The Impact of Piano Training on Cognitive Performance and Psychosocial Well-Being in Older Adults

Study Overview
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Brief Summary
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This project evaluates the effects of piano training and computerized cognitive training on cognitive performance in healthy older adults compared to controls. The project is intended for healthy older adults (60-80 years) with little to no previous musical training (less than three years of prior musical training or cognitive training and not currently engaged in music reading or musical performance, less than 10 hours of previous cognitive training). Investigators anticipate that musical engagement will serve as an enjoyable cognitive intervention for older adults. Investigators believe that piano training will enhance cognitive performance on executive functions essential for maintaining independence in older adulthood. Learning a musical instrument, while challenging, will improve self-efficacy, mood, and qualtiy of life. Participants engaged in piano training will demonstrate reduced cortisol levels and increased immune function responses. Investigators predict that adults enrolled in computerized cognitive training will demonstrate enhanced memory, working memory and self-efficacy post-training.

Detailed Description
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The project purpose is to scientifically examine the benefits of piano training as compared to computer cognitive training and no treatment controls on cognitive (processing speed, task-switching, verbal fluency, verbal memory, and working memory), psychosocial (mood, self-efficacy, and quality of life), and physiological variables (biomarkers) in healthy older adult participants in a randomized clinical trial design. Participants: Ninety community dwelling older adults will be recruited from the community. Criteria for enrollment are: between the ages of 60-80, native English speakers, not currently taking medications affecting memory performance, have no pre-existing cognitive impairment or neurological disorders, (as indicated by the Telephone Interview for Cognitive Status > 30), no moderate to severe depression (as indicated by the Geriatric Depression Scale), no difficulty with hand movements, less than three years of prior musical training, not currently engaged in music reading or musical performance, and less than ten hours of prior computer brain training experience. Participants will be randomly assigned to one of three groups stratified by intelligence and gender: piano instruction, computerized cognitive training or a no treatment control group. Informed written consent will be obtained in accordance with the Institutional Review Board. Procedure: Participants will be tested in three visits: pre-training, immediately post-training, and three months follow-up. Those randomized to piano training or computerized cognitive training will complete their assigned training between pre-training and post-training visits. Measures of music aptitude and intelligence will be administered at the pre-training visit. These factors can influence cognitive performance. Any significant differences at baseline between the three assigned groups will be statistically controlled for in the analyses. Standardized cognitive measures will be used to examine processing speed, task-switching, verbal fluency, verbal memory, and working memory at each visit. Psychosocial outcomes (mood, self-efficacy, and quality of life) and physiological biomarkers will also be evaluated at each visit. The goal for both interventions will be to complete 48 hours of group training over a four month period (16 weeks). Sixty participants (30 piano training; 30 auditory computer training) will be asked to attend three hours of training each week. Thirty participants will serve in the no treatment control group. Piano training will consist of basic piano technique, dexterity exercises, piano literature, and music theory. Participants will be expected to perform all major scales, repertoire from the Alfred All-in-One Method, and complete weekly theory assignments. Each class session is structured as a cognitive intervention that focuses upon review of materials (15-20 min), and the remaining portion of the class focuses upon learning new skills and concepts. Computerized cognitive training involves computerized perceptual practice exercises that vary in difficulty ranging from basic auditory processing speed to application through memory exercises. Within each exercise, the stimuli (i.e., tones, speech sounds, words, sentences) become less discriminable and speed of presentation increases (making the exercises more difficult) as performance improves. The Brain Fitness training program with working memory exercises will be used. Data source(s). Data will consist of a series of standardized cognitive, psychosocial, and neurophysiological measures administered at three time points: pre-training, post-training, and at a three month follow-up. All standardized measures have been previously used to assess the efficacy of cognitive training approaches and demonstrate good psychometric properties.

