Choral singing is a unique activity that encompasses and integrates many aspects of cognition and learning. It is a simultaneously social, emotional, physical, and cognitive activity that has therefore been suggested as a useful addition to health promotion interventions. This dissertation explores an integrated perspective of choral singing and cognition using mixed-methods.

Study I investigated how different learning formats affect song lyric learning. Participants were asked to learn a new song by ear and were randomized into one of three conditions: AI (audio with images), A (audio only), or AT (audio and text). Hypotheses were formulated using established theories from cognitive and learning psychology that had not previously been applied to song learning, such as dual coding theory, picture superiority effect, and levels of processing. The study showed that using pictures significantly improved learning the song lyrics compared to the other two conditions.

Study II had two aims. First, it aimed to apply design thinking, an established framework in many other fields, to a new domain: a choral singing intervention for psychological research. The second aim was to use design thinking and qualitative methods to design a health-promoting choral singing intervention for Study III. Focus group analyses and co-creation with participants – senior singers in choirs without audition requirements – formed the basis for creating a specification for the choral singing intervention in Study III. The study also presented a selection of the analyses to illustrate how design thinking was used.

Study III was a choral singing intervention for healthy older adult beginners. It had a within-group design that included three identical data collections (T1-T3), which were spaced approximately 11 months apart. T1-T2 constituted a passive control period, while T2-T3 constituted a choral singing intervention, which included weekly repetitions. At each data collection, participants took logical memory tests and underwent functional magnetic resonance imaging (fMRI) while performing an episodic memory task. The results showed a significant dose-effect relationship between the frequency of choral rehearsal attendance and improvement on the memory tests. Additionally, a dose-effect relationship was observed between rehearsal attendance and hippocampal activity during the episodic memory task. Finally, the results showed increased effective functional connectivity between the prefrontal cortex, fusiform cortex, and hippocampus after the intervention. It was concluded that regular choral singing can improve memory task performance, particularly among older adults.

This dissertation concludes that choir singing is a promising strategy for cognitive health promotion in elderly, and that more research in this area is warranted, particularly using mixed-methods, since choral singing is a complex activity with a diverse set of practices. Hence, future interventions involving choral singing could be more precisely tailored, and more specific conclusions could be drawn about which factors in choral singing promote cognitive health.

Introduction: Lifestyle factors are important predictors of successful aging, and targeted interventions could be key to mitigating the negative effects of aging. Episodic memory is of particular interest as it is notably sensitive to aging. Given the social, intellectual, and physical stimulation that choral singing provides, along with the enjoyment it offers which is a strong motivator, it has been suggested as a particularly promising intervention to promote successful aging.

Method: Thirty-four participants, aged 65 to 75 at recruitment, took part in a choral singing intervention involving 47 weekly 1.5-h rehearsals. The study included examinations at three time points: T1, T2, and T3. A control period (T1-T2) was followed by the intervention period (T2-T3), each lasting approximately 11 months. At each assessment, episodic memory was measured with the Wechsler Memory Scale (WMS-LMI, WMS-LMII), and participants completed an fMRI Face-Name Paired Associates Task (FN-PA) to examine brain activity during memory encoding and retrieval.

Results: Partial correlation analyses, adjusting for age and cognitive ability, showed significant improvements in episodic memory following both the control period (T1-T2) and the choir intervention (T2-T3), but only the latter scaled with rehearsal attendance. Right hippocampal activity during encoding in the FN-PA task also correlated with attendance, and with age. Additionally, task-dependent functional connectivity increased between the right lateral prefrontal cortex, left posterior fusiform cortex and left hippocampus, while connectivity between the right lateral prefrontal cortex and the left inferior frontal gyrus decreased after the intervention.

Discussion: These findings suggest that regular participation in choral singing may enhance episodic memory and have a positive influence on related brain networks in older adults. The suggestive dose–response effect highlights choir singing as an engaging, multifaceted activity with the potential to contribute to cognitive resilience in aging populations.

In this method article, we aimed to demonstrate how design thinking can be used as a conceptual framework for planning a scientific, health-promoting intervention for a non-clinical group, with the intention of making it an enjoyable and meaningful experience that the participants are motivated to pursue. The intervention was an 11-month choral singing course specifically designed for healthy participants between the ages 65–75 years. Before launching the intervention, we conducted a preparatory study, which constitutes the current study. A focus group session and a co-creation workshop was held with participants with similar characteristics to those recruited for the upcoming intervention. The findings are presented in an affinity diagram, including an exctract of key aspects identified as crucial for a health-promoting, positive experience, such as the conductor’s leadership qualities, motivation, equipment, and more. Based on the findings, we constructed a design specification establishing the intervention content. A participant journey map was developed to consider various aspects of the participants’ experiences throughout the upcoming intervention. Our conclusion is that utilizing the design thinking framework for planning health-promoting interventions of psychological studies offers researchers valuable insights and a systemic approach to design the experience to fit the specific needs of the target group.

A central part of singing includes learning new pieces of vocal music. Learning a new song is a complex task that involves several functions and modalities, such as memory functions, language and motor skills, and auditory and visual perception. Memory functions are a well-studied area, but it is unknown how memory theories apply to a multimodal activity such as singing. In this study, an attempt is made to translate the theories to the applied field of singing. This study aims to investigate the effectiveness of three types of learning formats for learning new song lyrics: auditory learning with image support (AI), auditory learning with text support (AT), and auditory learning only (A). Ninety-five participants were randomly assigned to one of the three experimental conditions. A univariate analysis of variance revealed a significant effect of condition on the lyric recall score and post-hoc tests showed that participants performed significantly better in the AI condition in comparison to both the AT and the A condition. No significant difference was found between AT and A. This study sheds light on how memory processes might work in learning song lyrics. Practical implications for practitioners such as music educators, conductors, and choir singers are discussed.