Musical tests can detect mental deterioration in old age

Researchers at Tel Aviv University have developed a method that employs musical tests and a portable instrument for measuring brain activity to detect cognitive decline in old age. According to the researchers, the method, which is based on the measurement of 15 minutes of electrical activity in the brain while performing simple musical tasks, can be easily implemented by any staff member in any clinic, without requiring special training.

The researchers: "Our method enables routine monitoring and early detection of cognitive decline in order to provide treatment and prevent rapid, severe deterioration. Prophylactic tests of this kind are commonly accepted for a variety of physiological problems such as diabetes, high blood pressure or breast cancer; however, to date no method has yet been developed to enable routine, accessible monitoring of the brain for cognitive issues." The researchers further note that tests of this kind are particularly important in light of increasing longevity and associated growth of the elderly population.

The study was led at Tel Aviv University by PhD student Neta Maimon from the School of Psychological Sciences and the Buchmann-Mehta School of Music, and Lior Molcho from Neurosteer Ltd, headed by Prof. Nathan Intrator from the Blavatnik School of Computer Science and the Sagol School of Neuroscience. Other participants included: Adi Sasson, Sarit Rabinowitz, and Noa Regev-Plotnick from the Dorot-Netanya Geriatric Medical Center. The article was published in the journal Frontiers in Aging Neuroscience.

As part of the study, the researchers developed a groundbreaking method combining a portable device for the measurement and innovative analysis of electroencephalography (EEG), developed by Neurosteer, and a short musical test of about 12-15 minutes, developed by Neta Maimon. During the test, the subject is connected to the portable EEG device by means of a adhesive band with only three electrodes attached to the forehead. The subject performs a series of musical-cognitive tasks according to audible instructions given automatically through earphones. The tasks include short melodies played by different instruments, with the subjects instructed to perform various tasks on them at varying levels of difficulty. For example, pressing a button each time any melody is played or pressing it only when the violin plays. In addition, the test includes several minutes of musically guided meditation designed to bring the brain to a resting state, as this state is known to indicate cerebral functioning in various situations.

Neta Maimon, who specializes in musical cognition, explains that music has great influence on different centers in the brain. On the one hand, music is known to be a quick mood stimulant, particularly of positive emotion. On the other hand, in different situations, music can be cognitively challenging, activating the frontal parts of the brain, especially if we try to concentrate on different aspects of the music, and at the same time perform a particular task.

According to Maimon, if we combine these two capabilities, we can create cognitive tests that are quite complex, yet also pleasant and easy to perform. Furthermore, music that is positive and reasonably rhythmic will enhance concentration and performance of the task. Thus, for example, the famous "Mozart effect," showing improved performance on intelligence tests after listening to Mozart's music, actually has nothing to do with Mozart's music, but rather the fact that music creates a positive mood and stimulates us to a state that is optimal for performing intelligence and creativity tests.

Accordingly, the researchers hypothesized that with musical tools, it would also be possible to challenge the subjects to an extent that would enable testing of the brain's frontal activity as well as raising their spirits, thus enhancing their performance on the test while the overall experience is pleasant.

The study included an experiment at the Dorot-Netanya Geriatric Medical Center. Neta Maimon: "Anyone hospitalized at Dorot, or any other geriatric rehabilitation institution, undergoes a standard test called "mini-mental," designed to evaluate their cognitive condition as a routine part of the intake process. The test is conducted by an occupational therapist specially trained for it, and includes a variety of tasks. For example, enumerating the days of the week or months of the year backwards. In this test, up to 30 points can be accrued. A high score indicates normal cognition.

The experiment included the testing of 50 elderly people hospitalized at Dorot who scored 18-30 on the mini-mental test, indicating various levels of cognitive functioning. The participants performed the musical-cognitive tasks, administered automatically. The EEG device registered the electrical activity in the brain during the activity, with the results analyzed using machine learning technology. This allowed mathematical indices to be identified that were precisely correlated with the mini-mental test scores; in other words, we obtained new neuro-markers (brain markers) that may stand alone as indices of the subject's cognitive status.

Maimon adds: "We have actually succeeded in illustrating that music is indeed an effective tool for measuring brain activity. The brain activity and response times to tasks correlated to the subjects' cerebral conditions (correlating to the mini-mental score assigned to them). More importantly, all those who underwent the experiment reported that, on the one hand, it challenged the brain, but on the other it was very pleasant to perform."

The researchers conclude: "Our method enables the monitoring of cognitive capability and detection of cognitive decline already in the early stages. all by simple and accessible means, with a quick and easy test that can be conducted in any clinic. This method is of special importance today due to the increase in longevity and accelerated population growth, particularly among the elderly. Today, millions of people around the world already suffer or are liable to suffer soon from cognitive decline and its dire consequences, and their number will only increase in the coming decades. Our method could pave the way towards efficient cognitive monitoring of the general population, and thus detect cognitive decline in its early stages, when treatment and prevention of severe decline are possible. It is therefore expected to improve the quality of life of millions around the world."

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The younger we feel, the better we rehabilitate, research shows

As scientists gradually discover evidence that people who feel younger than their chronological age are typically healthier and more psychologically resilient, the saying "you're only as old as you feel" rings increasingly true.

Could the expression also hold true for older people recuperating from physical disabilities? Apparently so. Researchers from Bar-Ilan University in Israel have found that feeling young can increase the chances of successful rehabilitation from medical conditions, even in old age. Their study was recently published in the journal Gerontology.

The study tracked 194 adult patients aged 73-84 undergoing rehabilitation from osteoporotic fractures or stroke in several rehabilitation facilities across Israel. Fractures (mostly due to falls) and stroke are frequent health events that result in the loss of one's functional independence, considered the greatest fear of older adults.

Patients were interviewed several times throughout their rehabilitation. They were asked about their subjective age (how young they felt), feelings and experiences. Their functional independence was assessed by nursing personnel who rated their functioning level at admission and at discharge using the Functional Independence Measurement (FIM) test.

Patients who felt younger (had a younger subjective age) at hospital admission showed better functional independence at discharge approximately one month later. The beneficial effect of feeling younger was found both for patients who rehabilitated from osteoporotic fractures (mainly due to falls) and for those who rehabilitated from a stroke. The researchers also found that those who felt younger rehabilitated better because they were more optimistic about their chances of regaining their functional abilities.

"The effect of subjective age at admission on functional independence at discharge was confirmed," says Prof. Amit Shrira, from the Gerontology Program at the Department of Interdisciplinary Social Sciences, who led the study together with Prof. Ehud Bodner, also from the Interdisciplinary Social Sciences department. "However, the reverse effect -- that of functional independence at admission on subjective age at discharge -- was not confirmed. This supports the conclusion that a younger age identity is an important psychological construct that contributes to a more successful rehabilitation," added Shrira, who conducted the research with Dr. Daphna Magda Kalir from the Gender Studies Program, among others.

Surprisingly, subjective age was the strongest predictor of rehabilitation outcomes, stronger even than patients' chronological age and multiple chronic health conditions occurring simultaneously (physical multimorbidity) at admission. Chronological age and physical multimorbidity are generally considered by health care practitioners in determining prognosis, whereas subjective age is unknown to most practitioners. "Those who feel younger can maintain their health and functioning for longer periods, and as the current study shows, can recuperate better from disability. Therefore, by perceiving themselves to age successfully people may preserve a healthy and vigorous lifestyle," says Shrira.

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