Art therapy is associated with sustained improvement in cognitive function in the elderly with mild neurocognitive disorder: findings from a pilot randomized controlled trial for art therapy and music reminiscence activity versus usual care

BACKGROUND: Mild cognitive impairment (MCI) is a phase in cognitive decline when it is still possible to intervene to reverse the decline. Cognitive stimulation delivered through psychosocial interventions provides both psychological intervention and social stimulation to improve cognition. A pilot open-label parallel-arms randomized controlled trial was undertaken to examine the effects of art therapy (AT) and music reminiscence activity (MRA) compared to the control, on the primary outcome of neurocognitive domain assessments in elderly people with MCI. METHODS: Community-living elderly people with MCI (Petersen's criteria), assessed for study eligibility, were randomized using a web-based system with equal allocation to two intervention arms: AT (guided viewing of art pieces and production of visual arts) and MRA (listening, and recalling memories related to music) and a control arm (standard care without any intervention). Interventions were led by trained therapists weekly for 3 months, then fortnightly for 6 months. Neurocognitive domains (mean of memory, attention, and visuo-spatial abilities standardized scores), psychological wellbeing (subsyndromal depression and anxiety) and telomere length as a biological marker of cellular ageing, were assessed by intervention-blinded assessors at baseline, 3 months and 9 months. RESULTS: In total, 250 people were screened and 68 were randomized and included in the analysis. In the AT arm, neurocognitive domains improved compared to the control arm at 3 months (mean difference (d)?=?0.40; 90% CI 0.126, 0.679) and were sustained at 9 months (d?=?0.31; 90% CI 0.068, 0.548). There was some improvement in depression and anxiety at 3 and 9 months and in telomere length at 9 months, but this was not significant. Similar improvements were observed in the MRA arm over the control arm, but they were not significant. There were no intervention-related adverse effects. CONCLUSIONS: Art therapy delivered by trained staff as "art as therapy" and "art psychotherapy" may have been the significant contributor to cognitive improvements. The findings support cognitive stimulation for elderly people with cognitive decline and signal the need for larger studies and further investigation of carefully designed psycho-social interventions for this group. TRIAL REGISTRATION: Clinical Trials.gov, NCT02854085 . Registered on 7 July 2016

Aesthetic appreciation of poetry correlates with ease of processing in event-related potentials

Rhetorical theory suggests that rhythmic and metrical features of language substantially contribute to persuading, moving, and pleasing an audience. A potential explanation of these effects is offered by “cognitive fluency theory,” which stipulates that recurring patterns (e.g., meter) enhance perceptual fluency and can lead to greater aesthetic appreciation. In this article, we explore these two assertions by investigating the effects of meter and rhyme in the reception of poetry by means of event-related brain potentials (ERPs). Participants listened to four versions of lyrical stanzas that varied in terms of meter and rhyme, and rated the stanzas for rhythmicity and aesthetic liking. The behavioral and ERP results were in accord with enhanced liking and rhythmicity ratings for metered and rhyming stanzas. The metered and rhyming stanzas elicited smaller N400/P600 ERP responses than their nonmetered, nonrhyming, or nonmetered and nonrhyming counterparts. In addition, the N400 and P600 effects for the lyrical stanzas correlated with aesthetic liking effects (metered–nonmetered), implying that modulation of the N400 and P600 has a direct bearing on the aesthetic appreciation of lyrical stanzas. We suggest that these effects are indicative of perceptual-fluency-enhanced aesthetic liking, as postulated by cognitive fluency theory