PROJECT SUMMARY The overall objective of the proposed work is to test the benefits of a music-based intervention on speech-in- competition abilities in an older adult population that includes individuals that may be at risk of Alzheimer's disease and related dementias (ADRD). Age-related hearing difficulties are prevalent, with speech-in- competition difficulties being a common challenge amongst older adults. Critically, these difficulties and frustrations often lead to social isolation and decreased cognitive engagement, and they are associated with an increased risk of developing ADRD. There is evidence suggesting that musical training is associated with cognitive advantages in older adults, including preserved ability for speech-in-competition. However, to date, there is extremely limited knowledge and lack of experimental evidence explaining how music might benefit speech-in-competition abilities, along with more basic auditory processes and/or cognitive functions. We aim to contribute to uncovering the underlying mechanisms driving the potential effects of music and attention through an innovative, attention-based music listening intervention that cultivates auditory and attentional skills akin to those developed during formal instrumental training. To disentangle potential effects of music and attention and to get at the underlying mechanisms of music effects, we will compare outcomes of this attention-based music intervention with those of two active control interventions that consist of either passive music listening or active listening to non-music sounds. Specific aims are to develop and test the feasibility of music and control interventions and assessments targeting auditory processing and cognition (R61; Aim 1); test for intervention- specific improvements in speech-in-competition using a randomized-controlled trial (R33; Aim 2); and determine whether experimental and control interventions differentially impact measures of auditory processing, memory, and attention, and test how these may mediate performance on measures of speech-in-competition (R33; Aim 3). Long-term objectives are to understand the key mechanisms underlying the benefits of music with the overall goal to inform interventions aimed at mitigating the effects of ADRD. This proposal is transformative in that it utilizes an innovative approach to uncover potential benefits and underlying mechanisms of music by testing the added benefits of interventions and testing their benefits against a broad set of outcomes measures that can be used to further understand the malleability of auditory processes and cognition in aging. In addition, the intervention is cost-effective, easily administrable, and accessible to individuals who may not possess the physical capabilities or resources that formal instrumental practice demands. In addition, music has been shown to provide other benefits including mood regulation and psychological well-being, and as such, the intervention may have benefits that go beyond the auditory or cognitive domain. Overall, the proposed work aims to contribute to the amelioration and/or prevention of cognitive decline in individuals that may be at risk for developing ADRD.

PROJECT NARRATIVE The proposed research is relevant to public health in that it aims to achieve greater understanding of, and creation of music-based interventions for those suffering from age-related cognitive decline and hearing loss, which predict the development of Alzheimer's disease and Alzheimer's disease and related dementias (AD/ADRD). This research is aligned with the NIH mission of improving health and well-being of older adults who may be at risk to develop AD/ADRD, in that it seeks to understand underlying mechanisms and fundamental knowledge of how music is associated with speech-in-competition using innovative interventions that can be used on an outpatient basis aimed at mitigating the effects of age-related cognitive decline. Thus, the proposed research cuts across the bounds of numerous NIH agencies, with our framework contributing to the missions of the NIA, NCI, NEI, NIMH, NIAAA, NINCD, NIDA, NINDS, in that all of these agencies work with populations who can gain direct benefits from successful approaches to mental fitness, and the NIH's greater mission to seek knowledge that will result in enhanced health and a reduced burden of disabilities.