其 对假设的自我调节机制的影响。如果达到里程碑，我们将进入 R33 阶段并进行随机机制试验，以检查干预措施的效果，与 注意力控制对患有和不患有 MCI 的老年人的自我调节和认知参与的影响。这 这项研究的结果将提高我们对音乐训练的潜在机制的理解 干预措施可以促进行为改变，以维护老年人的健康。