{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T16:20:11Z","timestamp":1784996411915,"version":"3.55.0"},"reference-count":97,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T00:00:00Z","timestamp":1582502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"PDMHD Co., LTD., Tokyo, Japan","award":["no numbers"],"award-info":[{"award-number":["no numbers"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>We tested whether karaoke training improves cognitive skills and reduces the risk of physical function impairments. We conducted a single-blinded randomized controlled trial in 26 elderly participants at residential care facilities, who were generally healthy or required the lowest level of care. Participants were near the threshold for mild cognitive impairment with the Montreal Cognitive Assessment (MoCA) and close to the sarcopenia cut-off with the skeletal muscle mass index. Pulmonary function as measured with spirometry and tongue strength were used as markers for physical functions affected by sarcopenia. Karaoke training occurred once a week for two hours, with an hour of homework assigned weekly. Karaoke training significantly improved the Frontal Assessment Battery at bedside (FAB) compared with an active control group receiving scratch art training (F = 8.04, permutation p-value = 0.013). Subscore improved with inhibitory control (F = 7.63, permutation p-value = 0.015) and sensitivity to interference (F = 11.98, permutation p-value = 0.001). We observed improved tongue pressure (F = 4.49, permutation p-value = 0.040) and pulmonary function by a greater increase in FIV1 (F = 5.22, permutation p-value = 0.047). Engaging elderly people, especially those in care homes, with karaoke training exercises that are moderately physically challenging may be a key to slowing cognitive decline and preventing dysphagia by sarcopenia.<\/jats:p>","DOI":"10.3390\/ijerph17041459","type":"journal-article","created":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T04:21:26Z","timestamp":1582604486000},"page":"1459","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Frequent Karaoke Training Improves Frontal Executive Cognitive Skills, Tongue Pressure, and Respiratory Function in Elderly People: Pilot Study from a Randomized Controlled Trial"],"prefix":"10.3390","volume":"17","author":[{"given":"Atsuko","family":"Miyazaki","sequence":"first","affiliation":[{"name":"Technology and Innovation Hub, Cluster for Science, RIKEN, Saitama 351-0198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Mori","sequence":"additional","affiliation":[{"name":"Technology and Innovation Hub, Cluster for Science, RIKEN, Saitama 351-0198, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1093\/geront\/gnv030","article-title":"The impact of memory change on daily life in normal aging and mild cognitive impairment","volume":"56","author":"Parikh","year":"2016","journal-title":"Gerontologist"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S1474-4422(09)70299-6","article-title":"Hypothetical model of dynamic biomarkers of the Alzheimer\u2019s pathological cascade","volume":"9","author":"Jack","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"390","DOI":"10.2967\/jnumed.107.045385","article-title":"Multicenter standardized 18F-FDG PET diagnosis of mild cognitive impairment, Alzheimer\u2019s disease, and other dementias","volume":"49","author":"Mosconi","year":"2008","journal-title":"J. Nucl. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.gerinurse.2007.10.015","article-title":"Dementia and dysphagia","volume":"29","author":"Easterling","year":"2008","journal-title":"Geriatr. Nurs."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1016\/j.apmr.2004.03.019","article-title":"The effects of exercise training on elderly persons with cognitive impairment and dementia: A meta-analysis","volume":"85","author":"Heyn","year":"2004","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"73","DOI":"10.7326\/0003-4819-144-2-200601170-00004","article-title":"Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older","volume":"144","author":"Larson","year":"2006","journal-title":"Ann. Intern. Med."},{"key":"ref_7","first-page":"196","article-title":"Using memory strategies to improve 24-hour dietary recalls among older adults","volume":"32","author":"Shumaker","year":"2003","journal-title":"J. Allied Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"384","DOI":"10.3389\/fneur.2017.00384","article-title":"Cognitive improvement and brain changes after real-time functional MRI neurofeedback training in healthy elderly and prodromal Alzheimer\u2019s disease","volume":"8","author":"Hohenfeld","year":"2017","journal-title":"Front. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1093\/gerona\/60.3.380","article-title":"Reading aloud and arithmetic calculation improve frontal function of people with dementia","volume":"60","author":"Kawashima","year":"2005","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1177\/1533317514539542","article-title":"Cognitive stimulation of executive functions in mild cognitive impairment: Specific efficacy and impact in memory","volume":"30","author":"Moro","year":"2015","journal-title":"Am. J. Alzheimers Dis. Other Dement."