{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:30:58Z","timestamp":1791484258073,"version":"4.3.4"},"reference-count":55,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T00:00:00Z","timestamp":1663718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2019S1A5A2A01051170"],"award-info":[{"award-number":["2019S1A5A2A01051170"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Deficits in executive functioning are a common feature of Alzheimer\u2019s disease (AD) and result from impairment in the central executive system. As a result, elderly patients with early stage AD may require interventions that are more cognitively intense than traditional interventions. To address this need, in this multiple case study, we explored a dual-task-based music therapy intervention that involved drum playing and singing designed to induce attentional and motor controls. Three octogenarians diagnosed with early stage AD participated in 12 dual-task-based music therapy sessions over 6 weeks. Measures of executive functioning and the performance of a bimanual drum tapping task were evaluated before and after the intervention. Improvements in executive functioning were observed for participants A and C. After the intervention, reduced mean synchronization errors were found for the simultaneous tapping condition for all three participants. Although there was variability in the functional changes between participants, it is noteworthy that positive improvements in the elderly patients with early stage AD were obtained following dual-task-based music therapy. The results suggest that music therapy integrated into the dual-task paradigm can be an effective way to address degenerative cognitive deficits among elderly patients with early stage AD.<\/jats:p>","DOI":"10.3390\/ijerph191911940","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T01:47:06Z","timestamp":1663811226000},"page":"11940","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Dual-Task-Based Music Therapy to Improve Executive Functioning of Elderly Patients with Early Stage Alzheimer\u2019s Disease: A Multiple Case Study"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7279-1804","authenticated-orcid":false,"given":"Soo Ji","family":"Kim","sequence":"first","affiliation":[{"name":"Music Therapy Education, Graduate School of Education, Ewha Womans University, Seoul 03760, Korea"},{"name":"Arts Therapy Education Institute, Ewha Womans University, Seoul 03760, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8342-683X","authenticated-orcid":false,"given":"Jin-Kyoung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Music Therapy, Graduate School, Ewha Womans University, Seoul 03760, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung Sun","family":"Yeo","sequence":"additional","affiliation":[{"name":"Music Therapy Education, Graduate School of Education, Ewha Womans University, Seoul 03760, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,21]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021, September 01). Global Status Report on the Public Health Response to Dementia. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240033245."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"249","DOI":"10.3988\/jcn.2021.17.2.249","article-title":"Prevalence and incidence of dementia in South Korea: A nationwide analysis of the national health insurance service senior cohort","volume":"17","author":"Jang","year":"2021","journal-title":"J. Clin. Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1016\/j.amjmed.2018.01.022","article-title":"Dementia","volume":"131","author":"Gale","year":"2018","journal-title":"Am. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e041856","DOI":"10.1002\/alz.041856","article-title":"What older adults do with results from a community-based dementia screening program: Dementia care research: Dementia care-evaluation","volume":"16","author":"Galvin","year":"2020","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"948","DOI":"10.3349\/ymj.2021.62.10.948","article-title":"Prevalence of dementia in Korea based on hospital utilization data from 2008 to 2016","volume":"62","author":"Choi","year":"2021","journal-title":"Yonsei Med. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/S0140-6736(15)01124-1","article-title":"Alzheimer\u2019s disease","volume":"388","author":"Scheltens","year":"2016","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jalz.2010.04.005","article-title":"Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer\u2019s disease","volume":"7","author":"Marshall","year":"2011","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1093\/brain\/122.3.383","article-title":"Attention and executive deficits in Alzheimer\u2019s disease: A critical review","volume":"122","author":"Perry","year":"1999","journal-title":"Brain"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1159\/000504340","article-title":"Review of gait, cognition, and fall risks with implications for fall prevention in older adults with dementia","volume":"48","author":"Zhang","year":"2019","journal-title":"Dement. Geriatr. Cogn. Disord."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"748212","DOI":"10.1155\/2015\/748212","article-title":"Working memory and executive function decline across normal aging, mild cognitive impairment, and Alzheimer\u2019s disease","volume":"2015","author":"Kirova","year":"2015","journal-title":"BioMed Res. Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1177\/0963721411429458","article-title":"The nature and organization of individual differences in executive functions: Four general conclusions","volume":"21","author":"Miyake","year":"2012","journal-title":"Curr. Dir. Psychol. