Publication Date



Open access

Embargo Period


Degree Type


Degree Name

Doctor of Philosophy (PHD)


Music Education and Music Therapy (Music)

Date of Defense


First Committee Member

Teresa Lesiuk

Second Committee Member

Shannon K. de l'Etoile

Third Committee Member

James G. Moore

Fourth Committee Member

Carlos Abril

Fifth Committee Member

Don D. Coffman


The purpose of this study was to examine the effect of a music-movement intervention (MMI) on cognitive flexibility and arousal in older adults with typical cognitive aging (TCA) or with symptoms of mild neurocognitive disorder (MND). This study also examined the relationships among participants’ demographics, including age, exercise frequency, and years of music participation, and the dependent variables of cognitive flexibility, perceived arousal, physiological arousal, and perceived exertion. Previous research and current theory suggests that multimodal interventions combining simultaneous physical activity and cognitive training may be an effective avenue for enhancing older adults’ cognition. Moreover, theory suggests that participation in such interventions can have an immediate effect on cognition via an arousal mechanism. As far as can be determined, no research exists exploring the cognitive outcomes associated with music-facilitated multimodal interventions, such as those that might be implemented by a board-certified music therapist. Forty-eight older adults with and without MND completed a series of assessments and then took part in either the MMI or an identical intervention without music (i.e., the Movement-Only Intervention [MOI]). The MMI is a researcher-developed, single session, combined cognitive-movement intervention consisting of playing musical instruments that simulate functional, everyday movements in time with familiar, recorded music. Assessments included a demographics questionnaire; heart rate measured at pre-test, mid- test, and post-test; perceived arousal measured at pre-test and post-test; perceived exertion measured at pre-test, mid-test, and post-test; and cognitive flexibility measured at pre-test and post-test. Results indicated that regardless of cognitive status, participants assigned to the MMI significantly improved their cognitive flexibility from pre-test to post-test, as indicated by a decrease in the time necessary to complete the cognitive flexibility measure. By contrast, changes in cognitive flexibility over time for MOI participants were not significant. This result suggests that the addition of music listening and simple music instrument playing tasks to the movement intervention was more effective in improving cognition than the multimodal intervention without the music components. Moreover, these results suggest that older adults both with and without MND can immediately benefit from participation in the MMI. Results also indicated that changes in perceived arousal, physiological arousal, and perceived exertion were not significantly different over time according to cognitive status and/or intervention assignment. This finding suggests that the MMI and MOI were comparable in terms of arousal potential. Moreover, changes in perceived arousal, physiological arousal, and perceived exertion did not significantly correlate with changes in cognitive flexibility. These results imply that the significant changes in cognitive flexibility observed in MMI participants were not due to alterations in arousal. Researcher observations and participants’ feedback suggest that the interventions differed in terms of their ability to affect changes in state mood. Specifically, MMI participants seemed to enjoy the combination of familiar music and novel instrument playing tasks, which led to improved mood and greater attention to task completion. By contrast, MOI participants shared that they felt bored, unmotivated by, and disengaged from the movement intervention. Thus, MMI participants’ improved mood and enhanced attention appeared to temporarily enhance their cognitive flexibility. Overall, while both the MMI and MOI included completing an identical series of functional movements and engaged the same cognitive skills, the MMI appeared to do so to a greater extent. This study’s findings may be useful in conceptualizing how music perception and performance can be integrated into multimodal training to improve older adults’ cognition. If older adults are offered the opportunity to participate in interventions such as the MMI and enjoy doing so, they may be more likely to regularly take part in the training and potentially experience lasting benefits. For this reason, music therapists and related professionals may utilize information from this study to design, implement, and research the effects of similar functional training protocols.


music therapy; older adults; cognitive flexibility; cognition; movement; cognitive training