Abstract

Objectives

Music-based interventions are postulated to mitigate cognitive decline in individuals with dementia. However, the mechanisms underlying why music-based interventions facilitate cognitive benefits remain unknown. The present study examines whether a choral intervention can modulate patterns of cognitive change in persons with dementia and whether within-person variation in affect is associated with this change.

Methods

Thirty-three older adults with dementia engaged weekly in the Voices in Motion (ViM) study consisting of 3 choral seasons spanning 18-months. Performance on the Mini-Mental State Examination (MMSE) and the Positive and Negative Affect Schedule was assessed monthly within each choral season using a longitudinal intensive repeated-measures design. Three-level multilevel models were employed to disaggregate between- and within-person effects across short- (month-to-month) and long-term (season-to-season) intervals.

Results

ViM participants exhibited an annual MMSE decline of 1.8 units, notably less than the clinically meaningful 3.3 units indicated by non-intervention literature. Further, variability in negative affect shared a within-person time-varying association with MMSE performance; decreases in negative affect, relative to one’s personal average, were linked to corresponding improvements in cognitive function.

Conclusion

Engagement in the ViM choral intervention may attenuate cognitive decline for persons with dementia via a reduction of psychological comorbidities such as elevated negative affect.

中文翻译：

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探索以社区为基础的合唱参与对痴呆症患者认知功能和幸福感的影响：来自 Voices in Motion 项目的证据

摘要

目标

基于音乐的干预被认为可以减轻痴呆症患者的认知能力下降。然而，基于音乐的干预促进认知益处的潜在机制仍然未知。本研究检验了合唱干预是否可以调节痴呆症患者的认知变化模式，以及个人情感差异是否与这种变化相关。

方法

33 名患有痴呆症的老年人每周参与 Voices in Motion (ViM) 研究，该研究包括跨越 18 个月的 3 个合唱季。使用纵向强化重复测量设计，在每个合唱季节内每月评估迷你精神状态检查 (MMSE) 和积极和消极影响表的表现。采用三级多层次模型来分解短期（月对月）和长期（季节对季节）间隔的人与人之间和人内的影响。

结果

ViM 参与者表现出 1.8 个单位的年度 MMSE 下降，明显低于非干预文献表明的具有临床意义的 3.3 个单位。此外，负面影响的可变性与 MMSE 表现共享一个人内随时间变化的关联；相对于一个人的个人平均水平，负面影响的减少与认知功能的相应改善有关。

结论

参与 ViM 合唱干预可以通过减少心理合并症（例如升高的负面情绪）来减轻痴呆症患者的认知能力下降。