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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| A1 Piano Training | Experimental | 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. |
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| A2 Computer Cognitive Training | Experimental | 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. |
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| A 3 No Treatment Controls | No Intervention | No classes will be provided to our control group. This is a no-treatment control group. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Piano Training | Behavioral | The intervention focuses upon progressively difficult piano performance exercises (repertoire), technique, and finger dexterity exercises. |
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| 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 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jennifer Bugos, PhD | Assistant Professor | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of South Florida | Tampa | Florida | 33620 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19220558 | Result | Smith GE, Housen P, Yaffe K, Ruff R, Kennison RF, Mahncke HW, Zelinski EM. A cognitive training program based on principles of brain plasticity: results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) study. J Am Geriatr Soc. 2009 Apr;57(4):594-603. doi: 10.1111/j.1532-5415.2008.02167.x. Epub 2009 Feb 9. | |
| 25722349 |
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No, there is no plan to share individual participant data. We plan on publishing all data collectively.
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| Computer Cognitive Training | Behavioral | The intervention focuses upon progressively difficult perceptual exercises using the Brain Fitness program plus working memory exercises. |
|
| (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 |
| Duff K, Tometich D, Dennett K. The Modified Telephone Interview for Cognitive Status is More Predictive of Memory Abilities Than the Mini-Mental State Examination. J Geriatr Psychiatry Neurol. 2015 Sep;28(3):193-7. doi: 10.1177/0891988715573532. Epub 2015 Feb 26. |
| 17612811 | Result | Bugos JA, Perlstein WM, McCrae CS, Brophy TS, Bedenbaugh PH. Individualized piano instruction enhances executive functioning and working memory in older adults. Aging Ment Health. 2007 Jul;11(4):464-71. doi: 10.1080/13607860601086504. |
| 35134913 | Derived | Bugos JA, Wang Y. Piano Training Enhances Executive Functions and Psychosocial Outcomes in Aging: Results of a Randomized Controlled Trial. J Gerontol B Psychol Sci Soc Sci. 2022 Sep 1;77(9):1625-1636. doi: 10.1093/geronb/gbac021. |