Restricted accessResearch articleFirst published online 2025-6
Virtual group singing programs for well-being in healthy older adults and persons with neurocognitive disorders during early COVID-19 pandemic: A perspective from Chicago
During the COVID-19 pandemic, older adults experienced health declines due to isolation. Group singing is known to enhance social, emotional, and physical well-being, but its feasibility in virtual formats was unclear.
Objective
To assess the feasibility of virtual group singing for cognitively healthy (CH) adults and individuals with neurocognitive disorders (NcD) during the pandemic.
Method
Two teleconferencing programs were conducted for participants aged >55: (1) a sing-along series with 52 weekly sessions of familiar music and (2) a choir program with structured weekly rehearsals culminating in a virtual concert. Retrospective surveys assessed anxiety reduction, social connection, and physical well-being using Likert scales and participants provided open-ended responses. Quantitative data were analyzed with ordinal regression and probability modeling, while qualitative themes were explored with Fisher's exact test.
Results
Participants reported high levels of satisfaction across all measures. Sing-along programs provided greater satisfaction, particularly through reminiscence (p = 0.003). Choir participants noted enhanced intellectual well-being (p = 0.017). NcD participants were less satisfied with social connection but showed similar overall satisfaction levels compared to CH participants.
Conclusions
Virtual group singing was feasible during periods of isolation as supported by satisfaction of the participants with pertaining to anxiety reduction, social connection and physical well-being. Sing-along programs provided emotional satisfaction through reminiscence (connection to past), while choir programs offered intellectual stimulation through multiple rehearsals. These findings highlight the potential of virtual singing to promote stability, connection, and well-being for older adults during times of disruption.
BakerFALeeY-ECSousaTV, et al.Clinical effectiveness of music interventions for dementia and depression in elderly care (MIDDEL): Australian cohort of an international pragmatic cluster-randomised controlled trial. Lancet Healthy Longev2022; 3: e153–e165.
3.
SärkämöTTervaniemiMLaitinenS, et al.Cognitive, emotional, and social benefits of regular musical activities in early dementia: randomized controlled study. Gerontologist2014; 54: 634–650.
4.
LehmbergLJFungCV. Music, senior centers, and quality of life. Cambridge, UK: Cambridge University Press, 2023.
5.
DorrisJLNeelySTerhorstL, et al.Effects of music participation for mild cognitive impairment and dementia: a systematic review and meta-analysis. J Am Geriatr Soc2021; 69: 2659–2667.
6.
RaglioAAttardoLGonteroG, et al.Effects of music and music therapy on mood in neurological patients. World J Psychiatry2015; 5: 68–78.
7.
PentikäinenEPitkäniemiASiponkoskiS-T, et al.Beneficial effects of choir singing on cognition and well-being of older adults: evidence from a cross-sectional study. PLoS One2021; 16: e0245666.
8.
PetrovskyDVSefcikJSCacchionePZ. A qualitative exploration of choral singing in community-dwelling older adults. West J Nurs Res2020; 42: 340–347.
9.
AhessyB. The use of a music therapy choir to reduce depression and improve quality of life in older adults – a randomized control trial. Music Med2016; 8: 17–28.
10.
PetersenRCWeintraubSSabbaghM, et al.A new framework for dementia nomenclature. JAMA Neurol2023; 80: 1364–1370.
11.
CacioppoJTCacioppoS. The growing problem of loneliness. Lancet2018; 391: 426.
12.
CurelaruAMarzolfSJProvostJ-CKG, et al.Social isolation in dementia: the effects of COVID-19. J Nurse Pract2021; 17: 950–953.
13.
ZhangYCaiJAnL, et al.Does music therapy enhance behavioral and cognitive function in elderly dementia patients? A systematic review and meta-analysis. Ageing Res Rev2017; 35: 1–11.
14.
JacobsenJ-HStelzerJFritzTH, et al.Why musical memory can be preserved in advanced Alzheimer’s disease. Brain2015; 138: 2438–2450.
15.
JenkinsA. Participation in learning and wellbeing among older adults. Int J Lifelong Educ2011; 30: 403–420.
16.
QuinnJBlandonC. Lifelong learning and dementia: a posthumanist perspective. Cham, Switzerland: Springer Nature, 2020.
17.
KatadaYYoshidaNKitaI. Effects of warm-up focused on the mind–body on choral performance. J Voice2025; 39: 562.e7–562.e16.
18.
JohnsonJKStewartALAcreeM, et al.A community choir intervention to promote well-being among diverse older adults: results from the Community of Voices Trial. J Gerontol B Psychol Sci Soc Sci2020; 75: 549–559.