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1080\/13607863.2019.1584785","article-title":"Executive functions in the elderly with mild cognitive impairment: A systematic review on motor and cognitive inhibition, conflict control and cognitive flexibility","volume":"24","author":"Guarino","year":"2020","journal-title":"Aging Ment. Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1002\/agm2.12037","article-title":"Functional MRI on executive functioning in aging and dementia: A scoping review of cognitive tasks","volume":"1","author":"McDonald","year":"2018","journal-title":"Aging Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1111\/j.1467-8721.2008.00574.x","article-title":"Cognitive deficits in the early stages of Alzheimer\u2019s disease","volume":"17","author":"Storandt","year":"2008","journal-title":"Curr. Dir. Psychol. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1037\/xhp0000309","article-title":"Higher-order cognitive control in dual tasks: Evidence from task-pair switching","volume":"43","author":"Hirsch","year":"2017","journal-title":"J. Exp. Psychol. Hum. Percept. Perform."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"57","DOI":"10.3233\/JAD-181196","article-title":"Are cognitive subtypes associated with dual-task gait performance in a clinical setting?","volume":"71","author":"Cullen","year":"2019","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1017\/S1355617717000261","article-title":"Improving sensitivity to detect mild cognitive impairment: Cognitive load dual-task gait speed assessment","volume":"23","author":"MacAulay","year":"2017","journal-title":"J. Int. Neuropsychol. Soc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1001\/jamaneurol.2017.0643","article-title":"Association of dual-task gait with incident dementia in mild cognitive impairment: Results from the gait and brain study","volume":"74","author":"Speechley","year":"2017","journal-title":"JAMA Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1002\/mds.21720","article-title":"The role of executive function and attention in gait","volume":"23","author":"Hausdorff","year":"2008","journal-title":"Mov. Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s13670-018-0237-1","article-title":"Rehabilitation for individuals with dementia: Facilitating success","volume":"7","author":"Ries","year":"2018","journal-title":"Curr. Geriatr. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.3389\/fpsyg.2017.01569","article-title":"Age-related changes in bimanual instrument playing with rhythmic cueing","volume":"8","author":"Kim","year":"2017","journal-title":"Front. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"671","DOI":"10.3389\/fneur.2017.00671","article-title":"The applicability of rhythm-motor tasks to a new dual task paradigm for older adults","volume":"8","author":"Kim","year":"2017","journal-title":"Front. Neurol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3027","DOI":"10.3389\/fpsyg.2019.03027","article-title":"Rhythm-motor dual task intervention for fall prevention in healthy older adults","volume":"10","author":"Kim","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.brainres.2007.05.045","article-title":"A network for audio\u2013motor coordination in skilled pianists and non-musicians","volume":"1161","author":"Baumann","year":"2007","journal-title":"Brain Res."},{"key":"ref_25","first-page":"2768","article-title":"Modulation of functional connectivity in auditory\u2013motor networks in musicians compared with nonmusicians","volume":"27","author":"Zatorre","year":"2017","journal-title":"Cereb. Cortex"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1038\/nrn2152","article-title":"When the brain plays music: Auditory\u2013motor interactions in music perception and production","volume":"8","author":"Zatorre","year":"2007","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1080\/13607863.2017.1348474","article-title":"The effect of music therapy on cognitive functions in patients with dementia: A systematic review and meta-analysis","volume":"22","author":"Bieleninik","year":"2018","journal-title":"Aging Ment. Health"},{"key":"ref_28","first-page":"300","article-title":"Music therapy and Alzheimer\u2019s disease: Cognitive, psychological, and behavioural effects","volume":"32","author":"Gallego","year":"2017","journal-title":"Neurolog\u00eda"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2348","DOI":"10.1212\/01.WNL.0000147478.03911.28","article-title":"Benefits of cognitive-motor intervention in MCI and mild to moderate Alzheimer disease","volume":"63","author":"Olazaran","year":"2004","journal-title":"Neurology"},{"key":"ref_30","first-page":"1068","article-title":"Bimanual motor impairments in older adults: An updated systematic review and meta-analysis","volume":"21","author":"Kang","year":"2022","journal-title":"EXCLI J."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Park, J.-K., and Kim, S.J. (2021). Dual-task-based drum playing with rhythmic cueing on motor and attention control in patients with Parkinson\u2019s disease: A preliminary randomized study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph181910095"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.neucli.2020.10.010","article-title":"Cognitive and physical impact of cognitive-motor dual-task training in cognitively impaired older adults: An overview","volume":"50","author":"Mandigout","year":"2020","journal-title":"Neurophysiol. Clin."},{"key":"ref_33","first-page":"48","article-title":"Validation of geriatric depression scale, Korean version (GDS) in the assessment of DSM-III-R major depression","volume":"38","author":"Cho","year":"1999","journal-title":"J. Korean Neuropsychiatr. Assoc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1521\/soco.19.6.625.20886","article-title":"The go\/no-go association task","volume":"19","author":"Nosek","year":"2001","journal-title":"Soc. Cogn."