Efficacy of memory training interventions targeting metacognition for older adults: a systematic review and meta-analysis.

OBJECTIVES: This review examined the evidence about training interventions targeting metacognition in improving memory and cognitive performance, metacognitive functioning, and well-being in healthy older adults. METHODS: Studies were identified in the PsycInfo, PubMed, and Scopus databases. The risk of bias was assessed using tools based on the Joanna Briggs criteria. The data were meta-analyzed using random effects models for those training targeting metacognition alone (metacognitive training) or combined with memory strategy training (strategic metacognitive training). RESULTS: Out of the 3,487 articles first identified, 25 studies were eligible for our review (N = 1,768 older adults; mean age range: 64-85 years). Metacognitive training and strategic metacognitive training elicited improvements in memory (d = 0.52 [95% CI: 0.19; 0.84], and d = 0.44 [95% CI: 0.29; 0.58], respectively), metacognitive beliefs (d = 0.58 [95% CI: 0.23; 0.93], and d = 48 [95% CI: 0.28; 0.69], respectively), strategy use (d = 0.98 [95% CI: 0.46; 1.49] and 0.87 [95% CI: 0.14; 1.61], respectively), and memory self-efficacy (d = 0.08 [95% CI: -0.39; 0.56] and 0.55 [95% CI: 0.36; 0.75], respectively). Strategic metacognitive training also improved well-being (d = 0.21 [95% CI: 0.07; 0.35]). CONCLUSION: Interventions targeting metacognition (alone or combined with memory strategy training) have the potential to support older adults' memory and metacognitive functioning. The methodological quality of most studies on the topic was often limited, however. Furthermore, well-designed studies needed to confirm the benefits of such interventions in older age.

Individual differences in musical ability among adults with no music training.

Good musical abilities are typically considered to be a consequence of music training, such that they are studied in samples of formally trained individuals. Here, we asked what predicts musical abilities in the absence of music training. Participants with no formal music training (N = 190) completed the Goldsmiths Musical Sophistication Index, measures of personality and cognitive ability, and the Musical Ear Test (MET). The MET is an objective test of musical abilities that provides a Total score and separate scores for its two subtests (Melody and Rhythm), which require listeners to determine whether standard and comparison auditory sequences are identical. MET scores had no associations with personality traits. They correlated positively, however, with informal musical experience and cognitive abilities. Informal musical experience was a better predictor of Melody than of Rhythm scores. Some participants (12%) had Total scores higher than the mean from a sample of musically trained individuals (⩾6 years of formal training), tested previously by Correia et al. Untrained participants with particularly good musical abilities (top 25%, n = 51) scored higher than trained participants on the Rhythm subtest and similarly on the Melody subtest. High-ability untrained participants were also similar to trained ones in cognitive ability, but lower in the personality trait openness-to-experience. These results imply that formal music training is not required to achieve musician-like performance on tests of musical and cognitive abilities. They also suggest that informal music practice and music-related predispositions should be considered in studies of musical expertise.

Music Listening, Emotion, and Cognition in Older Adults.

Using the arousal and mood hypothesis as a theoretical framework, we examined whether community-dwelling older adults (N = 132) exhibited cognitive benefits after listening to music. Participants listened to shorter (≈2.5 min) or longer (≈8 min) excerpts from recordings of happy- or sad-sounding music or from a spoken-word recording. Before and after listening, they completed tasks measuring visuospatial working memory (WM), cognitive flexibility and speed, verbal fluency, and mathematical ability, as well as measures of arousal and mood. In general, older adults improved from pre- to post-test on the cognitive tasks. For the test of WM, the increase was greater for participants who heard happy-sounding music compared to those in the other two groups. The happy-sounding group also exhibited larger increases in arousal and mood, although improvements in mood were evident only for the long-duration condition. At the individual level, however, improvements in WM were unrelated to changes in arousal or mood. In short, the results were partially consistent with the arousal and mood hypothesis. For older adults, listening to happy-sounding music may optimize arousal levels and mood, and improve performance on some cognitive tasks (i.e., WM), even though there is no direct link between changes in arousal/mood and changes in WM.