19.
HolmesCKnightsADeanC, et al.Keep music live: music and the alleviation of apathy in dementia subjects. Int Psychogeriatr2006; 18: 623–630.
20.
SakamotoMAndoHTsutouA. Comparing the effects of different individualized music interventions for elderly individuals with severe dementia. Int Psychogeriatr2013; 25: 775–784.
21.
CheungDSKLaiCKYWongFKY, et al.The effects of the music-with-movement intervention on the cognitive functions of people with moderate dementia: a randomized controlled trial. Aging Ment Health2018; 22: 306–315.
22.
SiponkoskiS-TPitkäniemiALaitinenS, et al.Efficacy of a multicomponent singing intervention on communication and psychosocial functioning in chronic aphasia: a randomized controlled crossover trial. Brain Commun2023; 5: fcac337.
23.
FälthNBrorssonALondosE. Choral singing enriches everyday life for people with mild to moderate dementia and their family caregivers. J Psychosoc Nurs Ment Health Serv2022; 60: 29–36.
24.
JohnsonJKLouhivuoriJStewartAL, et al.Quality of life (QOL) of older adult community choral singers in Finland. Int Psychogeriatr2013; 25: 1055–1064.
25.
SixsmithAGibsonG. Music and the wellbeing of people with dementia. Ageing Soc2007; 27: 127–145.
26.
BournePCamicPMCrutchSJ. Psychosocial outcomes of dyadic arts interventions for people with a dementia and their informal caregivers: a systematic review. Health Soc Care Community2021; 29: 1632–1649.
27.
DowsonBMcDermottOSchneiderJ. What indicators have been used to evaluate the impact of music on the health and wellbeing of people with dementia? A review using meta-narrative methods. Maturitas2019; 127: 26–34.
28.
BakerFKroutR. Songwriting via Skype. Br J Music Ther2009; 23: 3–14.
29.
FancourtDSteptoeA. Present in body or just in mind: differences in social presence and emotion regulation in live vs. virtual singing experiences. Front Psychol2019; 10: 778.
30.
StegemöllerELDiazKCraigJ, et al.The feasibility of group therapeutic singing telehealth for persons with Parkinson’s disease in rural Iowa. Telemed J E Health2020; 26: 66–70.
31.
TamplinJMorrisMEMariglianiC, et al.Parkinsong: outcomes of a 12-month controlled trial of therapeutic singing groups in Parkinson’s disease. J Parkinsons Dis2020; 10: 1217–1230.
32.
TamplinJLoveridgeBClarkeK, et al.Development and feasibility testing of an online virtual reality platform for delivering therapeutic group singing interventions for people living with spinal cord injury. J Telemed Telecare2020; 26: 365–375.
33.
DowsonBSchneiderJMcDermottO, et al.Online singing groups for people with dementia: adaptation and resilience in the face of the COVID-19 pandemic. Dementia2023; 22: 1348–1371.
34.
DowsonBAtkinsonRBarnesJ, et al.Digital approaches to music-making for people with dementia in response to the COVID-19 pandemic: current practice and recommendations. Front Psychol2021; 12: 625258.
35.
TamplinJThompsonZ. How health-focused choirs adapted to the virtual world during the COVID-19 pandemic - an international survey. Arts Psychother2023; 82: 101997.
36.
KellyLClements-CortésAAhessyB, et al.“Follow the musical road”: selecting appropriate music experiences for people with dementia living in the community. Int J Environ Res Public Health2023; 20: 5818.
37.
MacDonaldRZumbansenA. Successful online choir for people living with dementia: a qualitative case study. OBM Integr Complement Med2023; 8: 024.
38.
LeeSO’NeillDMossH. Dementia-inclusive group-singing online during COVID-19: a qualitative exploration. Nord J Music Ther2022; 31: 308–326.
39.
DowsonBSchneiderJ. Online singing groups for people with dementia: scoping review. Public Health2021; 194: 196–201.
40.
DaffernHBalmerKBreretonJ. Singing together, yet apart: the experience of UK choir members and facilitators during the COVID-19 pandemic. Front Psychol2021; 12: 624474.
KrendlACPerryBL. The impact of sheltering in place during the COVID-19 pandemic on older adults’ social and mental well-being. J Gerontol B Psychol Sci Soc Sci2021; 76: e53–e58.
43.
López-CanoMANavarroBNietoM, et al.Autobiographical emotional induction in older people through popular songs: effect of reminiscence bump and enculturation. PLoS One2020; 15: e0238434.