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"349","DOI":"10.3233\/JAD-2011-0009","article-title":"Cognitive training changes hippocampal function in mild cognitive impairment: A pilot study","volume":"26","author":"Rosen","year":"2011","journal-title":"J. Alzheimers Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"217","DOI":"10.3389\/fnhum.2016.00217","article-title":"Reading aloud and solving simple arithmetic calculation intervention (learning therapy) improves inhibition, verbal episodic memory, focus attention and processing speed in healthy elderly people: Evidence from a randomized controlled trial","volume":"10","author":"Nouchi","year":"2016","journal-title":"Front. Hum. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11357-007-9044-x","article-title":"Kawashima, R. Reading and solving arithmetic problems improves cognitive functions of normal aged people: A randomized controlled study","volume":"30","author":"Uchida","year":"2008","journal-title":"Age"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"68","DOI":"10.3389\/fnagi.2018.00068","article-title":"The beneficial effects of cognitive training with Simple Calculation and Reading Aloud (SCRA) in the elderly postoperative population: A pilot randomized controlled trial","volume":"10","author":"Kulason","year":"2018","journal-title":"Front. Aging Neurosci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1682\/JRRD.2004.07.0077","article-title":"Implications of expiratory muscle strength training for rehabilitation of the elderly: Tutorial","volume":"42","author":"Kim","year":"2005","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/ggi.13591","article-title":"Sarcopenia and dysphagia: Position paper by four professional organizations","volume":"19","author":"Fujishima","year":"2019","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_17","first-page":"1290","article-title":"Decreased skeletal muscle mass and risk factors of sarcopenic dysphagia: A prospective observational cohort study","volume":"72","author":"Maeda","year":"2016","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/ggi.12715","article-title":"Effects of aging and sarcopenia on tongue pressure and jaw opening force","volume":"17","author":"Machida","year":"2017","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"M634","DOI":"10.1093\/gerona\/55.11.M634","article-title":"Age effects on the temporal evolution of isometric and swallowing pressure","volume":"55","author":"Nicosia","year":"2000","journal-title":"J. Gerontol. A. Biol. Sci. Med. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s00455-005-9011-6","article-title":"Decreased tongue pressure reflects symptom of dysphagia","volume":"21","author":"Yoshida","year":"2006","journal-title":"Dysphagia"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s00455-008-9171-2","article-title":"Differences in tongue strength across age and gender: Is there a diminished strength reserve?","volume":"24","author":"Youmans","year":"2009","journal-title":"Dysphagia"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1007\/s00455-006-9013-z","article-title":"Measures of tongue function related to normal swallowing","volume":"21","author":"Youmans","year":"2006","journal-title":"Dysphagia"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/ger.12347","article-title":"Oral hypofunction in the older population: Position paper of the Japanese Society of Gerodontology in 2016","volume":"35","author":"Minakuchi","year":"2008","journal-title":"Gerodontology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1007\/s00455-014-9577-y","article-title":"Decreased tongue pressure is associated with sarcopenia and sarcopenic dysphagia in the elderly","volume":"30","author":"Maeda","year":"2015","journal-title":"Dysphagia"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1111\/jgs.12124","article-title":"Tongue strength is associated with jumping mechanography performance and handgrip strength but not with classic functional tests in older adults","volume":"61","author":"Buehring","year":"2013","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1016\/j.pmr.2008.06.002","article-title":"Dysphagia in the elderly","volume":"9","author":"Humbert","year":"2008","journal-title":"Phys. Med. Rehabil. Clin. N. Am."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1111\/j.1532-5415.2005.53467.x","article-title":"The effects of lingual exercise on swallowing in older adults","volume":"53","author":"Robbins","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.apmr.2006.11.002","article-title":"The effects of lingual exercise in stroke patients with dysphagia","volume":"88","author":"Robbins","year":"2007","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1682\/JRRD.2009.05.0068","article-title":"Pressure profile similarities between tongue resistance training tasks and liquid swallows","volume":"47","author":"Steele","year":"2010","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/S0889-8537(05)70148-6","article-title":"Respiratory function in the elderly","volume":"18","author":"Zaugg","year":"2000","journal-title":"Anesthesiol. Clin. N. Am."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/j.1741-2358.1984.tb00362.x","article-title":"Speech and swallowing in the elderly","volume":"3","author":"Sonies","year":"1984","journal-title":"Gerodontology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/MOO.0b013e3282febd4b","article-title":"Clinical implications of respiratory-swallowing interactions","volume":"16","year":"2008","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"136","DOI":"10.3109\/13685538.2014.936001","article-title":"Relation between hand grip strength, respiratory muscle strength and spirometric measures in male nursing home residents","volume":"17","author":"Bahat","year":"2014","journal-title":"Aging Male"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1007\/s00198-015-3152-8","article-title":"Low pulmonary function is related with a high risk of sarcopenia in community-dwelling older adults: The Korea National Health and Nutrition Examination Survey (KNHANES) 2008\u20132011","volume":"26","author":"Jeon","year":"2015","journal-title":"Osteoporos. Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.apmr.2012.10.006","article-title":"Effect of singing on respiratory function, voice, and mood after quadriplegia: A randomized controlled trial","volume":"94","author":"Tamplin","year":"2013","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"16080","DOI":"10.1038\/npjpcrm.2016.80","article-title":"Singing for Lung Health\u2014a systematic review of the literature and consensus statement","volume":"26","author":"Lewis","year":"2016","journal-title":"NPJ Prim. Care Respir. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1111\/j.1748-0361.2009.00256.x","article-title":"Didgeridoo playing and singing to support asthma management in Aboriginal Australians","volume":"26","author":"Eley","year":"2010","journal-title":"J. Rural Health"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"40","DOI":"10.47513\/mmd.v7i4.429","article-title":"Changes in spirometry, quality of life and well-being in persons with asthma following singing, diaphragmatic breathing, and singing and diaphragmatic breathing: A pilot study","volume":"7","author":"Gick","year":"2015","journal-title":"Music Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1080\/17533015.2013.840853","article-title":"\u2018Singing for Breathing\u2019: Participants\u2019 perceptions of a group singing program for people with COPD","volume":"6","author":"Skingley","year":"2014","journal-title":"Arts Health"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Lord, V.M., Hume, V.J., Kelly, J.L., Cave, P., Silver, J., Waldman, M., White, C., Smith, C., Tanner, R., and Sanchez, M. (2012). Singing classes for chronic obstructive pulmonary disease: A randomized controlled trial. BMC Pulm. Med., 12.","DOI":"10.1186\/1471-2466-12-69"},{"key":"ref_41","first-page":"158","article-title":"The role of singing therapy in pulmonary rehabilitation. PM3","volume":"16","author":"Nistor","year":"2015","journal-title":"Civiliz. Sport"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1159\/000436960","article-title":"Music therapy using singing training improves psychomotor speed in patients with Alzheimer\u2019s disease: A neuropsychological and fMRI Study","volume":"5","author":"Satoh","year":"2015","journal-title":"Dement. Geriatr. Cognit. Disord. Extra"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"601","DOI":"10.2147\/CIA.S194808","article-title":"Tongue-pressure resistance training improves tongue and suprahyoid muscle functions simultaneously","volume":"14","author":"Namiki","year":"2019","journal-title":"Clin. Interv. Aging"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.3109\/02770903.2010.513077","article-title":"The improvement of cognitive functions in patients with bronchial asthma after therapy","volume":"47","author":"Bozek","year":"2010","journal-title":"J. Asthma"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1111\/ggi.13003","article-title":"Development of a candy-sucking test for evaluating oral function in elderly patients with dementia: A pilot study","volume":"17","author":"Mori","year":"2017","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1159\/000091438","article-title":"Pulmonary function, cognitive impairment and brain atrophy in a middle-aged community sample","volume":"21","author":"Sachdev","year":"2006","journal-title":"Dement. Geriatr. Cognit. Disord."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal cognitive assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"c332","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials","volume":"340","author":"Schulz","year":"2010","journal-title":"BMJ"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1057\/palgrave.gpp.2510101","article-title":"Behavioral analysis of the choice of community-based formal home care, informal home care and nursing home care in Japan","volume":"31","author":"Yamada","year":"2006","journal-title":"Geneva Pap. Risk Insur.-Issues Pract."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"61","DOI":"10.3109\/09638288809164103","article-title":"The Barthel ADL Index: A reliability study","volume":"10","author":"Collin","year":"1988","journal-title":"Int. Disabil. Stud."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/geront\/9.3_Part_1.179","article-title":"Assessment of older people: Self-maintaining and instrumental activities of daily living","volume":"9","author":"Lawton","year":"1969","journal-title":"Gerontologist"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1097\/PSY.0b013e318218e1fb","article-title":"Usual and unusual care: Existing practice control groups in randomized controlled trials of behavioral interventions","volume":"73","author":"Freedland","year":"2011","journal-title":"Psychosom. