TYPE Original Research

PUBLISHED 30 January 2025

DOI 10.3389/fpsyg.2025.1526761

Exploring the effects of

OPEN ACCESS combined nostalgic activities and
music therapy on Alzheimer’s
EDITED BY
Lawrence M. Parsons,
The University of Sheffield, United Kingdom

REVIEWED BY
Kriti Mishra,
disease outcomes
Lincoln County Hospital, United Kingdom
Mina Sufineyestani,
Heriot-Watt University, United Kingdom Yunqiu Zhang, Yunqiong Wang, Qiao Liu, Jun Xiao, Ling Huang,
*CORRESPONDENCE Lan Zhou and Xuemei Liu*
Xuemei Liu
1441388429@[Link] Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine,
University of Electronic Science and Technology of China, Chengdu, China
RECEIVED 13 November 2024
ACCEPTED 13 January 2025
PUBLISHED 30 January 2025

CITATION Objective: Exploring the effects of combination of nostalgic activity-based

Zhang Y, Wang Y, Liu Q, Xiao J, Huang L, therapies, including music therapy on cognitive function, negative emotions, and
Zhou L and Liu X (2025) Exploring the effects
sleep quality in patients with mild to moderate Alzheimer’s disease.
of combined nostalgic activities and music
therapy on Alzheimer’s disease outcomes. Methods: A total of 63 patients with mild to moderate Alzheimer’s disease who
Front. Psychol. 16:1526761.
were treated at the Sichuan Provincial Psychiatric Center of the People’s Hospital
doi: 10.3389/fpsyg.2025.1526761
of Sichuan Province from January to June 2023 were selected as the research
COPYRIGHT
© 2025 Zhang, Wang, Liu, Xiao, Huang, Zhou
subjects. They were randomly divided into a study group (n = 31) and a control
and Liu. This is an open-access article group (n = 32) using a random number table method. The control group received
distributed under the terms of the Creative routine treatment and nursing care, while the study group received nostalgic
Commons Attribution License (CC BY). The
use, distribution or reproduction in other
music therapy intervention on the basis of the control group. The Mini Mental
forums is permitted, provided the original State Examination (MMSE), Montreal Cognitive Assessment Scale (MOCA), Self
author(s) and the copyright owner(s) are Rating Anxiety and Depression Scale (SAS, SDS), and Pittsburgh Sleep Quality
credited and that the original publication in
this journal is cited, in accordance with
Index (PSQI) of the two groups were compared.
accepted academic practice. No use, Results: A total of 30 cases from each group completed the study. After 12
distribution or reproduction is permitted
which does not comply with these terms.
weeks of intervention, the MMSE and MOCA scores of both groups of patients
increased, and the treatment group was higher than the control group (P < 0.05);
SAS, SDS and PSQI scores decreased compared with those before intervention,
and the treatment group was lower than the control group (P < 0.05).
Conclusion: Nostalgic music therapy can improve cognitive function, alleviate
negative emotions, and improve sleep quality in patients with mild to moderate
Alzheimer’s disease.

KEYWORDS

Alzheimer’s disease, nostalgic music therapy, cognitive function, negative emotions,

sleep quality

1 Introduction
Alzheimer’s disease (AD) is an irreversible neurodegenerative disease characterized
by acquired cognitive impairment. Its primary clinical manifestations include progressive
intellectual decline, behavioral abnormalities, and deterioration in daily activities (Wang
et al., 2024). Due to the aging population, AD has become a leading cause of
disability and death among the elderly (Safiri et al., 2024). In China, the number
of individuals over 60 years old diagnosed with AD has reached 9.83 million, with
prevalence progressively increasing with age. As the disease advances, it affects basic
bodily functions such as walking and swallowing, significantly reducing the quality
of life. This condition not only reduces the quality of life for the elderly but also
imposes a substantial burden on families and society (2017). While medications can

