Musical dual-task training in patients with mild-to-moderate dementia: a randomized controlled trial

Figures & data

Table 1 Level of attention demand of dual-tasks in MDTT

Level of attention demand	Low	High
Musical task
Singing	Singing familiar/preferred songs	Singing contingently on visual or auditory cues
Instrument playing	Playing steady beats on simple percussive musical instruments	Playing simple percussive musical instruments contingently on visual or auditory cues
Walking task	Forward walking at preferred pace	Stepping from side to side

Abbreviation: MDTT, Musical Dual-Task Training.

Figure 1 Flow chart of study pathway.

Abbreviations: MDTT, Musical Dual-Task Training; TMT, Trail Making Test; TUG, Timed Up and Go; FES-I, Falls Efficacy Scale International; CMAI-C, Cohen-Mansfield Agitation Inventory scale, Chinese community-version.

Table 2 Baseline characteristics and pretests of outcome measurements

Characteristics	MDTT group	Control group	P-value
Age (years)	77.3 ± 9.4	77.3 ± 10.0	1.00
Gender, n			0.26
Male	6	8
Female	9	5
MMSE	16.4 ± 7.3	17.9 ± 3.7	0.53
CDR score, n			0.29
0.5	6	3
1	6	9
2	3	1
Dementia type, n			0.77
AD	11	8
VaD	2	2
Other	2	3
TMT part A (s)	285.7 ± 232.3	267.8 ± 173.9	0.82
Walking speed (m/min)
Single	57.4 ± 8.6	63.7 ± 15.0	0.20
Forward	47.9 ± 7.3	53.2 ± 16.7	0.31
Backward	45.4 ± 6.0	50.3 ± 17.0	0.36
Stride length (m)
Single	1.1 ± 0.1	1.2 ± 0.2	0.09
Forward	1.0 ± 0.1	1.2 ± 0.2	0.03*
Backward	1.0 ± 0.1	1.1 ± 0.2	0.08
Walking speed DTC (%)
Forward	15.7 ± 13.6	17.2 ± 18.0	0.81
Backward	19.6 ± 14.7	21.8 ± 21.7	0.76
Stride length DTC (%)
Forward	10.0 ± 11.4	4.1 ± 12.5	0.22
Backward	11.2 ± 14.2	9.5 ± 13.5	0.77
TUG (s)	15.0 ± 5.5	17.2 ± 16.6	0.64
FES-I	33.4 ± 14.9	23.7 ± 10.3	0.06
CMAI-C	44.3 ± 14.8	34.7 ± 10.8	0.07

Notes: Single = Single-task walking only; Forward = Forward digit recall dual-task; Backward = Backward digit recall dual-task; Data are presented as mean ± SD. Independent t-test.

* P<0.05.

Abbreviations: MDTT, Musical Dual-Task Training; MMSE, Mini–Mental State Examination; CDR, Clinical Dementia Rating; AD, Alzheimer’s Disease; VaD, vascular dementia; TMT, Trail Making Test; DTC, dual-task cost; TUG, Timed Up and Go; FES-I, Falls Efficacy Scale International; CMAI-C, Cohen-Mansfield Agitation Inventory scale, Chinese community-version; SD, standard deviation.

Figure 2 TMT part A for the MDTT and control groups at the pretest and posttest assessments.

Abbreviations: TMT, Trail Making Test; MDTT, Musical Dual-Task Training.

Table 3 Changes in the primary outcome measurement, TMT part A, between the pretest and posttest assessments

	MDTT group				Control group				P-valuea
	n	Pretest	Posttest	Change (95% CI)	n	Pretest	Posttest	Change (95% CI)
TMT part A (s)	15	285.7 ± 232.3	228.1 ± 199.7	−56.2 (−102.5 to 10.0)	13	267.8 ± 173.9	270.0 ± 211.6	2.2 (−67.7 to 71.2)	<0.001***

Notes: Data are presented as mean ± SD.

*** P<0.001.

a Comparison of change between the MDTT and control groups.

Abbreviations: TMT, Trail Making Test; MDTT, Musical Dual-Task Training; CI, confidence interval; SD, standard deviation.

