Cognitive Intervention with Musical Stimuli Using Digital Devices on Mild Cognitive Impairment: A Pilot Study

Abstract

The effect of music therapy on cognitive function has been widely reported; however, its clinical implications remain controversial. Performing therapeutic musical activities in groups using individualized instruments can help overcome the issues of engagement and compliance. We aimed to evaluate the effect of a cognitive intervention with musical stimuli using digital devices on mild cognitive impairment (MCI). In this prospective study, 24 patients with MCI (intervention group, 12; and control group, 12) were enrolled. We developed an electronic device with musical instruments and the Song-based Cognitive Stimulation Therapy protocol (SongCST). Patients in the intervention group underwent a 10-week cognitive intervention involving musical stimuli generated by our device. Effect of the intervention on cognitive function was evaluated by the Mini-Mental State Examination-Dementia Screening (MMSE-DS), Montreal Cognitive Assessment-Korean (MOCA-K), and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB). In the intervention group, MMSE-DS and MOCA-K scores improved significantly after the 10-week intervention. The changes in MOCA-K and CDR-SB scores were significantly different between the intervention and control groups. Our study showed that music therapy with digital devices has a positive effect on the executive function and overall disease severity in patients with MCI. Our study can facilitate individualization of music therapy using digital devices in groups.

The use of technology for arts-based activities in older adults living with mild cognitive impairment or dementia: A scoping review

“…Active production of music, most typically designed as playing a musical instrument, was facilitated in various ways. Systems could present visual prompts on screen for a user to press a key/button of associated colour on a device ( Cheng & Lee, 2018 ; Han et al, 2020 ). For a different example, users were free to create movements which would then be sonified (e.g.…”

“…Second, 16 of the studies relayed findings related to improvements in their participants’ BPSD. Thirteen of which used behavioural measures, 5 number of negative behaviours observed, social validation check, task-related error rate over time, number of actions or utterances made when engaging with device; ( Benveniste et al, 2012 ; Boulay et al, 2011 ; Cheng et al, 2019 ; Cheng & Lee, 2018 ; Cruz-Sandoval et al, 2018 ; Cunningham et al, 2019 ; Kwak et al, 2020 ; Lancioni et al, 2014 , 2015 , 2017 ; Manca et al, 2021 ; Murphy et al, 2018 ; Tyack et al, 2017 ) to indicate these changes in BPSD, two used cognitive measures 6 ( Azman et al, 2017 ; Han et al, 2020 ), while one other used a combination of cognitive and behavioural measures 7 ( Iacono & Marti, 2016 ). Almost all studies presenting behavioural evidence quantitatively described improvements as occurring along their behavioural measures, with reporting mixed on the types of statistics used, and whether corrections for multiple comparisons were employed.…”

“…Three additional studies included music among other activities. Technology was designed for music listening ( n = 16) (Bennett et al, 2016; Cruz-Sandoval et al, 2018; Cunningham et al, 2019; De Kok et al, 2018; Hodge et al, 2018; Houben, Brankaert, et al, 2020; Hsu et al, 2019; Kwak et al, 2020; Lancioni et al, 2014; Lancioni et al, 2015; Murphy et al, 2018; Nayer et al, 2014; Orpwood et al, 2010; Peeters et al, 2016; Seymour et al, 2017; Thoolen et al, 2019), interactive music listening involving the participant’s active movement ( n = 2) (Morrissey et al, 2016; Rosseland & Culén, 2016) and music making ( n = 9) (Benveniste et al, 2012; Boulay et al, 2011; Cheng et al, 2019; Cheng & Lee, 2018; Favilla & Pedell, 2013, 2014; Han et al, 2020; Houben, Lehn, et al, 2020; Kenning et al, 2019). Music-making included versions of familiar instruments such as the keyboard/percussion, or new instruments manipulating sounds.…”

Case Report: Accessible Digital Musical Instrument Can Be Used for Active Music Therapy in a Person With Severe Dementia and Worsening Behavioral and Psychological Symptoms: A Case Study Over a Year and a Half

“…Despite the fact that accessible digital musical instruments can take into account the level of cognitive demands, previous studies ( 20 ) have been conducted with MCI, and it is not known whether these instuments can be used by people with moderate to severe dementia or dementia with worsening BPSD. In our case, the patient with VaD was able to play the Cymis throughout the 18 months of MT.…”

“…Current advances in music technology have enabled the creation of customized accessible digital musical instruments, and in recent years, the use of music technology in music therapy has been gaining attention ( 19 ). Han et al ( 20 ) aimed to evaluate the effect of a cognitive intervention with an accessible digital musical instrument on MCI. In this prospective study, 24 patients with MCI (intervention group, 12; and control group, 12) were enrolled.…”