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enhance physical function and sleep quality in patients, they are years, with ability to complete all neuropsychological assessments;
often associated with side effects such as nausea, loss of appetite, and (3) a Mini-Mental State Examination (MMSE) score of 10–
diarrhea, vomiting, and weight loss (Jia et al., 2020). These 24. Exclusion criteria included: (1) significant auditory or visual
limitations have driven the exploration of non-pharmacological impairment; (2) severe diseases of major organs (e.g., heart, liver,
interventions, which offer safer, low-cost alternatives to alleviate kidney) or other serious physical illnesses; and (3) history of
AD symptoms. Thus, non-pharmacological interventions— organic or affective mental disorders. The cognitive functions
including exercise, social activities, music therapy, cognitive were measured at the time of patient admission. Sample size
challenges, and a balanced diet—are recommended as preventive was calculated using G-Power software with reference to previous
measures with fewer side effects (Mühlbauer et al., 2021; Langoni studies (McKhann et al., 1984), assuming a 10% attrition rate,
et al., 2019; Higuti et al., 2021). yielding a target of 30 cases per group. All participants in both
Music therapy is a one such non-pharmacological intervention the intervention and control groups continued their standard
that has garnered attention due to its potential to maintain and pharmacological treatments for Alzheimer’s disease throughout the
improve cognitive function and social behavior in Alzheimer’s study. A total of 63 patients were enrolled, randomly allocated
disease patients (Cuddy et al., 2015; Li et al., 2015). Numerous to the treatment group (n = 31) or control group (n =
studies have shown that music therapy can enhance various 32). A CONSORT flowchart of the present study is shown in
cognitive and psychological aspects, including attention, memory, Figure 1.
orientation, depression, and anxiety (Shokri et al., 2023; Raglio
et al., 2014; Sun et al., 2024). Non-pharmacological treatments
have become essential in both preventing and alleviating symptoms 2.2 Training protocol
of AD. Music therapy (Moreira et al., 2023) and reminiscence
therapy (Bleibel et al., 2023), in particular, work by stimulating the The control group received standard care, which included
brain to awaken individuals’ positive memories, with meaningful routine lifestyle care, health education, monitoring of patients’
music further enhancing the recall experience. These therapies condition, administration of medications as prescribed, and
have shown positive effects on patients’ physical, psychological, and participation in regular recreational activities. These activities
social wellbeing, although few studies have examined the impact of included 30-min group sessions of Tai Chi or calisthenics each
their combined intervention. Bayram (2024) found that activities afternoon and singing or movie-watching sessions on Monday,
and discussions centered around family or traditional cultural Wednesday, and Friday afternoons. In addition to standard care,
experiences are crucial in reminiscence therapy. Music associated the treatment group received nostalgia-based music therapy.
with cultural themes, moreover, can evoke positive memories Since individuals from the same country often resonate with
and enhance subjective wellbeing (Macleod et al., 2021). While their traditional culture, this study was designed around Chinese
music therapy has been extensively studied, the integration of traditional solar terms, using relevant music, customs, and activities
cultural or nostalgic music with activities remains underexplored. as core elements. The intervention process was as follows: (1)
Thus, incorporating music and activities rooted in traditional Formation of a nostalgia music intervention team, consisting of
culture as core elements of reminiscence music therapy could one chief neurologist, two psychotherapists, three senior neurology
represent a novel and effective strategy for symptom management nurses, and three nurse practitioners. The team discussed and
in AD patients. revised the intervention plan, finalizing it following a pilot test
This study seeks to address these gaps by exploring the within the hospital. The head nurse served as the team leader,
innovative integration of nostalgia-based music therapy with providing pre-activity training to team members and clarifying
traditional cultural activities. The inclusion of cultural activities, their responsibilities. (2) Intervention methods: 12 significant
such as those rooted in local customs and traditions, is Chinese solar terms, such as Beginning of Spring, Awakening of
hypothesized to create a richer, more meaningful context for Insects, Pure Brightness, Grain in Ear, Summer Solstice, Great
therapy, thereby enhancing its efficacy. We hypothesize that the Heat, White Dew, Autumn Equinox, Descent of Frost, Beginning
combination of nostalgia-based music therapy and culturally- of Winter, Winter Solstice, and Great Cold, were chosen as
themed activities, particularly those rooted in traditional Chinese activity themes. Each theme was accompanied by 10–15 images,
solar terms, can produce a synergistic effect on the cognitive, a song, and interactive games related to the theme. Handcraft
emotional, and sleep outcomes of AD patients. activities were included to improve participants’ cognitive and
coordination abilities, enhancing engagement and enjoyment.
Participants were divided into three groups of 8–10 individuals
2 Materials and methods each. (a) Each session began with a welcome song, followed
by introductions among the leader and members (2 min); (b)
2.1 Study design Listening to and singing along with music related to the solar
term (15 min); (c) Distributing images for participants to select
This study is a randomized clinical trial, patients with mild- those related to the theme and identify them correctly, followed
to-moderate Alzheimer’s disease (AD) who attended Sichuan by discussions of the theme and sharing positive memories
Provincial People’s Hospital or Sichuan Mental Health Center or experiences associated with the solar term (15 min); (d)
between January and June 2023 were selected as study subjects. Engaging in traditional customs-themed games and handcraft
Inclusion criteria included: (1) fulfillment of AD diagnostic criteria activities, such as origami, paper cutting, creative drawing, and
established by the NINCDS-ADRDA (Rio, 2018); (2) age ≥60 clay modeling, with participants free to choose based on their