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"135","DOI":"10.12779\/dnd.2016.15.4.135","article-title":"A comparison of five types of trail making test in Korean elderly","volume":"15","author":"Jang","year":"2016","journal-title":"Dement. Neurocogn. Disord."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1002\/1097-4679(197204)28:2<167::AID-JCLP2270280212>3.0.CO;2-X","article-title":"The Trail Making Test in neuropsychological diagnosis","volume":"28","author":"Gordon","year":"1972","journal-title":"J. Clin. Psychol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1076\/1380-3395(200008)22:4;1-0;FT518","article-title":"Trail making test, part B as a measure of executive control: Validation using a set-switching paradigm","volume":"22","author":"Arbuthnott","year":"2000","journal-title":"J. Clin. Exp. Neuropsychol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1037\/0022-006X.50.2.291","article-title":"The Luria-Nebraska Neuropsychological Battery: Theoretical orientation and comment","volume":"50","author":"Golden","year":"1982","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/j.neuroimage.2008.04.026","article-title":"A regulation role of the prefrontal cortex in the fist-edge-palm task: Evidence from functional connectivity analysis","volume":"41","author":"Rao","year":"2008","journal-title":"Neuroimage"},{"key":"ref_40","unstructured":"Korean Ministry of Health and Welfare (2021, January 01). A Guide to 2021 Dementia Policy. Available online: https:\/\/www.korea.kr\/archive\/expDocView.do?docId=39385."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1159\/000205512","article-title":"Development of the subjective memory complaints questionnaire","volume":"27","author":"Youn","year":"2009","journal-title":"Dement. Geriatr. Cogn. Disord."},{"key":"ref_42","first-page":"212","article-title":"The geriatric depression scale (GDS)","volume":"20","author":"Kurlowicz","year":"1999","journal-title":"Geriatr. Nurs."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"8913","DOI":"10.1073\/pnas.1705373114","article-title":"Motor origin of temporal predictions in auditory attention","volume":"114","author":"Morillon","year":"2017","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1111\/j.1440-1819.2006.01526.x","article-title":"Effect of age and education on the Trail Making Test and determination of normative data for Japanese elderly people: The Tajiri Project","volume":"60","author":"Hashimoto","year":"2006","journal-title":"Psychiatr. Clin. Neurosci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1002\/hbm.20943","article-title":"The neural control of bimanual movements in the elderly: Brain regions exhibiting age-related increases in activity, frequency-induced neural modulation, and task-specific compensatory recruitment","volume":"31","author":"Goble","year":"2010","journal-title":"Hum. Brain Mapp."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1093\/geronb\/55.2.P85","article-title":"Effects of aging on automatic and effortful processes in bimanual coordination","volume":"55","author":"Wishart","year":"2000","journal-title":"J. Gerontol. B Psychol. Sci. Soc. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.neubiorev.2017.01.010","article-title":"Cognitive-motor dual-task interference: A systematic review of neural correlates","volume":"75","author":"Leone","year":"2017","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1177\/1321103X10384202","article-title":"Students\u2019 motivation to study music as compared to other school subjects: A comparison of eight countries","volume":"32","author":"McPherson","year":"2010","journal-title":"Res. Stud. Music Educ."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1212\/01.wnl.0000260968.92345.3f","article-title":"Predictors of progression from mild cognitive impairment to Alzheimer disease","volume":"68","author":"Palmer","year":"2007","journal-title":"Neurology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"949","DOI":"10.3233\/JAD-150998","article-title":"Music and memory in Alzheimer\u2019s disease and the potential underlying mechanisms","volume":"51","author":"Peck","year":"2016","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.disamonth.2010.06.001","article-title":"Alzheimer disease","volume":"56","author":"Castellani","year":"2010","journal-title":"Dis. Mon."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.tics.2007.06.009","article-title":"Capitalizing on cortical plasticity: Influence of physical activity on cognition and brain function","volume":"11","author":"Kramer","year":"2007","journal-title":"Trends Cogn. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1093\/jmt\/44.4.308","article-title":"The temporal limits of cognitive change from music therapy in elderly persons with dementia or dementia-like cognitive nmpairment: A randomized controlled trial","volume":"44","author":"Bruer","year":"2007","journal-title":"J. Music Ther."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1093\/geront\/gnt100","article-title":"Cognitive, emotional, and social benefits of regular musical activities in early dementia: Randomized controlled study","volume":"54","author":"Tervaniemi","year":"2014","journal-title":"Gerontologist"},{"key":"ref_55","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. Cogn. Dis. Extra"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/19\/11940\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:36:37Z","timestamp":1760142997000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/19\/11940"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,21]]},"references-count":55,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["ijerph191911940"],"URL":"https:\/\/doi.org\/10.3390\/ijerph191911940","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,21]]}}}