Choral singing for the prevention of dementia: a randomized - - PowerPoint PPT Presentation

▶

Jul 16, 2023 377 likes •592 views

Choral singing for the prevention of dementia: a randomized controlled trial FENG Lei Department of Psychological Medicine, Yong Loo Lin School of Medicine National University of Singapore Cognitive function decline with increasing age. Yu J,

SLIDE 1

Choral singing for the prevention of dementia: a randomized controlled trial

FENG Lei Department of Psychological Medicine, Yong Loo Lin School of Medicine National University of Singapore

SLIDE 2

Cognitive function decline with increasing age.

Yu J, Yu J, Feng Q, Zeng L, Feng L. Late-life cognitive trajectories and their associated lifestyle factors 2017 (manuscript under review)

SLIDE 3

SLIDE 4

Alz Alzheim heimer er’s “pa patho tholo logy”

Gross Pathology Cellular Pathology Normal AD

Amyloid plaques:

v Aggregated amyloid-β

peptide (Aβ) Neurofibrillary tangles:

v Hyperphosphorylated

Tau protein

SLIDE 5

THE RACE AGAINST ALZHEIMER?

Source: Miia Kivipelto ICAD 2010

SLIDE 6

My research focues on: Diet, nutrition, behaviors, lifestyles, cultural activities. Promote healthy aging, prevent dementia, understand the biology.

SLIDE 7

Choral Singing for the Prevention of Dementia: A Randomized Controlled Trial

SLIDE 8

Ai Aims

To evaluate the efficacy of choral singing in the prevention of

dementia

To examine the underlying mechanisms using Magnetic Resonance

Imaging (MRI) technique and a panel of peripheral biomarkers in venous blood and urine

SLIDE 9

Study Design

Randomized, controlled trial
N=360 (93 recruited)
Choral Singing vs. Health Education
Intervention duration: 2 years

SLIDE 10

Interventions

Focuses on joy of choral singing and providing a full musical, physical and social experience for participants Active control arm: target at lifestyles and vascular health, involve social interactions and learning new skills

SLIDE 11

Inclusion and Exclusion Criteria

Inclusion criteria:

Community-living elderly aged 60 years and above, and
Subjective cognitive complaints based on self-report, or
Objective cognitive impairment based on neuropsychological test scores, or
Multiple risk factors of dementia such as family history, depression, etc., and
Not demented: Clinical Dementia Rating (CDR) global score=0

Exclusion criteria:

Any terminal illness, OR
Aphasia, OR
Marked hearing impairment, OR
Participating in another interventional study.

High risk of dementia

SLIDE 12

Outcome Measures

Primary outcome measure: Composite cognitive score from a standard neuropsychological test battery: Rey Auditory Verbal Learning Test (RAVLT), Digit Span, Color Trails Test 1&2, Block Design, Symbol Digit Modality Test (SDMT), and Boston Naming Test. Secondary outcome measures:

1. Brain magnetic resonance imaging (MRI).
2. Blood and urine based biological markers
3. Mini-Mental State Examination (MMSE)
4. Montreal Cognitive Assessment (MoCA)
5. Depressive symptoms
6. Anxiety symptoms
7. Neuropsychiatric symptoms
8. Perceived stress
9. Sleep quality

SLIDE 13

SLIDE 14

SLIDE 15

Biological effects (HYPOTHESIZED)

Changes in biological markers
Reduced oxidative damage
Reduced inflammation
Increased immunity
epigenetic changes
Changes in the brain (MRI)
Slowed age-related atrophy
Better connectivity
Better functional activation

SLIDE 16

MRI Protocol, John Suckling

Sequence Purpose Time (min) 1 Localizer Position imaging slice 0:14 2 3D MPRAGE High-resolution anatomy 5:01 3 BOLD_Resting Detect functional connectivity under resting state 9:01 4 BOLD_FNPA brain activations under FNPA task 7:36 5 BOLD_SIN Brain activations under singing task 2:36 6 BOLD_auditory localizer Location of auditory cortex 3:06 7 Gre field map for distortion correction 1:07 8 Ep2d_diff (DTI) White matter integrity 9:06 9 T2_SWI Detect micro-bleeds 4:54 10 T2_TSE_ FLAIR Detect and characterize structural lesions 4:28 11 BOLD_TUNE Brain activations under the TUNE task 3:06 12 ASL (optional) Cerebral blood flow 8:38 TOTAL

SLIDE 17

Age-related biomarkers

Anis Larbi

Classical markers of senescence (CD57,

KLRG1) and exhaustion (PD1) of T cells.

Identification of subpopulations of B cells

and myeloid cells with a focus on pro- inflammatory cells.

Functional capacity: proliferation profile

and pro-inflammatory cytokines.

Irwin Cheah, Barry Halliwell

Markers of oxidative damage (F2-

isoprostanes; F4-neuroprostanes; 8-hydroxy- 2’-deoxyguanosine; allantoin and urate concentrations; hydroxyeicosatetraenoic acids) in the plasma and urine.

Protein carbonyl contents in the plasma.

Plan: Epigenetics @Roger FOO

SLIDE 18

1 2 3 Baseline 6-month Score

Geriatric Depression Scale

Choral group HEP group

1 2 3 Baseline 6-month Score

Geriatric Anxiety Inventory

Choral group HEP group

SLIDE 19

Acknowledgements

NUS Virtual Institute for the Study of Ageing (VISA), Singapore
National Medical Research Council, Singapore
National lnnovation Challenge on Active and Confident Ageing Programme, MOH, Singapore
NUS Society Choir Research Fund, Singapore
Alice Lim Memorial Fund, Singapore
Training and Research Academy at Jurong Point (TaRA@JP), Singapore
Kwan Im Thong Hood Cho Temple, Singapore
Health Promotion Board (HPB), Singapore
Anonymous private donors, volunteers and all research study participants
Forte – Swedish Research Council for Health, Working Life and Welfare
Investigators, study musicians, study participants.

SLIDE 20

The FENG research lab, current members:

Senior executive: Elisabeth Ow Research Assistants: Christabel See, Tan Yue Qian, Angela Au Research Nurses: Low Yin Fong, Linda Boon Lee Chin, Bernard Lee, Elaine Phang, Eileen Sin, Chua Sok Hwee.

https://www.researchgate.net/profile/Lei_Feng6