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FIGURE 1
Schematic overview of study timeline (CONSORT flow diagram).

interests (25 min); (e) Concluding with a recap and singing a and rounded to the nearest integer to obtain the standard score.
closing song (3 min). (3) Intervention duration: Each themed Higher scores indicate more severe negative emotions (Folstein
activity session lasted ∼60 min, conducted once per week for a total et al., 1975).
of 12 weeks. Sleep quality was assessed using the Pittsburgh Sleep Quality
Index (PSQI) before and after the intervention in AD patients. This
scale comprises 18 self-rated items grouped into seven components:
2.3 Outcome measures sleep quality, sleep latency, sleep duration, sleep efficiency, sleep
disturbances, use of sleep medication, and daytime dysfunction.
Cognitive function, assessed using the Mini-Mental State Each component is rated on a scale from 0 to 3, with a total score
Examination (MMSE) and the Montreal Cognitive Assessment ranging from 0 to 21. Higher scores indicate poorer sleep quality.
Scale (MOCA). The MMSE provides a preliminary assessment
of cognitive function for screening and follow-up, covering
domains such as orientation, memory, calculation, attention, recall,
2.4 Ethical aspect
naming, language, and visuospatial function (Faul et al., 2007).
The MOCA includes spatial ability, naming, attention, sentence
All procedures involving human participants were conducted
repetition, fluency, abstraction, delayed recall, and orientation, with
in alignment with the Declaration of Helsinki. The Ethics
a Cronbach’s α coefficient of 0.933 and a correlation coefficient
Committee of Sichuan Provincial People’s Hospital approved this
with the MMSE total score of 0.825, indicating high reliability
study (approval number: 357[2021]).
and validity. Both scales have a maximum score of 30, with an
MMSE score of ≥27 and a MOCA score of ≥26 indicating normal
cognitive function.
Psychological status was assessed using the Self-Rating Anxiety 2.5 Statistical analysis
Scale (SAS) and the Zung Self-Rating Depression Scale (SDS)
before and after the intervention in both groups. The SAS and Data analysis was performed using SPSS version 26.0 and
SDS each contain 20 items, with total scores multiplied by 1.25 Python 3, with data independently entered by two researchers.

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TABLE 1 Baseline characteristics of patients in the treatment and control

groups before intervention.
3.3 Sleep quality

Treatment Control P-value No significant differences were observed in baseline PSQI

group group scores between the two groups. As shown in Figure 2, both groups
(n = 30) (n = 30) exhibited a downward trend in the sleep quality, sleep onset
Gender 0.605 time, total sleep time, sleep efficiency, sleep disorders, sleep aids,
Male 17 (56.7%) 14 (46.7%)
daytime dysfunction, and total score. Post-intervention, both the
control and experimental groups showed statistically significant
Female 13 (43.3%) 16 (53.3%)
improvements in PSQI-related sleep indices. The experimental
Age (years) 65.0 [61.2 ;67.0] 64.5 [62.0; 67.8] 0.779 group showed significantly greater improvements in the total score
Duration of AD 4.00 [3.00; 4.75] 4.00 [3.25; 5.00] 0.200 and individual indicators compared to the control group, with
(years) statistical significance (Table 4). Overall, after 12 weeks of the
Education level 0.779 training program, the experimental group exhibited significant
improvements in all sleep performance indicators compared to the
Primary school 5 (16.7%) 4 (13.3%)
control group.
Junior high 22 (73.3%) 20 (66.7%)
school

