Do Executive Skills and Musical Sophistication Preserve Function in Older Adults with Mild Cognitive Impairment?
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DESCRIPTION (provided by applicant): The purpose of this individual National Research Service Award (NRSA) application is to provide research training for a nurse to become an independent investigator. In addition to the acquisition of methodological and statistical skills, this NRSA will focus on investigating the impact of Executive Function (EF) and musical sophistication on the relationship between the underlying neurodegenerative processes (reflected in Alzheimer's Disease (AD) biomarkers) and functional status in older adults with mild cognitive impairment (MCI). EF, defined as cognitive abilities of decision-making, planning, behavior initiation, and organization, may play a protective role against neurodegeneration-driven changes in functional status in persons with MCI. For instance, persons with memory problems related to MCI may be able to preserve their complex instrumental activities of daily living (i.e. functional status), by relying on higher levels of EF. They may develop compensatory cognitive strategies and skills to deal with amnestic deficits. By this account, the relationship between AD biomarkers and functional status decline ought to be weakened among persons with higher levels of EF compared to those with lower levels of EF. Cognitively stimulating activities, such as music, involve many aspects of EF and therefore may correlate with performance on measures of EF in persons with MCI. Moreover, as a complex skill that engages EF and other cognitive faculties, extensive musical experience may also weaken the interaction between AD biomarkers and functional status, preserving aspects of day-to-day performance in persons with a relatively severe neurodegeneration. I will investigate these hypotheses using a Goldsmiths Musical Sophistication Index (Gold-MSI) in combination with neuropsychological and AD cerebrospinal biomarker data available for persons with MCI from the Alzheimer's Disease Research Center (ADRC) at the University of Pennsylvania (Penn). I have received permission to collect prospective data (which includes Gold-MSI and the Geriatric Depression Scale) and analyze select components of the ADRC dataset, including neuropsychological test results and AD cerebrospinal biomarker data from Dr. Steven Arnold, Director of the Penn's ADRC. My research training will be guided by my sponsor, Dr. Roy Hamilton, and my co-sponsor, Dr. Pamela Cacchione. The long-term impact of this research training has the potential to be profound for persons with MCI, their caregivers, and families. The proposed study will be the first to assess the influence of higher levels of EF and musical sophistication on the relationship between AD cerebrospinal biomarkers and functional status among persons with MCI. The results of this study will further NINR's mission to promote discovery of new ways to enhance health, delay the onset of AD symptoms and achieve positive health outcomes in individuals across the lifespan. Furthermore, this work may lead to the development of novel music-based interventions centered around enhancing cognitive and functional outcomes in older adults with MCI and dementia.
