Funded Projects

Alzheimer’s disease and related dementias (ADRD) are often accompanied by behavioral and psychological symptoms that worsen daily function, increase caregiver distress, and reduce quality of life for both persons living with ADRD and their care partners. Although group singing programs are increasingly used in dementia care, most studies have focused on feasibility without clearly specifying mechanistic targets, active intervention ingredients, or pathways of benefit. ENCORE addresses this gap by developing a mechanism-based dyadic group singing program for persons with mild ADRD and their care partners, with “uplift,” defined as brief, modifiable experiences of shared joy, meaning, pride, and positive affect during caregiving interactions, as a candidate mechanism of behavioral change. Guided by the NIH Music-Based Intervention Toolkit and NIH Stage Model, this Stage Ia/Ib study will refine the ENCORE manual, materials, and delivery procedures, and develop recruitment and retention strategies to engage racially and ethnically diverse dyads. Feasibility and acceptability will be evaluated among 12 mild ADRD dyads, volunteers, and interventionists. Using a multimodal assessment battery, including self-report measures, ecological momentary assessment, and qualitative interviews, the study will inform how group singing elicits uplift and explore its associations with behavioral symptoms and caregiver distress. Findings will provide the manualized protocol, feasibility data, and mechanistic foundation needed for subsequent NIH/NIA proof-of-concept and pilot randomized controlled trials.

Music can unlock vivid, specific autobiographical memories, even in patients with severe dementia, but the underlying mechanisms of this phenomenon remain mysterious, making it difficult to develop tailored music-based therapeutic interventions. For example, it remains unknown what role the acoustic and emotional features of a song (vs. its high-level “song identity”) play in driving the content and qualities of memories (Aim 1). In addition, it is unclear how fine-grained neural mechanisms, such as functional connectivity between brain regions involved in perception, emotion, and memory, may drive the vividness and other qualities of reported memories (Aim 2). To address these critical questions, we built a novel corpus of pop songs to elicit memories in an online behavioral study and in the fMRI scanner, in both younger and older adults.