Senior high 3 (10.0%) 5 (16.7%) 4 Discussion

school

University 0 (0.00%) 1 (3.33%) The primary aim of this study is to assess the impact of
combined nostalgic music therapy on cognitive function, negative
emotions, and sleep quality in patients with mild to moderate
Alzheimer’s disease (AD). The results indicate that combined
Variable normality was assessed via the Shapiro–Wilk test. nostalgic music therapy resulted in significant improvements in
Quantitative data are reported as mean ± standard deviation, cognitive function, negative emotions, and sleep quality compared
while categorical data are presented as frequencies and percentages. to the control group. The findings suggest that incorporating
Independent-sample t-tests, paired t-tests, and chi-square (χ ²) tests combined nostalgic music and other cognitive stimuli into routine
were applied as appropriate, with statistical significance defined at treatment and care may enhance neural activation and arousal,
α = 0.05. leading to improved psychological and physical outcomes and
additional benefits.
Due to the aging population, AD has become a leading
3 Results cause of disability and death among the elderly (Dunstan et al.,
2017). In addition to the gradual decline in cognitive function,
3.1 Baseline assessment AD is often accompanied by emotional changes, behavioral
abnormalities, negative emotions such as anxiety and depression,
During the study, one case in the treatment group was lost due
as well as sleep disorders and hallucinations (Jacobsen et al., 2015).
to health reasons, and two cases in the control group were lost due
The condition typically progresses over time, and most patients
to disease progression and death, leaving 30 cases completed in
eventually lose their ability to live independently (García-Navarro
each group. A comparison of baseline characteristics between the
et al., 2022). Numerous studies have shown that systematic,
two groups showed no statistically significant differences (P > 0.05)
comprehensive, and regular non-pharmacological treatments can
(Table 1).
improve brain structure and functional plasticity in AD patients,
alleviate clinical symptoms, delay disease progression, enhance
social participation, and improve patients’ quality of life (Jiménez-
3.2 Cognitive and emotional performance Palomares et al., 2024; Rajendran and Krishnan, 2024; Ting et al.,
2024). For instance, Shokri et al. investigated the effects of remote
There was no significant difference between groups at the music and exercise training on cognitive and physical functions
MMSE and MOCA test at baseline (p > 0.05). As shown in in AD patients, reporting significant improvements in MMSE
Figure 2, both groups demonstrated an improvement in MMSE scores and physical performance measures in the group receiving
and MOCA scores from baseline after the intervention. Following combined music and exercise training compared to exercise-only
the intervention, MMSE and MOCA scores in the treatment and control groups (Shokri et al., 2023). Their findings underscore
group were significantly higher than those in the control group the importance of multi-modal interventions in addressing the
(P < 0.05), as shown in Table 2. There were no significant multifaceted challenges of AD. Nostalgic music therapy utilizes
differences in baseline SAS and SDS scores between the two traditional festivals, specific music, and past life experiences to
groups (P > 0.05). As depicted in Figure 2, both groups showed stimulate the brain and awaken pleasant and meaningful memories
a reduction in SAS and SDS scores following the intervention. related to past events, thus enhancing the recollection experience
The changes in SAS and SDS scores were significantly greater (Ismail et al., 2018). Research has shown that musical stimulation
in the treatment group than in the control group (P < 0.05) activates specific brain regions, such as the hypothalamus and
(Table 3). hippocampus, and regulates cognitive and emotional functions

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FIGURE 2
The scores of the cognitive, physical and sleep quality tests following the treatment.

TABLE 2 Comparison of MMSE and MoCA scores in patients before and after intervention between treatment and control groups.

