Brotherhood, Emilie Victoria; (2023) 'In-the-moment' physiological responses to recreational music activities in people living with dementia. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Evidence for music being a ‘relative island in a sea of impairments’ in people living with a dementia (PLWD) mostly relies on data capture before and after the fact, overlooking the opportunity to explore physiological phenomena observable ‘in-the-moment’. This PhD and the work herein explores physiological data acquired using passive recording techniques while PLWD engage in recreational music activities. The Play It Again study acquired pupillometry responses alongside pleasantness and familiarity ratings of music excerpts in 90 healthy older adults (HOAs; Chapter 3) and 39 people living with typical [tAD] and atypical Alzheimer’s disease [Posterior Cortical Atrophy; PCA] (Chapter 4). Within HOA and tAD groups, curvilinear pupil-affect profiles were observed. In all participant groups, pupillometry profiles were distinguishable to an extent between familiar and unfamiliar songs. A secondary analysis of the Play It Again dataset (Chapter 5) harnessed machine learning methods to attempt classification between the two syndromic groups using a ‘fusion model’ of both pupil-based and self-report latency metrics. The model yielded ‘excellent’ discrimination classification performance, which remained unaltered when considering different missing data thresholds within the pupillometry pre-processing pipeline. The final empirical study, Our Dementia Choir, (Chapter 6) acquired physiological data in 16 PLWD before, during and after six choral rehearsals using discreet wearable devices. Accompanying pre- and post-rehearsal wellbeing and stress scales revealed Bonferroni-corrected significant increases in composite wellbeing scores in three of the six weeks, alongside differential overall within-rehearsal autonomic responses in multiple physiological domains relative to baseline (pre-session) levels. Methodological limitations were noted, particularly in terms of challenges acquiring physiological data from individuals with oculomotor difficulties, or in real-world settings. Nevertheless, findings of a coupling between physiological responses and (a) self-reported musical experiences or (b) low-burden disease classification indicate justification for future work to integrate biosignal responses to music in dementia classification, care and support.

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