Musical training, speech perception, and cognition (Merten et al., 2021)

Purpose: The aim of this study was to determine the long-term associations of musical training with speech perception in adverse conditions and cognition in a longitudinal cohort study of middle-age to older adults.

Method: This study is based on Epidemiology of Hearing Loss Study participants. We asked participants at baseline (1993–1995) about their musical training. Speech perception (word recognition in competing message; Northwestern University Auditory Test Number 6), cognitive function (cognitive test battery), and impairment (self-report or surrogate report of Alzheimer’s disease or dementia, and/or a Mini-Mental State Examination score ≤ 24) were assessed up to 5 times over the 20-year follow-up. We included 2,938 Epidemiology of Hearing Loss Study participants who had musical training data and at least one follow-up of speech perception and/or cognitive assessment. We used linear mixed-effects models to determine associations between musicianship and decline in speech perception and cognitive function over time and Cox regression models to evaluate associations of musical training with 20-year cumulative incidence of speech perception and cognitive impairment. Models were adjusted for age, sex, and occupation and repeated with additional adjustment for health-related confounders and education.

Results: Musicians showed less speech perception decline over time with stronger effects in women (0.16% difference, 95% confidence interval [CI] [0.05, 0.26]). Among men, musicians had, on average, better speech perception than nonmusicians (3.41% difference, 95% CI [0.62, 6.20]) and were less likely to develop a cognitive impairment than nonmusicians (hazard ratio = 0.58, 95% CI [0.37, 0.91]).

Conclusions: Musicians showed an advantage in speech perception abilities and cognition later in life and less decline over time with different magnitudes of effect sizes in men and women. Associations remained with further adjustment, indicating that some degree of the advantage of musical training is independent of socioeconomic or health differences. If confirmed, these findings could have implications for developing speech perception intervention and prevention strategies.

Supplemental Material S1. Correlations between cognitive scores at Epidemiology of Hearing Loss Study (EHLS) 4.

Supplemental Material S2. Linear mixed-effects model on decline in speech perception.

Supplemental Material S3. Linear mixed-effects model on decline in cognitive performance.

Supplemental Material S4. Survival plot for the onset of cognitive impairment stratified by musicianship in women.

Supplemental Material S5. Survival plot for the onset of cognitive impairment stratified by musicianship in men.

Supplemental Material S6. Baseline characteristics of participants included in the analytic dataset and the EHLS cohort.

Merten, N., Fischer, M. E., Dillard, L. K., Klein, B. E. K., Tweed, T. S., & Cruickshanks, K. J. (2021). Benefit of musical training for speech perception and cognition later in life. Journal of Speech, Language, and Hearing Research. Advance online publication. https://doi.org/10.1044/2021_JSLHR-20-00588