Treatment group (n = 30) Control group (n = 30) t P-value

MMSE Basal Mean (SD) 18.17 ± 3.69 17.67 ± 3.25 0.556 0.580
∗ ∗
Final Mean (SD) 19.97 ± 3.15 18.30 ± 2.91 2.129 0.038

MOCA Basal Mean (SD) 12.13 ± 4.17 11.63 ± 3.27 0.517 0.607
∗ ∗
Final Mean (SD) 14.73 ± 5.27 12.30 ± 3.88 2.036 0.046
The indexes were compared with those before intervention. ∗ P < 0.05.

TABLE 3 Comparison of SAS and SDS scores in patients before and after intervention between treatment and control groups.

Treatment group (n = 30) Control group (n = 30) t P-value

SAS Basal Mean (SD) 51.00 ± 4.15 51.47 ± 4.29 −0.428 0.670
∗ ∗
Final Mean (SD) 47.03 ± 3.05 49.20 ± 4.5 −2.180 0.033

SDS Basal Mean (SD) 52.33 ± 5.60 52.13 ± 5.18 0.144 0.886

Final Mean (SD) 46.23 ± 3.72∗ 49.03 ± 4.06∗ −2.787 0.007

The indexes were compared with those before intervention. ∗ P < 0.05.

(Plourde-Kelly et al., 2021). Chéour et al. (2023) conducted a (MMSE, ADAS-Cog) and motor (step length, walking speed, and
randomized controlled trial to evaluate the effects of MT and BBS) functions, with MT showing a stronger influence on cognition
physical rehabilitation (PR), either individually or in combination, and PR on motor abilities. Similar to these studies, our results
on cognitive and motor functions in elderly Tunisian patients show a positive impact of nostalgic music therapy on cognitive
with mild AD. Their findings revealed that combined MT and functions, as evidenced by significant improvements in the MMSE
PR interventions yielded the greatest improvements in cognitive and MOCA scores. While Chéour et al. highlighted the synergistic

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TABLE 4 Comparison of PSQI scores in patients before and after intervention between treatment and control groups.

Group Treatment group (n = 30) Control group (n = 30) t P-value

Sleep quality Basal Mean (SD) 1.70 ± 0.99 1.90 ± 0.89 −0.428 0.670
∗ ∗
Final Mean (SD) 0.70 ± 0.79 1.27 ± 0.64 −2.180 0.033

Sleep onset time Basal Mean (SD) 2.17 ± 1.02 2.13 ± 0.86 0.144 0.886
∗ ∗
Final Mean (SD) 1.10 ± 0.61 1.67 ± 0.61 −2.787 0.007

Total sleep time Basal Mean (SD) 1.27 ± 1.08 1.57 ± 0.94 −1.150 0.255

Final Mean (SD) 0.80 ± 0.71∗ 1.33 ± 0.76∗ −2.804 0.007

Sleep efficiency Basal Mean (SD) 1.40 ± 1.28 1.73 ± 1.08 −1.092 0.279
∗ ∗
Final Mean (SD) 0.80 ± 0.76 1.30 ± 0.84 0.279 0.019

Sleep disorders Basal Mean (SD) 1.63 ± 0.85 1.73 ± 0.83 −0.462 0.646
∗ ∗
Final Mean (SD) 0.90 ± 0.71 1.43 ± 0.63 −3.081 0.003

Sleep aids Basal Mean (SD) 1.13 ± 1.25 1.43 ± 1.10 −0.984 0.329

Final Mean (SD) 0.37 ± 0.56∗ 0.90 ± 0.71∗ −3.234 0.002

Daytime Basal Mean (SD) 1.87 ± 1.01 2.00 ± 0.83 −0.559 0.578
dysfunction
Final Mean (SD) 0.83 ± 0.59∗ 1.33 ± 0.61∗ −3.231 0.002

Total score Basal Mean (SD) 11.13 ± 4.38 12.10 ± 4.05 −0.887 0.379

Final Mean (SD) 6.73 ± 2.21∗ 8.80 ± 2.82∗ −3.158 0.003

The indexes were compared with those before intervention. ∗ P < 0.05.

