Authors (including presenting author) :
Chow WK (1), Yau CF (2), Tang LM (2), Chan WK(2), Ho CME(2)
Affiliation :
Occupational Therapy Department, Tai Po Hospital
Keyword 1: :
Cognitive Stimulation
Keyword 2: :
Rhythmic Musical Activity
Keyword 3: :
Minor Neurocognitive Disorder
Keyword 4: :
Executive Function
Introduction :
One-fifth of community-dwelling older adults have mild neurocognitive disorder (The Chinese University of Hong Kong's Faculty of Medicine, 2023), highlighting the prevalence of cognitive impairments in elderly. Aging primarily impacts cognitive domains in attention, memory, and executive function (Murman, 2015; Glisky, 2007), with executive dysfunction recognized as a key contributor to Instrumental Activities of Daily Living (IADL) impairment (Marshall et al., 2011). Rhythmic musical activity provides an engaging platform for improving planning, working memory and cognitive flexibility (Colverson et al., 2024; Kim et al., 2022). These cognitive abilities are essential for executing IADLs, facilitating efficient task completion and adaptation to changing circumstances. Additionally, cognitive stimulation activities that simulate daily life situations may facilitate community reintegration.
Objectives :
This study investigates the effectiveness of using cognitive stimulation groups incorporated with rhythmic musical activity for patients with mild neurocognitive disorder in an inpatient rehabilitation setting.
Methodology :
Patients admitted to Tai Po Hospital who are 1) aged 65 or above and 2) have an HK-MoCA or HK-MoCA 5-minute score below the 7th percentile but above the 2nd percentile were recruited. The cognitive stimulation group incorporated themes of rhythmic musical activities, IADL components (such as shopping and transportation), and leisure activities, aimed at improving attention, working memory, and executive function. Participants are required to attend a minimum of five sessions, each lasting 20-30 minutes. The selected outcome measures are: 1) Forward Digit Span Test (DST-F), 2) Backward Digit Span Test (DST-B), and 3) Chinese Frontal Assessment Battery (CFAB) to measure changes in cognitive functions before and after attending the group.
Result & Outcome :
A total of 17 patients were recruited from April 2025 to December 2025. The mean age was 73.7 years (SD=8.4), with 76% being female. An average of 6 sessions were conducted (SD=2.48). The Shapiro-Wilk Normality Test was selected to test the normality of the collected data. A paired t-test was used to analyze the results of the CFAB and DST-F, while the Wilcoxon Signed-Rank Test was used to analyze the results of the DST-B. Significant improvement was found in executive functions, with the mean score of the CFAB improving from 8.71 to 10.71 (p=0.009). However, there were no significant improvements in the DST-F (p=0.455) and DST-B (p=0.38). The mean span of DST-F for both pre and post assessments remained constant at 7, while the mean span of DST-B improved from 2 to 3. Engaging in rhythmic musical activity combined with cognitive stimulation activities based on daily life scenarios could improve executive function for patients with mild neurocognitive disorder. To support continued improvement post-discharge, a home program can be introduced to caregivers, guiding participants through rhythmic musical activities and shopping-related calculations for ongoing training. Although the improvement in attention span is not significant, it may be affected by the patients' baseline cognitive functions and environmental factors. It is suggested to consider other outcome measures to avoid the potential underestimation of its true impact.
