Intervention and mediation effects of a community-based singing group on older adults’ perceived physical and mental health: the Sing4Health randomized controlled trial

Abstract

ObjectiveTo examine short- and long-term effects of a group singing program on older adults’ perceived physical and mental health levels, and also investigate subjective well-being (life satisfaction, positive/negative affect and hedonic balance), body balance and serum biomarkers (C-reactive protein and erythrocyte sedimentation rate) as putative mediating mechanisms, controlling for the cognitive status of the participants. Design: The randomized controlled trial included 149 participants (60 to 95 years), allocated to an immediate intervention group (IG) or a wait-list active control group (WLG). The intervention comprised 34 sessions of group singing during 4-months. Main outcome measures: Self-report measures of physical health, anxiety, stress, and depression. Blinded assessments were conducted at baseline, post-intervention (4 months) and follow-up (6 months). Results: Participants in the IG reported a lower decline in perceived physical health after the intervention, as compared to the WLG. These benefits were maintained at follow-up. Singing-related changes in physical and mental health outcomes were mediated via an increase in positive affect. Moderation results showed that participants with very low cognitive functioning reported more anxiety and depression symptoms after the intervention. Conclusions: These findings provide further understanding on the psychological and physical mechanisms and effects of group singing in older adults.

Acknowledgments

To Anabela Pires (Singer) and João Frizza (Singer) for the Artistic Direction of the Intervention and Sérgio Fontão (Maestro) and Pedro Baião (Pianist) for the Singing Group Intervention Implementation. To Maria D’Assis Ribamar and Alexandra Antunes from the SCM of Almada; and Etelvina Ferreira, Neusa Freixinho, Maria Teresa Barata from the SCM of Lisboa for the promotion and logistics support of the intervention, and the recruitment, contacts, transportation, and support of participants’ mobility. To the City of Almada and OPART TNSC (National Opera House) for providing theatres and rehearsal rooms.

Disclosure statement

No potential conflict of interest was reported by the authors.

RCT registration number

The Sing4Health study was pre-registered in June 14, 2019, with the trial registration number NCT03985917.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1 For detailed results on the direct effects of the Sing4Health on these variables, see Galinha, Pinal, et al. (2021) and Galinha, García-Martín, et al. (In press).

Additional information

Funding

This study is part of a larger research project supported by a grant from Portugal’s Participatory Budget (Project n.° 626, OPP 2017; Dispatch n.° 11409 C/2017).