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.