effects of MT and PR, our study delves deeper into the cognitive particularly those focused on cultural experiences, help evoke
and emotional impacts of nostalgic music therapy, specifically positive memories and improve mood.
designed to evoke personal and cultural memories. Additionally, Sleep disturbances are a common clinical symptom of
by helping patients recall the details of past experiences, it AD and also serve as a contributing and exacerbating factor.
promotes neurogenesis and cell repair, thus enhancing cognitive Approximately 50% of AD patients experience sleep disorders,
function (Raglio et al., 2014). Our study expands on previous which can result in complications such as immune dysfunction
research by combining nostalgic music with other cognitive stimuli, and neurotransmitter imbalances. These issues lead to progressive
demonstrating that such an integrative approach may enhance the declines in patients’ behavioral abilities, cognitive, and social
therapeutic effects. functions, thereby increasing both the mental and physical burdens
The prevalence of anxiety and depression in AD patients on caregivers (Lacerda et al., 2024). Therefore, enhancing sleep
exceeds 60%, with over 50% of patients experiencing both anxiety care for AD patients is critical for improving their health outcomes
and depression simultaneously. These emotional disturbances and reducing the burden on families and society. Studies indicate
have a negative impact on cognitive function and overall health that active music therapy can effectively harmonize physiological,
outcomes in AD patients (Pagonabarraga et al., 2023). Research psychological, and emotional states, thus contributing to improved
has shown that music listening and recall can activate the brain’s sleep quality (Keskin Töre and Yagmur, 2023; Lin et al., 2024;
limbic and adjacent regions, while also promoting the release Lund et al., 2023; Mu et al., 2022). Results from this study
of biochemical mediators such as endorphins and dopamine, indicate that patients receiving nostalgic music therapy had
which induce a state of relaxation in patients (Saragih et al., significantly lower PSQI scores across various domains and overall
2022). In this study, nostalgic music therapy—designed around compared to the control group. This effect may be attributed
China’s traditional solar terms—was shown to alleviate symptoms to the therapy’s use of traditional seasonal themes to create a
of anxiety and depression, which is consistent with findings from comforting atmosphere, guiding patients in recalling pleasant
previous studies on music therapy The incorporation of personal memories from the past. This process, enhanced through music and
experiences, such as events tied to the solar terms, and the use of interactive games, helped alleviate anxiety, thereby mitigating the
photos or musical cues, facilitated the recall of positive memories negative impact of these emotions on sleep quality. Additionally,
and created a joyful atmosphere, thus improving emotional the interaction between musical sound waves and the brain can
wellbeing. This highlights the importance of fostering positive increase neuronal excitability, aiding in the regulation of circadian
memories and creating an emotionally supportive environment as rhythms and ultimately supporting better sleep quality (Zaatar
key factors in alleviating negative emotions during the treatment et al., 2024; Chen et al., 2023). Caregivers and therapists have
and rehabilitation of AD patients. These results are consistent with observed that nostalgic music therapy brings positive experiences
previous research that suggests music and reminiscence therapies, for patients across different sessions, stemming from memories

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evoked by music, past experiences, and connections with others. 5 Conclusion

