Date of Award

2017

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Graduate Group

Nursing

First Advisor

Pamela Z. Cacchione

Abstract

Older adults with mild cognitive impairment (MCI) are at increased risk for dementia. Despite the presence of cognitive deficits in persons with MCI and dementia, older adults with dementia preserve their ability to engage in music throughout their disease. However, musical abilities have not previously been explored in individuals with MCI. The purpose of this dissertation was twofold: 1) to better understand the relationship between musical and cognitive abilities in persons with MCI (Chapter II) and how preserved musical abilities may contribute to enhanced cognitive abilities despite the underlying atrophy in the brain (Chapter III); and 2) to develop and submit a post-doctoral application to investigate the feasibility and acceptability of an individualized music intervention to reduce sleep disturbances in older adults with dementia (Chapter IV).

We conducted a cross-sectional study at the University of Pennsylvania Alzheimer’s Disease Core Center (ADCC). We combined existing data from the ADCC and asked 60 older adults with MCI to complete two questionnaires, one screening for depression and the other gauging their musical abilities. We broadly operationalized musical abilities as musical skills, expertise, achievements and related behaviors and used hippocampal volume as a biomarker for the underlying atrophy in the brain. The participants, on average, scored lower on the index of musical abilities compared to published norms. Using Pearson’s correlations and linear regression analyses, we found that participants who scored lower on the index of musical abilities had lower scores on the measure of verbal naming. Additionally, musical abilities moderated the relationship between hippocampal volume and one of the cognitive abilities – executive function in 38 older adults for whom magnetic resonance imaging was available.

Enhanced musical abilities emerged as a possible compensatory mechanism for persons with MCI who are struggling with cognitive deficits. Given the relationship between musical and cognitive abilities, music may be an effective intervention to maintain cognition and improve the well-being of older adults with cognitive impairment. This body of work, my passion for music, and a desire to garner skills in intervention research served as a platform for writing and submitting a post-doctoral application exploring how a music intervention may help alleviate one of the most distressing behavioral symptoms of dementia – sleep disturbances.

Available for download on Saturday, August 15, 2020

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