Can musical ability be tested online?

We sought to determine whether an objective test of musical ability could be successfully administered online. A sample of 754 participants was tested with an online version of the Musical Ear Test (MET), which had Melody and Rhythm subtests. Both subtests had 52 trials, each of which required participants to determine whether standard and comparison auditory sequences were identical. The testing session also included the Goldsmiths Musical Sophistication Index (Gold-MSI), a test of general cognitive ability, and self-report questionnaires that measured basic demographics (age, education, gender), mind-wandering, and personality. Approximately 20% of the participants were excluded for incomplete responding or failing to finish the testing session. For the final sample (N = 608), findings were similar to those from in-person testing in many respects: (1) the internal reliability of the MET was maintained, (2) construct validity was confirmed by strong associations with Gold-MSI scores, (3) correlations with other measures (e.g., openness to experience, cognitive ability, mind-wandering) were as predicted, (4) mean levels of performance were similar for individuals with no music training, and (5) musical sophistication was a better predictor of performance on the Melody than on the Rhythm subtest. In sum, online administration of the MET proved to be a reliable and valid way to measure musical ability.

Cognitive Stimulation Therapy for Older Adults With Mild-to-Moderate Dementia in Italy: Effects on Cognitive Functioning, and on Emotional and Neuropsychiatric Symptoms.

OBJECTIVES: Cognitive Stimulation Therapy (CST) is one of the most popular evidence-based interventions for people with dementia. The aim of the present study was to assess the effectiveness in the short- and long-term (on completing the treatment and 3 months later) of an Italian adaptation of the CST protocol (CST-IT). METHOD: Older adults with mild-to-moderate dementia at 16 residential care homes were randomly assigned to a CST-IT group (N = 123) or an active control group (N = 102). The following domains were examined for potential benefits: general cognitive functioning (Mini-Mental State Examination [MMSE] and the Alzheimer's Disease Assessment Scale-Cognitive subscale [ADAS-Cog]), language (Narrative Language Test), mood and behavior (Cornell scale and Neuropsychiatric Inventory), everyday life functioning (Disability Assessment for Dementia), and quality of life (Quality of Life-Alzheimer's Disease scale). RESULTS: At both the short- and long-term assessments, the CST-IT group's MMSE scores remained stable, while the control group's scores decreased slightly from pretest to posttest and at follow-up. The CST-IT group also had short-term benefits in other cognitive measures (ADAS-Cog and Narrative Language Test) and mood and behavior measures, which were generally maintained at follow-up. No other differences were observed. DISCUSSION: The effectiveness of CST in sustaining cognitive and emotional functioning, and counteracting the progression of behavioral/neuropsychiatric symptoms in people with dementia was confirmed, and a long-term benefit was demonstrated. CST is a promising option for the treatment of people with dementia in clinical practice.

Is working memory training in older adults sensitive to music?

Evidence in the literature suggests that listening to music can improve cognitive performance. The aim of the present study was to examine whether the short- and long-term gains of a working memory (WM) training in older adults could be enhanced by music listening-the Mozart's Sonata K448 and the Albinoni's Adagio in G minor-which differ in tempo and mode. Seventy-two healthy older adults (age range: 65-75 years) participated in the study. They were divided into four groups. At each training session, before starting the WM training activities, one group listened to Mozart (Mozart group, N = 19), one to Albinoni (Albinoni group, N = 19), one to white noise (White noise group, N = 16), while one served as an active control group involved in other activities and was not exposed to any music (active control group, N = 18). Specific training gains on a task like the one used in the training, and transfer effects on visuo-spatial abilities, executive function and reasoning measures were assessed. Irrespective of listening condition (Mozart, Albinoni, White noise), trained groups generally outperformed the control group. The White noise group never differed from the two music groups. However, the Albinoni group showed larger specific training gains in the criterion task at short-term and transfer effects in the reasoning task at both short-and long term compared to the Mozart group. Overall the present findings suggest caution when interpreting the effects of music before a WM training, and are discussed according to aging and music effect literature.