Singing for Memory: Neural and Cognitive Effects of a Choral Intervention in Older Adults

Miriam Napadow^1*Håkan Fischer^2,3,4,5Maria Sandgren⁶Maté Magyar⁷Zsuzsanna Lénárd⁸Laszlo Harmat¹Örjan De Manzano^10,9

• ¹Linnaeus University, Växjö, Sweden
• ²Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
• ³Stockholm University Brain Imaging Centre, Stockholm, Sweden
• ⁴Department of Psychology, Stockholms Universitet, Stockholm, Sweden
• ⁵Linkopings universitet Institutionen for beteendevetenskap och larande, Linköping, Sweden
• ⁶Malardalens universitet, Västerås, Sweden
• ⁷Department of Neuroradiology, Medical Imaging Centre, Faculty of Medicine, Semmelweis Egyetem, Budapest, Hungary
• ⁸Department of Radiology, Medical Imaging Centre, Faculty of Medicine, Semmelweis Egyetem, Budapest, Hungary
• ⁹Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
• ¹⁰Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany

Introduction Lifestyle factors are important predictors of successful aging, and targeted interventions could be key to mitigating the negative effects of aging. Episodic memory is of particular interest as it is notably sensitive to aging. Given the social, intellectual, and physical stimulation that choral singing provides, along with the enjoyment it offers which is a strong motivator, it has been suggested as a particularly promising intervention to promote successful aging. Method Thirty-four participants, aged 65 to 75 at recruitment, took part in a choral singing intervention involving 47 weekly 1.5-hour rehearsals. The study included examinations at three time points: T1, T2, and T3. A control period (T1-T2) was followed by the intervention period (T2-T3), each lasting approximately 11 months. At each assessment, episodic memory was measured with the Wechsler Memory Scale (WMS-LMI, WMS-LMII), and participants completed an fMRI Face-Name Paired Associates Task (FN-PA) to examine brain activity during memory encoding and retrieval. Results Partial correlation analyses, adjusting for age and cognitive ability, showed significant improvements in episodic memory following both the control period (T1-T2) and the choir intervention (T2-T3), but only the latter scaled with rehearsal attendance. Right hippocampal activity during encoding in the FN-PA task also correlated with attendance, and with age. Additionally, task-dependent functional connectivity increased between the right lateral prefrontal cortex, left posterior fusiform cortex and left hippocampus, while connectivity between the right lateral prefrontal cortex and the left inferior frontal gyrus decreased after the intervention. Discussion These findings suggest that regular participation in choral singing may enhance episodic memory and have a positive influence on related brain networks in older adults. The suggestive dose-response effect highlights choir singing as an engaging, multifaceted activity with the potential to contribute to cognitive resilience in aging populations.