Musical instrument learning throughout ageing and cognitive impairment

This doctoral thesis examines the benefits of music improvisation as a method of piano training compared to traditional piano instruction. A rapid systematic review of the cognitive training literature (Study 1) informed the design of the music-based cognitive training program within this research. Two further empirical studies, using a mixed-methods embedded sequential design, examined group piano training for healthy older adults aged 60 and above who were novice musicians. Older adults in the study reported whether they had SCD. Study 2 was a feasibility study with older adults (n=39) engaged in a music improvisation piano training program. Study 3 was a randomised controlled trial (RCT). Participants (n=111) in the RCT were randomly assigned to either group piano training using music improvisation techniques (experimental intervention group), group piano training using traditional piano instruction (active control), or an inactive waitlisted control group. The RCT group piano training programs were delivered online via Zoom. The results demonstrated that piano training using both music improvisation and traditional music instruction methods enhanced global cognition and spatial working memory, particularly for those who entered the program with lower cognitive scores and SCD. Participants in the music improvisation group demonstrated improved self-efficacy and a transfer of creative confidence to their everyday lives. These improvements in well-being among older adults who engaged in music improvisation were not observed for participants who completed the traditional piano instruction program. The overall results indicated that increasing participant autonomy and self-directed input within music-based programs for older adults is health-enhancing. In conclusion, using music improvisation to support musical instrument learning is feasible and beneficial for older adults’ cognitive health and general well-being. Piano training using music improvisation as the method offers well-being advantages over traditional piano instruction, particularly in terms of older adults' creative self-efficacy. Music improvisation and traditional instruction as piano training methods can be offered as cognitive training programs and prescribed as arts-for-health interventions to support healthy ageing. These music-based programs can also support cognitive health as part of a dementia prevention strategy.