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.bbr.2008.09.012","article-title":"Hand motor activity, cognition, mood, and the rest-activity rhythm in dementia: A clustered RCT","volume":"196","author":"Eggermont","year":"2009","journal-title":"Behav. Brain Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1093\/jpepsy\/jsv094","article-title":"Systematic review: Audiovisual interventions for reducing preoperative anxiety in children undergoing elective surgery","volume":"41","author":"Chow","year":"2016","journal-title":"J. Pediatr. Psychol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.pain.2004.04.028","article-title":"Imagery reduces children\u2019s post-operative pain","volume":"110","author":"Huth","year":"2004","journal-title":"Pain"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1212\/WNL.55.11.1621","article-title":"The FAB: A frontal assessment battery at bedside","volume":"55","author":"Dubois","year":"2000","journal-title":"Neurology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1007\/s00455-007-9142-z","article-title":"Standard values of maximum tongue pressure taken using newly developed disposable tongue pressure measurement device","volume":"23","author":"Utanohara","year":"2008","journal-title":"Dysphagia"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1300\/J018v01n01_06","article-title":"Screening tests for geriatric depression","volume":"1","author":"Brink","year":"1982","journal-title":"Clin. Gerontol."},{"key":"ref_59","first-page":"111","article-title":"Correlates of happiness in old age: Covariance structure model analysis of national survey date","volume":"8","author":"Koyano","year":"1993","journal-title":"Sociol. Theory Meth."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1093\/oxfordjournals.aje.a009520","article-title":"Epidemiology of sarcopenia among the elderly in New Mexico","volume":"147","author":"Baumgartner","year":"1998","journal-title":"Am. J. Epidemiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jamda.2013.11.025","article-title":"Sarcopenia in Asia: Consensus report of the Asian Working Group for Sarcopenia","volume":"15","author":"Chen","year":"2014","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_62","unstructured":"Wheeler, B., Torchiano, M., and Torchiano, M.M. (2020, February 22). Package \u2018lmPerm\u2019. Available online: ftp:\/\/ftp.math.ethz.ch\/sfs\/pub\/Software\/R-CRAN\/web\/packages\/lmPerm\/lmPerm.pdf."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Nouchi, R., Taki, Y., Takeuchi, H., Hashizume, H., Nozawa, T., Kambara, T., Sekiguchi, A., Miyauchi, C.M., Kotozaki, Y., and Nouchi, H. (2013). Brain training game boosts executive functions, working memory and processing speed in the young adults: A randomized controlled trial. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0055518"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"99","DOI":"10.3389\/fnagi.2019.00099","article-title":"Newly developed tv-based cognitive training games improve car driving skills, cognitive functions, and mood in healthy older adults: Evidence from a randomized controlled trial","volume":"11","author":"Nouchi","year":"2019","journal-title":"Front. Aging Neurosci."},{"key":"ref_65","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences, Routledge."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1111\/nyas.12674","article-title":"Music training and inhibitory control: A multidimensional model","volume":"1337","author":"Moreno","year":"2015","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1111\/j.0956-7976.2004.00711.x","article-title":"Music lessons enhance IQ","volume":"15","author":"Schellenberg","year":"2004","journal-title":"Psychol. Sci."},{"key":"ref_68","unstructured":"The Japanese Neurological Association (2017). Dementia Disease Clinical Practice Guidelines 2017, Igaku-Shoin Ltd.. (In Japanese)."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s11920-016-0721-2","article-title":"Cognitive reserve and the prevention of dementia: The role of physical and cognitive activities","volume":"18","author":"Cheng","year":"2016","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1001\/jama.2018.14854","article-title":"The physical activity guidelines for Americans","volume":"320","author":"Piercy","year":"2018","journal-title":"JAMA"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1002\/jcsm.12297","article-title":"Aspiration pneumonia induces muscle atrophy in the respiratory, skeletal, and swallowing systems","volume":"9","author":"Komatsu","year":"2018","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_72","unstructured":"Hixon, T.J., Minifine, F.D., and Williams, F. (1973). Normal Aspects of Speech, Hearing, and Language, Prentice-Hall."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/0963828021000031025","article-title":"Karaoke for quads: A new application of an old recreation with potential therapeutic benefits for people with disabilities","volume":"25","author":"Batavia","year":"2003","journal-title":"Disabil. Rehabil."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.jbiomech.2017.09.008","article-title":"Model-based inverse estimation for active contraction stresses of tongue muscles using 3D surface shape in speech production","volume":"64","author":"Koike","year":"2017","journal-title":"J. Biomech."},{"key":"ref_75","unstructured":"Roussos, C. (1995). The Thorax: Disease Lung Biology in Health and Disease, CRC Press."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.3109\/09638288.2013.769635","article-title":"The influence of inspiratory muscle training on diaphragmatic mobility, pulmonary function and maximum respiratory pressures in morbidly obese individuals: A pilot study","volume":"35","author":"Santos","year":"2013","journal-title":"Disabil. Rehabil."