Background: Non-pharmacological interventions such as music therapies may help maintain cognitive
function in older adults. This study investigated the effects of long-term exposure to high-resolution
music (192 kHz/24-bit, exceeding standard CD quality and including audible and inaudible frequencies)
on cognitive function in older adults living in residential care homes.
Methods: A randomized controlled trial was conducted between May and August 2024 in a residential
care home in Suzhou, China. Ninety-six older adults (mean age 80.3±6.4 years) were enrolled and
randomly assigned (1:1:1) to a high-resolution (HR) music group, a CD music group, or a control group.
Following randomization, six participants declined the assigned intervention, resulting in 90 participants
initiating the study (HR=32, CD=28, Control=30). Participants in the HR and CD groups listened to
music for 30 minutes per day, five days per week, over 12 weeks, while controls maintained usual
routines. Cognitive function, activities of daily living (ADL), and depressive symptoms were assessed at
baseline and at 12 weeks using the Montreal Cognitive Assessment (MoCA), the ADL scale, and the 15-
item Geriatric Depression Scale (GDS-15). Group differences over time were analyzed using generalized
estimating equation (GEE) models under the intention-to-treat principle, with missing data handled
within the GEE framework.
Results: Over 12 weeks, the control group showed a significant decline in MoCA total scores (p=0.023),
whereas cognitive performance remained stable in both music groups. At post-intervention, the HR
group had significantly higher MoCA scores than controls (p=0.041), while differences between the CD
and control groups were not significant. Domain-specific analyses indicated significant improvements
in attention (p=0.026) and orientation (p=0.011) in the HR group. No significant changes were
observed in other cognitive domains or ADL outcomes. Depressive symptoms increased in controls
(p=0.021) but remained stable in the music groups; between-group differences at post-intervention
were not significant.
Conclusion: A 12-week high-resolution music intervention was associated with preservation of global
cognitive function and selective improvements in attention and orientation compared with usual
routines in residential care home residents. Music interventions may also help mitigate the progression
of depressive symptoms, supporting HR music as a promising non-pharmacological strategy for
cognitive maintenance in this population.