Official Title
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The Impact of Piano Training on Cognitive Performance and Psychosocial Well-Being in Older Adults

Conditions
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Aging

Intervention / Treatment
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* Behavioral: Piano Training
* Behavioral: Computer Cognitive Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Between the ages of 60-80 native English speakers no pre-existing cognitive impairment or neurological impairment not taking medications affecting memory performance (sleep meds, antidepressants, etc.) Telephone Interview for Cognitive Status (score >30) no moderate to severe depression no difficulty with hand movements less than three years of formal music training no difficulty with the movement of their hands not currently engaged in music reading or musical performance < 10 hours of previous cognitive training Exclusion Criteria: Those not between 60-80 those taking medications affecting memory performance Non-Native English Speakers Those with pre-existing cognitive impairment Telephone Interview for Cognitive Status (score < 30) Those with difficulty in the movement of their hands Those with more than three years of formal music training or currently engaged in music reading or music performance Those with more than ten hours of cognitive training

Ages Eligible for Study
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Minimum Age: 60 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: A1 Piano Training<br>16 weekly classes will be provided to the piano training group. Each piano class session will focus upon review of materials (15-20 min), and the remaining portion of the class will focus upon learning new skills and concepts. This course includes finger dexterity exercises, basic piano technique, and basic piano repertoire. | Behavioral: Piano Training<br>* The intervention focuses upon progressively difficult piano performance exercises (repertoire), technique, and finger dexterity exercises.<br>|
| Experimental: A2 Computer Cognitive Training<br>16 weekly classes will be provided to the computerized cognitive training group. Computerized cognitive training involves process-based computerized practice of adaptive perceptual exercises. Each computer cognitive training class session will focus upon practice of cognitive exercises that vary in difficulty ranging from basic auditory processing speed to application through memory and working memory exercises. Within each exercise, the stimuli (i.e., tones, speech sounds, words, sentences) become less discriminable and speed of presentation increases (making the exercises more difficult) as performance improves. | Behavioral: Computer Cognitive Training<br>* The intervention focuses upon progressively difficult perceptual exercises using the Brain Fitness program plus working memory exercises.<br>|
| No Intervention: A 3 No Treatment Controls<br>No classes will be provided to our control group. This is a no-treatment control group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| N-Back | Working Memory Measure in the Visual Domain | (CHANGE) up to 16 weeks and after study completion 7 months | 
| Cued Color Word Stroop | Cognitive Control, Inhibition | (CHANGE) up to 16 weeks and after study completion 7 months | 
| Digit Coding- WAIS IV subtest | Simple Processing Speed | (CHANGE) up to 16 weeks and after study completion 7 months | 
| Symbol Search- WAIS IV subtest | Visual Scanning | (CHANGE) up to 16 weeks and after study completion 7 months | 
| Paced Auditory Serial Addition Task (PASAT) | Complex processing speed | (CHANGE) up to 16 weeks and after study completion 7 months | 
| Rey Auditory Verbal Learning Test | Verbal Memory | (CHANGE) up to 16 weeks and after study completion 7 months | 
| Delis Kaplan Executive Function Verbal Fluency subtest | Category Fluency, Letter Fluency, Category Switching | (CHANGE) up to 16 weeks and after study completion 7 months | 
| Trail Making Test | Planning and Processing Speed | (CHANGE) up to 16 weeks and after study completion 7 months | 
| Finger Tapper Test | Motor Speed | (CHANGE) up to 16 weeks and after study completion 7 months | 
| Salivary Cortisol | Stress Levels | (CHANGE) up to 16 weeks and after study completion 7 months | 
| SIgA levels | Immune Function | (CHANGE) up to 16 weeks and after study completion 7 months | 
| Musical Performance Self-Efficacy | Musical Self-Efficacy | (CHANGE) up to 16 weeks and after study completion 7 months | 
| General Self-Efficacy | General Self-Efficacy | (CHANGE) up to 16 weeks and after study completion 7 months | 
| Cognitive Self-Report Questionnaire (25) | Mood | (CHANGE) up to 16 weeks and after study completion 7 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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intervention, cognition, aging, piano training, computer brain training