Table 4 Changes in physical outcomes including walking, stride length, corresponding DTCs, and balance

	MDTT group				Control group				P-valuea
	n	Pretest	Posttest	Change (95% CI)	n	Pretest	Posttest	Change (95% CI)
Walking speed (m/min)
Single	14	57.7 ± 8.8	60.3 ± 16.8	2.6 (−6.1 to 11.3)	11	67.6 ± 12.7	66.5 ± 15.2	−1.1 (−6.4 to 4.2)	0.96
Forward	14	48.2 ± 7.5	50.9 ± 10.0	2.7 (−3.1 to 8.5)	11	57.2 ± 13.8	57.6 ± 13.6	0.4 (−8.2 to 8.9)	0.42
Backward	13	45.8 ± 6.1	49.9 ± 8.6	4.1 (−1.3 to 9.5)	10	55.3 ± 11.7	51.6 ± 12.8	−3.7 (−10.2 to 2.9)	0.06
Stride length (m)
Single	14	1.11 ± 0.14	1.16 ± 0.27	0.05 (−0.09 to 0.18)	11	1.26 ± 0.18	1.29 ± 0.20	0.02 (−0.07 to 0.12)	0.27
Forward	14	1.01 ± 0.15	1.03 ± 0.22	0.02 (−0.08 to 0.12)	11	1.21 ± 0.20	1.18 ± 0.24	−0.03 (−0.18 to 0.12)	0.81
Backward	13	1.00 ± 0.15	1.02 ± 0.17	0.03 (−0.06 to 0.11)	10	1.16 ± 0.18	1.13 ± 0.24	−0.02 (−0.17 to 0.12)	0.78
DTC on walking speed (%)
Forward	14	15.6 ± 14.1	13.6 ± 13.7	−2.0 (−9.0 to 5.0)	11	15.3 ± 16.0	12.4 ± 14.8	−2.9 (−17.6 to 11.9)	0.36
Backward	13	19.2 ± 15.2	17.4 ± 14.3	−1.8 (−13.1 to 9.6)	10	17.6 ± 16.0	21.5 ± 16.0	3.9 (−9.2 to 16.9)	0.13
DTC on stride length (%)
Forward	13	9.8 ± 11.8	10.2 ± 16.4	0.4 (−9.4 to 10.3)	11	4.0 ± 12.9	8.1 ± 14.8	4.1 (−7.8 to 15.9)	0.14
Backward	13	10.4 ± 14.5	12.1 ± 12.8	1.7 (−7.9 to 11.3)	10	9.1 ± 14.3	12.7 ± 14.8	3.6 (−8.2 to 15.5)	0.10
Balance
TUG (s)	12	14.5 ± 5.5	15.5 ± 6.6	1.0 (−0.3 to 2.3)	11	12.5 ± 4.1	13.5 ± 5.8	1.0 (−1.0 to 2.9)	0.20

Notes: Single = Single-task walking only; Forward = Forward digit recall dual-task; Backward = Backward digit recall dual-task.

a Comparison of change between the MDTT and control groups.

Abbreviations: DTC, dual-task cost; MDTT, Musical Dual-Task Training; CI, confidence interval; TUG, Timed Up and Go.

Table 5 Changes in falls efficacy and agitation

	MDTT group				Control group				P-valuea
	n	Pretest	Posttest	Change (95% CI)	n	Pretest	Posttest	Change (95% CI)
FES-I	14	33.4 ± 14.9	33.1 ± 12.4	−0.3 (−5.1 to 4.5)	12	23.7 ± 10.3	26.6 ± 14.3	2.9 (−0.3 to 6.1)	0.02*
CMAI-C	15	44.3 ± 14.8	41.9 ± 13.4	−2.4 (−10.8 to 6.0)	12	34.7 ± 10.9	39.0 ± 15.7	4.3 (−0.4 to 9.1)	<0.01**

Notes: Data are presented at mean ± SD.

* P<0.05;

** P<0.01.

a Comparison of change between the MDTT and control groups. Higher scores indicate a greater concern about falling and a greater frequency of agitation in daily living.

Abbreviations: MDTT, Musical Dual-Task Training; CI, confidence interval; FES-I, Falls Efficacy Scale International; CMAI-C, Cohen-Mansfield Agitation Inventory scale, Chinese community-version; SD, standard deviation.