Every music therapy format tested improved cognition
STUDY: Mangiacotti A et al, Journals of Gerontology Series B 2026;81(6):
STUDY TYPE: Randomized controlled trial
FUNDING: Vivensa Foundation
Background
Music therapy engages attention, memory, and executive function through structured, improvisational interaction with a trained therapist. Prior studies suggest it helps, and this study looks at which format works best.
The Study
- 62 healthy older adults without cognitive impairment (all over 60, average age 80), recruited from community centers in the UK
- Randomized to one-to-one, small-group (4–8 people), or large-group (15+) music therapy, or a passive control group
- 20 weekly 40-minute sessions over 5 months
All three music therapy groups improved on at least some cognitive measures, while general cognition declined in the control group. Depression scores dropped in every music therapy group but held steady in controls.
Each format showed a distinct cognitive profile:
- One-to-one: improved attention and visuospatial processing
- Small group: improved general cognition, attention, and verbal fluency
- Large group: improved general cognition and visuospatial ability, and showed the largest antidepressant effect
Sleep quality and general well-being didn’t change in any group.
Limitations
Small sample, passive control only (no active comparison like reading or crafts), and high dropout in the large-group arm (57%). Therapists weren’t blind to format.
Practice Implications
- The trial, though imperfect, builds on lots of evidence that music helps the mind.
- Other studies suggest it’s not about musical complexity but the pleasure it brings
— Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
