Research Paper Volume 12, Issue 24 pp 24798—24816
Effects of choral singing versus health education on cognitive decline and aging: a randomized controlled trial
- 1 Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- 2 Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- 3 Centre for Healthy Longevity, National University Health System, Singapore, Singapore
- 4 Department of Psychiatry, University of Cambridge, UK
- 5 Department of Psychology, Goldsmiths, University of London, UK
- 6 Biology of Aging Laboratory, Singapore Immunology Network, Singapore
- 7 Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- 8 Maurine Tsakok Inc, Singapore
- 9 Yong Siew Toh Conservatory of Music, National University of Singapore, Singapore
- 10 Darius Lim, Voices of Singapore Choral Society, Singapore
- 11 Department of Statistics and Applied Probability, Faculty of Science, National University of Singapore, Singapore
- 12 Presbyterian Community Services, Singapore
- 13 NTUC Health Co-operative Limited, Singapore
- 14 Beijing Chui Yang Liu Hospital, Beijing, PR China
- 15 Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- 16 Genetics and Aging Research Unit, McCance Center for Brain Health, MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
- 17 School of Computer Science and Electronic Engineering, University of Essex, UK
- 18 Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- 19 Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- 20 Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK
- 21 Cardiovascular Research Institute, National University Health Systems, Singapore
- 22 Genome Institute of Singapore, Singapore
- 23 Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- 24 Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- 25 Academic Development Department, Duke-NUS Medical School, Singapore
- 26 Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- 27 Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- 28 Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
Received: April 17, 2020 Accepted: November 20, 2020 Published: December 18, 2020
https://doi.org/10.18632/aging.202374How to Cite
Abstract
We conducted a randomized controlled trial to examine choral singing’s effect on cognitive decline in aging. Older Singaporeans who were at high risk of future dementia were recruited: 47 were assigned to choral singing intervention (CSI) and 46 were assigned to health education program (HEP). Participants attended weekly one-hour choral singing or weekly one-hour health education for two years. Change in cognitive function was measured by a composite cognitive test score (CCTS) derived from raw scores of neuropsychological tests; biomarkers included brain magnetic resonance imaging, oxidative damage and immunosenescence. The average age of the participants were 70 years and 73/93 (78.5%) were female. The change of CCTS from baseline to 24 months was 0.05 among participants in the CSI group and -0.1 among participants in the HEP group. The between-group difference (0.15, p=0.042) became smaller (0.12, p=0.09) after adjusting for baseline CCTS. No between-group differences on biomarkers were observed. Our data support the role of choral singing in improving cognitive health in aging. The beneficial effect is at least comparable than that of health education in preventing cognitive decline in a community of elderly people. Biological mechanisms underlying the observed efficacy should be further studied.
Abbreviations
RCT: Randomized Controlled Trials; QOL: Quality of Life; CSI: Choral Singing Intervention; HEP: Health Education Program; MRI: Magnetic Resonance Imaging; CCTS: Composite Cognitive Test Score; SM-MMSE: Singapore Modified Mini-Mental State Examination; GDS: Geriatric Depression Scale; LME: Linear Mixed-effects; GM: Grey Matter; WM: White Matter; FA: Fractional Anisotropy; MD: Mean Diffusivity; HSCs: Hematopoietic Stem Cells; CD: Cluster of Differentiation; TEMRA: Effector Memory RA; RTEs: Recent Thymic Emigrants; PD-1: Programmed Cell Death Protein 1; KLRG1: Killer Cell Lectin-like Receptor G1; TBSS: Tract-based Spatial Statistics; S-IgA: Secretory Immunoglobulin A; TIA: Transient Ischemia Attack; CDR: Clinical Dementia Rating; TaRA@JP: Training and Research Academy at Jurong Point; LF: Lei Feng; CIRC: Clinical Imaging Research Centre; NUS: National University of Singapore; MPRAGE: Magnetization-prepared Gradient-echo; TR: Repetition Time; TE: Echo Time; FA: Flip Angle; FoV: Field of View; DWI: Diffusion Weighted Images; FA: Fractional Anisotropy; MD: Mean Diffusivity; RRG: Rafael Romero-Garcia; PBMC: Peripheral Blood Mononuclear Cell; PBS: Phosphate-buffered Saline; FBS: Fetal Bovine Serum; DMSO: Dimethyl Sulfoxide; RPMI: Roswell Park Memorial Institute; FACS: Fluorescence Activated Cell Sorting; 8OHG: 8-hydroxyguanosine; 8OHdG: 8-hydroxy-2' -deoxyguanosine; LC-MS/MS: liquid Chromatography Mass Spectrometry; RAVLT: Rey Auditory Verbal Learning Test; CTT: Color Trails Test; SDMT: Symbol Digit Modality Test; BNT: Boston Naming Test; SCRI: Singapore Clinical Research Institute.