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1177\/000348940611501007","article-title":"Respiratory retraining therapy and management of laryngopharyngeal reflux in the treatment of patients with cough and paradoxical vocal fold movement disorder","volume":"115","author":"Murry","year":"2006","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/ggi.12486","article-title":"Sarcopenia is an independent risk factor of dysphagia in hospitalized older people","volume":"16","author":"Maeda","year":"2016","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1093\/gerona\/glq234","article-title":"The relationship of aspiration status with tongue and handgrip strength in healthy older adults","volume":"66","author":"Butler","year":"2011","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/joor.12461","article-title":"Tongue to palate resistance training improves tongue strength and oropharyngeal swallowing function in subacute stroke survivors with dysphagia","volume":"44","author":"Kim","year":"2017","journal-title":"J. Oral Rehabil."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S0021-9924(00)00023-X","article-title":"Research on speech motor control and its disorders: A review and prospective","volume":"33","author":"Kent","year":"2000","journal-title":"J. Commun. Disord."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1159\/000118510","article-title":"Changes in speaking fundamental frequency characteristics with aging","volume":"60","author":"Nishio","year":"2008","journal-title":"Folia Phoniatr. Logop."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1159\/000154929","article-title":"Functional decline in cognitive impairment--the relationship between physical and cognitive function","volume":"31","author":"Auyeung","year":"2008","journal-title":"Neuroepidemiology"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1001\/archneurol.2009.240","article-title":"Association of muscle strength with the risk of Alzheimer disease and the rate of cognitive decline in community-dwelling older persons","volume":"66","author":"Boyle","year":"2009","journal-title":"Arch. Neurol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"777","DOI":"10.3233\/JAD-2009-1185","article-title":"Bone density and brain atrophy in early Alzheimer\u2019s disease","volume":"18","author":"Loskutova","year":"2009","journal-title":"J. Alzheimers Dis."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1001\/archneurol.2010.38","article-title":"Reduced lean mass in early Alzheimer disease and its association with brain atrophy","volume":"67","author":"Burns","year":"2010","journal-title":"Arch. Neurol."},{"key":"ref_87","first-page":"175","article-title":"Older women with dementia can perform fast alternating forearm movements and performance is correlated with tests of lower extremity function","volume":"8","author":"Jarnlo","year":"2013","journal-title":"Clin. Interv. Aging"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"663","DOI":"10.2147\/CIA.S76275","article-title":"Sarcopenia and impairment in cognitive and physical performance","volume":"10","author":"Tolea","year":"2015","journal-title":"Clin. Interv. Aging"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Tolea, M.I., Morris, J.C., and Galvin, J.E. (2015). Longitudinal associations between physical and cognitive performance among community-dwelling older adults. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0122878"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1164.e7","DOI":"10.1016\/j.jamda.2016.09.013","article-title":"Association between sarcopenia and cognitive Impairment: A systematic review and meta-Analysis","volume":"17","author":"Chang","year":"2016","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1159\/000486711","article-title":"Lower cognitive function in older patients with lower muscle strength and muscle mass","volume":"45","author":"Verlaan","year":"2018","journal-title":"Dement. Geriatr. Cognit. Disord."},{"key":"ref_92","first-page":"10","article-title":"The need for clinical trials in dysphagia","volume":"13","author":"Logemann","year":"1998","journal-title":"Dysphagia"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1378\/chest.124.1.328","article-title":"Aspiration pneumonia and dysphagia in the elderly","volume":"124","author":"Marik","year":"2003","journal-title":"Chest"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1080\/03601277.2012.701157","article-title":"Effects of third age learning programs on the life satisfaction, self-esteem, and depression level among a select group of community dwelling Filipino elderly","volume":"40","year":"2014","journal-title":"Educ. Gerontol."},{"key":"ref_95","unstructured":"Hanna, G., and Perlstein, S. (2020, February 22). Creativity Matters: Arts and Aging in America. Available online: https:\/\/creativeaging.org\/."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1093\/geront\/gnu183","article-title":"The arts, health, and aging in America: 2005\u20132015","volume":"55","author":"Hanna","year":"2015","journal-title":"Gerontologist"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3384\/ijal.1652-8670.14238","article-title":"The participative arts for people living with a dementia: A critical review","volume":"9","author":"Zeilig","year":"2014","journal-title":"Int. J. Ageing Later Life"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/4\/1459\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:01:21Z","timestamp":1760173281000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/4\/1459"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,24]]},"references-count":97,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,2]]}},"alternative-id":["ijerph17041459"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17041459","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,24]]}}}