A study of music-sign language synesthetic training for maintaining cognitive and hand function in older adults

OBJECTIVE: To design a music training program incorporating sign language elements and evaluate its feasibility and effectiveness as a nonpharmacological intervention for promoting brain function (particularly auditory cognitive function) and hand function in older adults within geriatric nursing and health care. METHODS: A prospective study was conducted, enrolling 91 inpatients and outpatients from the Department of Geriatrics at Huadong Hospital affiliated with Fudan University during months 1 to 12 of 2025 as study participants, and a music training rehabilitation nursing team was established. The mean age was (82.3±9.4) years, and participants completed an 8-week music training course in 4 groups (1 session per week, 1.5 h per session). Training included breathing exercises accompanied by music, rhythm imitation using small musical instruments such as tambourine sticks, pinching and kneading auricular acupoints with alternating fingers, and learning sign language songs. Participants were assessed before and after training for auditory discrimination ability (frequency, intensity, and temporal discrimination), auditory attention (Go/No-go test), auditory memory (auditory digit span), auditory executive function (auditory Stroop test), and finger function (finger tapping test). Repeated-measures analysis of variance and analysis of covariance were used for statistical comparisons. RESULTS: After music training, participants' overall auditory perceptual discrimination ability improved significantly compared with that before training (P＜0.05). In particular, improvements in frequency resolution and temporal resolution were significant (P＜0.05), whereas the change in intensity resolution was not statistically significant (P=0.815). Auditory digit span and auditory attention improved significantly compared with those before training (P＜0.05). Under sound-meaning incongruent conditions, participants' task response speed increased significantly (P＜0.05). Regarding hand function, finger tapping speed in both the left and right hands increased compared with that before training; the differences in alternation speed between the middle and ring fingers and between the ring and little fingers of the left hand, as well as between each pair of fingers of the right hand, were statistically significant (P＜0.05). CONCLUSIONS: Music training incorporating sign language elements is an innovative nursing and health care intervention model that is readily accepted by older adults and can promote improvements in their brain and hand function to a certain extent, with particularly positive effects on auditory cognitive abilities and fine motor function of the hands. This training combines enjoyment, practical feasibility, and potential for wider implementation, and may provide a nonpharmacological nursing and health care strategy with practical value for preventing cognitive and functional decline and promoting health in older age.