Currently submitted to: JMIR Aging
Date Submitted: Jun 17, 2026
Open Peer Review Period: Jun 18, 2026 - Aug 13, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Comparing the effects of music and audiobooks on adults with cognitive impairment: a randomized controlled trial
ABSTRACT
Background:
BACKGROUND: Dementia and mild-to-moderate cognitive impairment (MCI) cases are projected to surpass 130 million by 2050, with anxiety and agitation symptoms common among those affected. Personalized music listening may help alleviate these symptoms, but current therapies are resource-intensive, making access a challenge. Additionally, comparisons to other auditory activities are limited.
Objective:
OBJECTIVES: The primary aim was to compare the effects of personalized music listening and audiobook listening using an Artificial Intelligence (AI)-powered auditory application on agitation and anxiety in older adults with MCI. The secondary aim was to examine session-level changes in affective wellbeing following repeated engagement with these auditory interventions.
Methods:
METHODS: An 8-week randomized-controlled trial evaluated the efficacy of an AI-powered auditory application delivering either personalized music or audiobooks to older adults with MCI. Sixty-six participants completed 30-minute sessions four times weekly. Agitation and anxiety were assessed pre-, mid-, and post-intervention, and affect was measured before and after listening sessions. Thirty-five participants listened to personalized music (intervention); 31 participants listened to audiobooks (control). Analysis assessed intent to treat with linear mixed-effects models and ANOVA, followed by sensitivity analyses.
Results:
RESULTS: Although both interventions temporarily reduced agitation by midtrial, no significant between-group differences were observed. Higher baseline agitation predicted greater post-session reduction in negative affect for both groups.
Conclusions:
CONCLUSION: There were no significant changes in agitation or anxiety after completing either intervention likely due to intervention design, personalization success, and study population. This app is a feasible method for increasing access to music-based interventions for older adults with MCI and their caregivers. Clinical Trial: NCT05858541
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