These observations should be interpreted with caution, and future
studies should incorporate structured evaluations to validate In conclusion, our findings suggest that integrating
these claims. This study was designed around the traditional nostalgic music with routine daily care as an appropriate
Chinese solar terms, incorporating related music, customs, and non-pharmacological intervention can improve cognitive
activities as core elements for intervention in AD patients. In function, alleviate negative emotions, and enhance sleep quality
summary, the application of nostalgic music combination therapy in Alzheimer’s disease (AD) patients, while also reducing the
effectively improves cognitive function in patients with mild to societal burden of the disease. This approach not only offers
moderate AD, alleviates anxiety and depression, and enhances potential benefits for patient wellbeing but also provides broader
sleep quality. implications for Alzheimer’s care by highlighting the value of
However, this study has several limitations. These include a culturally resonant, individualized therapeutic strategies within
small sample size, the absence of long-term effect validation, and healthcare practices. Based on these results, we recommend
the potential confounding effect of continued pharmacological that neurologists consider incorporating nostalgic music therapy
treatments, which cannot be entirely ruled out in the observed alongside pharmacological treatments as part of the comprehensive
outcomes. Additionally, the short duration of the intervention and patient-centered approach to managing AD. However, our
(60 min per session) may limit the sustainability of the observed study is subject to certain limitations, including the small sample
effects. The therapy duration was based on practicality and patient size, relatively short intervention duration, and its cultural
comfort, but longer sessions or more frequent interventions specificity, which may limit the generalizability of the findings.
may yield stronger and more lasting outcomes. Furthermore, Future research should focus on validating these outcomes in larger
baseline characteristics, such as disease severity, comorbidities, and more diverse populations, examining the long-term effects
and demographic factors, were not fully controlled for, which of combined nostalgic music therapy on cognitive and emotional
could introduce confounding variables. Moreover, the intervention health in AD patients.
was rooted in Chinese cultural practices, specifically the use of
traditional solar terms and culturally significant music, which
may limit its applicability in non-Chinese populations. Future Data availability statement
studies should explore the effectiveness of culturally adapted
versions of the therapy in diverse populations to assess their The original contributions presented in the study are included
universal effectiveness. Another important limitation is the in the article/supplementary material, further inquiries can be
lack of long-term follow-up data to evaluate the sustainability directed to the corresponding author.
of the effects of nostalgic music therapy. Future research
should consider extending the duration of the intervention
and conducting longitudinal studies to determine the lasting Ethics statement
impact on cognitive function, emotional wellbeing, and
sleep quality. The studies involving humans were approved by Sichuan
Future studies should explore several avenues to build Provincial People’s Hospital approved this study (approval number:
upon the current findings. First, it is important to evaluate the 357[2021]). The studies were conducted in accordance with the
differential impacts of live vs. recorded music to determine which local legislation and institutional requirements. The participants
format is more effective in enhancing cognitive function, provided their written informed consent to participate in this study.
emotional wellbeing, and sleep quality in AD patients.
Additionally, research should focus on the long-term effects Author contributions
of nostalgic music therapy and whether its benefits are sustained
over time. Finally, as our study utilized a culturally specific YZ: Formal analysis, Investigation, Methodology, Writing –
intervention, it would be valuable to investigate the applicability original draft, Writing – review & editing, Data curation. YW:
of similar therapies in non-Chinese populations to assess their Data curation, Investigation, Writing – review & editing. QL:
universal effectiveness. Writing – review & editing, Investigation, Methodology. JX:
Despite these limitations, the study provides valuable insights Data curation, Investigation, Writing – review & editing. LH:
into the potential role of nostalgic music therapy in improving Formal analysis, Investigation, Writing – review & editing. LZ:
outcomes for AD patients. The findings contribute to the broader Data curation, Formal analysis, Writing – review & editing. XL:
understanding of AD care by demonstrating the potential of Conceptualization, Funding acquisition, Project administration,
non-pharmacological interventions, particularly music therapy, Supervision, Writing – original draft, Writing – review & editing.
in enhancing cognitive, emotional, and physical wellbeing.
Our results suggest that nostalgic music therapy may be an
effective, low-cost, and non-invasive addition to routine care Funding
plans for AD patients. Given its simplicity and accessibility,
this intervention could be widely implemented in clinical and The author(s) declare financial support was received for the
home settings, offering a complementary approach to traditional research, authorship, and/or publication of this article. This work
pharmacological treatments. was supported by the Chengdu Municipal Financial Science and

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Technology Project (No. 2021-YF05-01749-SN) and the Sichuan Generative AI statement

Provincial Cadre Health Research Project (No. 2021-236).
The author(s) declare that no Gen AI was used in the creation
of this manuscript.
Acknowledgments
We would like to express our gratitude to all the medical staff
and patients who participated in this study.
Publisher’s note
All claims expressed in this article are solely those of the
Conflict of interest authors and do not necessarily represent those of their affiliated
organizations, or those of the publisher, the editors and the
The authors declare that the research was conducted in the reviewers. Any product that may be evaluated in this article, or
absence of any commercial or financial relationships that could be claim that may be made by its manufacturer, is not guaranteed or
construed as a potential conflict of interest. endorsed by the publisher.

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