a 
 previous study reported that singing affects the mental health and oral function of the 
 elderly1 and that listening to music or 
 singing is effective in improving cognitive function2 and quality of life ( qol)2 , and reducing anxiety3 in elderly individuals with dementia . some recent reports suggested 
 that interventions combining music and physical exercise were more effective than listening 
 to music alone . for example , sakamoto et al.4 reported that , in individuals with dementia , an interactive music 
 intervention in which individuals listened to music and clapped , sang , and danced affected 
 the improvement of behavioral and psychological symptoms of dementia ( bpsd ) more than a 
 passive music listening group . in addition , satoh et al.5 reported that physical exercise combined with music produced more 
 positive effects on the cognitive function of elderly individuals than exercise alone . thus , 
 these findings suggest that the combination of music and physical exercise more effectively 
 improves cognitive function , bpsd , and qol in people with dementia or the elderly . reminiscence therapy ( rt ) also affects cognitive function , bpsd , and qol in elderly 
 individuals with and without dementia6,7,8,9 . in rt , people speak about their experiences 
 or memories in a group using pictures as clues . combining rt with the music and physical 
 exercise combination mentioned above may be more effective in the elderly and in individuals 
 with dementia . however , no previous research has investigated the effects of interventions 
 comprising music , physical exercise , and rt . therefore , this study aimed to investigate the 
 effect of structured interventions that comprised music , physical exercise , and rt on 
 cognitive function and qol in the elderly . participants included 15 community - dwelling elderly people who used a day - care center 
 ( table 1table 1.characteristics of study participantsmean  sdage ( years)84.3  6.6female ( % ) 86.6diagnosis of dementia ( % ) 26.6able to walk ( % ) 93.3 ) . the 
 study protocol was approved by the tohoku fukushi university s institutional ethics review 
 board . structured interventions comprising music , physical exercise , and rt were conducted for 
 participants . their cognitive function and qol were compared before and after interventions . each session included the following three factors : 1 ) singing songs familiar to the elderly 
 or matched seasons ; 2 ) physical exercise to music ; and 3 ) observation of historical 
 pictures . participants could see the song lyrics , demonstrations of physical exercises , and 
 historical pictures on a big monitor in front of them . under the recreation instructors 
 instructions , sessions were conducted by an occupational therapist or care staff . they 
 conducted sessions using a music device and facilitated participant interaction . on 
 observing historical pictures , participants received intervention once or twice per week , 30 to 40  min per day , for 10 
 weeks . participants were assessed using the mini mental state examination ( mmse)10 , the behavioral rating scale for the 
 elderly11 , and the japanese version of 
 the medical outcome study short form 8-item health survey ( sf-8)12 . the mmse was used to assess cognitive function while the 
 behavioral rating scale for the elderly was used to assess vital function at home . the wilcoxon signed - rank test was performed to compare each pre and post 
 intervention score . the spss statistics 22.0 ( ibm , chicago , il , usa ) was used as the 
 statistical software and the level of significance was set at 5% . table 2table 2.comparison of each evaluation score by pre - post interventionprepostmini mental state examination20.8  5.720.9  5.9behavioral rating scale for the elderly119.7  22.8121.0  28.3sf-8physical component summary42.2  10.948.1  7.5*mental component summary51.0  9.051.8  5.8*p<0.05 outlines the outcomes of each assessment . no significant difference was 
 observed between pre- and post - intervention scores on the mmse and the behavioral rating 
 scale for the elderly . however , the post - intervention physical component summary of sf-8 was 
 significantly higher than the pre - intervention summary ( p<0.05 ) . this study suggests that interventions comprising music , physical exercise , and rt could 
 contribute toward improving community - dwelling elderly individuals health - related qol , 
 especially their physical health . in sf-8 , the average values for japanese individuals with 
 respect to the  physical component summary score  and the  mental component summary score  
 of 7079  year - old individuals ( the oldest age group to be examined ) were 44.78 and 50.95 
 points , respectively12 ; as the 
 participants scores in this study were 42.2 and 51.0 points , respectively , little 
 difference was observed between the two . post intervention , the  physical component summary 
 score  showed an improvement , and this score was higher than the national average value for 
 7079  year - old individuals . previous studies have reported that listening , singing , and rt 
 improve qol of individuals with dementia2 , 9 . as our intervention included these three 
 factors , we could provide relative improvement in qol in short sessions . however , our study 
 had no control group . therefore , we can not refer to the relevance between each factor and 
 its effect and further studies are required to examine the same . physical therapists have an important role to play in not only improving physical functions 
 but also the qol of patients . previous studies reported that experiencing a fall or pain was 
 associated with a low health - related qol related to bodily functions13 . some studies also reported that physical exercise can 
 have beneficial effects on the  physical component summary score  of sf-8 in the 
 community - dwelling elderly14 . however , 
 there are cases where it is difficult to clinically carry out continual aggressive physical 
 exercise due to various reasons such as pain , disease , or motivation in the elderly . in such 
 cases , the intervention used in this study may be useful to improve health - related qol 
 related to bodily functions in the elderly . our 
 results indicated that using music improved qol but did not improve cognitive function ; the 
 results thus corresponded with a previous study by choi15 . the relationship between interventions using music and improvement 
 of cognitive function is as yet unclear . for example , some research results did indicate 
 that interventions using music showed effects on the improvement of vital functions 
 including cognitive function and bpsd in elderly people with and without dementia1 , 2 , 16,17,18,19 . 
 however , other results do not indicate such significant effects on these functions13 , 20 , 21 . it is assumed that these differences are 
 associated with the variations in the duration of the interventions and the level of 
 participants cognitive function . it is possible that the duration of the intervention in 
 our study was shorter and thus did not affect people s cognitive and vital functions . therefore , it is necessary to investigate long - term intervention effects in future 
 studies . therefore , long - term intervention studies that include more number of participants and 
 use a control group are required .
[ purpose ] interventions using music , physical exercise , and reminiscence therapy are 
 widely used both for rehabilitation and care of the elderly . this study aimed to 
 investigate the effect of structured interventions comprising music , physical exercise , 
 and reminiscence therapy on cognitive function and quality of life of the 
 community - dwelling elderly . 
 [ subjects and methods ] the study included 15 
 community - dwelling elderly people who used a day - care center . 
 participants underwent 
 sessions comprising the following three factors : 1 ) singing songs familiar to the elderly ; 
 2 ) physical exercise to music ; and 3 ) observation of historical pictures . 
 sessions were 
 conducted once or twice per week , 30 to 40  min per day , for 10 weeks . 
 pre and post 
 interventions of the mini mental state examination , the behavioral rating scale for the 
 elderly , and the sf-8 were compared . 
 [ results ] no significant difference was observed 
 between pre- and post - intervention scores on the mini mental state examination and the 
 behavioral rating scale for the elderly . 
 however , the post intervention physical component 
 summary of sf-8 was significantly higher than the pre intervention summary . [ conclusion ] 
 this study suggests that interventions comprising music , physical exercise , and 
 reminiscence therapy may contribute toward the improvement of elderly individuals 
 health - related quality of life , especially physical health .