44.
BelfiAMKarlanBTranelD. Music evokes vivid autobiographical memories. Memory2016; 24: 979–989.
SchweitzerPBruceE. Remembering yesterday, caring today: reminiscence in dementia care: a guide to good practice. Philadelphia, PA: Jessica Kingsley Publishers, 2008.
CocuzzoBWrenchAO’MalleyC. Effects of COVID-19 on older adults: physical, mental, emotional, social, and financial problems seen and unseen. Cureus2022; 14: e29493.
BonakdarpourBMcFaddenAZlotkowskiS, et al.Neurology telemusic program at the time of the COVID-19 pandemic: turning hospital time into aesthetic time during crisis. Front Neurol2021; 12: 749782.
54.
TanJTsakokFHMOwEK, et al.Study protocol for a randomized controlled trial of choral singing intervention to prevent cognitive decline in at-risk older adults living in the community. Front Aging Neurosci2018; 10: 195.
55.
WilliamsEDingleGACliftS. A systematic review of mental health and wellbeing outcomes of group singing for adults with a mental health condition. Eur J Public Health2018; 28: 1035–1042.
56.
DingleGASharmanLSBauerZ, et al.How do music activities affect health and well-being? A scoping review of studies examining psychosocial mechanisms. Front Psychol2021; 12: 713818.
57.
FancourtDPerkinsR. Effect of singing interventions on symptoms of postnatal depression: three-arm randomised controlled trial. Br J Psychiatry2018; 212: 119–121.
58.
GickML. Singing, health and well-being: a health psychologist’s review. Psychomusicology2011; 21: 176–207.
59.
FancourtDWilliamonA. Attending a concert reduces glucocorticoids, progesterone and the cortisol/DHEA ratio. Public Health2016; 132: 101–104.
60.
BeckRJCesarioTCYousefiA, et al.Choral singing, performance perception, and immune system changes in salivary immunoglobulin A and cortisol. Music Percept2000; 18: 87–106.
61.
KeelerJRRothEANeuserBL, et al.The neurochemistry and social flow of singing: bonding and oxytocin. Front Hum Neurosci2015; 9: 518.
62.
PerryGPolitoVThompsonWF. Exploring the physiological and psychological effects of group chanting in Australia: reduced stress, cortisol and enhanced social connection. J Relig Health2024; 63: 4793–4815.
63.
ThompsonZBakerFATamplinJ, et al.How singing can help people with dementia and their family care-partners: a mixed studies systematic review with narrative synthesis, thematic synthesis, and meta-integration. Front Psychol2021; 12: 764372.
64.
GrapeCSandgrenMHanssonL-O, et al.Does singing promote well-being?: an empirical study of professional and amateur singers during a singing lesson. Integr Physiol Behav Sci2003; 38: 65–74.
65.
KreutzGBongardSRohrmannS, et al.Effects of choir singing or listening on secretory immunoglobulin A, cortisol, and emotional state. J Behav Med2004; 27: 623–635.
66.
LewisACavePSternM, et al.Singing for lung health—a systematic review of the literature and consensus statement. NPJ Prim Care Respir Med2016; 26: 16080.
67.
VickhoffBMalmgrenHAströmR, et al.Music structure determines heart rate variability of singers. Front Psychol2013; 4: 334.
68.
CliftSMHancoxG. The perceived benefits of singing: findings from preliminary surveys of a university college choral society. J R Soc Promot Health2001; 121: 248–256.
69.
Batt-RawdenKBStedjeK. Singing as a health-promoting activity in elderly care: a qualitative, longitudinal study in Norway. J Res Nurs2020; 25: 404–418.
70.
FlemingR. Music and mind: harnessing the arts for health and wellness. New York, NY: Penguin, 2024.
71.
CammisuliDMCiprianiGGiustiEM, et al.Effects of reminiscence therapy on cognition, depression and quality of life in elderly people with Alzheimer’s disease: a systematic review of randomized controlled trials. J Clin Med Res2022; 11: 5752.
72.
PrickettCABridgesMS. Song repertoire across the generations: a comparison of music therapy majors’ and senior citizens’ recognitions. J Music Ther2000; 37: 196–204.
73.
BonakdarpourBSchaferRMillerJ, et al.Group singing programs for well-being of older adults: an in-person quantitative follow-up. In: Alzheimer’s association international conference. ALZ, https://alz.confex.com/alz/2024/meetingapp.cgi/Paper/93587 (2024).
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