The Influence of Choir Singing on Quality of Life (QOL) for Older Adults in Jyväskylä Julene K Johnson, PhD University of California, San Francisco Institute for Health and Aging Fulbright Scholar (Fall 2010) University of Jyväskylä Departments of Gerontology and Music Jukka Louhivuori, PhD University of Jyväskylä Department of Music Why Fulbright? / Why Finland? Global aging Choirs and older adults Findings from Jyväskylä study established in 1946 to increase mutual understanding between the people of the US and the people of other countries ~300,000 persons have participated Each year, ~800 US faculty go abroad as part of Fulbright Scholar program 1
Aging Music August 2010 17% of the population in Finland is > age 65 Finland US Census Bureau (2008) An Aging World 2
Music is valued in Finland Finland has a strong focus on early music education Finland has many opportunities for music throughout life Community choirs : Amateur (non-professional) Includes all skill levels Stable membership and rehearsals Mostly organized by community Non-profit Rooted in volunteerism Reasons for choir singing Rated as Very important Being a member of a group 50% Artistic and emotional experiences 49% Social contacts in choir 48% Improving self confidence 40% Developingsinging skills 39% Development of artistic expression 30% Increasing knowledge about music 26% other reason 24% Desire to perform 11% 3
Often have improved mood after singing (Valentine) Often live a longer life (Bygren) Are less likely to get dementia (Verghese) Higher ratings of health doctor visits Cohen et al. (2006) Hyvää matkaa Suomeen to study how choir singing promotes healthy aging medications falls loneliness 4
~40 Choirs in Jyväskylä (population = 125,000) Canticulum Cantinovum Cupido -kuoro Cygnaeus -lukion kuoro Harjun Laulu Jyväskylän Musica kuoro Jyväskylän Eläkkeensaajien Sointu-kuoro Jyväskylän kristillisten eläkeläisten kuoro Jyväskylän Naislaulajat Jyväskylän Rautatieläisten Mieskuoro Jyväskylän Rintamaveteraanien lauluryhmä Jyväskylän Sotaveteraanikuoro Jyväskylän Studiokuoro Jyväskylän Tapiola-kuoro ry Jyväskylän Työväenyhdistyksen sekakuoro Jyväskylän yliopiston lapsikuoro Kannel-kuoro KaruSointi Keski-Suomen Alueooppera Kolmekuutoset Korteforte Lapsi- ja nuorisokuoro Sinikellot Laulustudio Lauluyhtye Fiori Mieskuoro Päijänne Mieskuoro Sirkat Mieskuoro Vaajan Laulu Naiskuoro Pulssi Naiskuoro Vaput Nollakakkoset (6-8 -vuotiaat) Palokan Viihdelaulajat Ruamjai Sekakuoro Iltatähdet Seminaarinmäen Mieslaulajat Sorpaanos Säynätsalon Veteraanilaulajat Tikkakosken kamarikuoro Tikkakosken Mieslaulajat Tikkakosken Naislaulajat Tulus-kuoro Viihdekuoro Jyväset Viittomakuoro Vox Aurea - musiikkiluokkien edustuskuoro Senior choirs Student & Adult choirs Goal: to explore the relationship between choir singing and health / well-being Children s choirs Participants: Retired choir singers in Jyväskylä 5
Kannel-kuoro Vaajan Laulu Yliopiston Seniorikuoro Harmaat Herrat Vaput Harjun Laulu Jyväskylän Rautatieläisten Mieskuoro Jyväskylän Sotaveteraanikuoro Kiitos! Health / Well-being (100 questions) 1. Quality of Life: WHOQOL-BREF 2. Health Status : Short-form 36 3. Depression: Geriatric Depression Scale 4. Resilience: CD-RISC Choir Singing (55 questions) (Professor Jukka Louhivuori) Quality of Life How much do you enjoy life? How safe do you feel? Health Compared to a year ago, how is your health? Can you climb several flights of stairs? Depressive symptoms Are you in good spirits most of the time? Do you often feel helpless? Resilience I do not give up easily. I can stay focused under pressure. 6
Social contacts in choir, being a member of group 1. Group support After a choir rehearsal, I feel refreshed. How often have you had these experiences (during choir)? Feeling moved Feeling emptiness Embarrassment Unity with others Feel refreshed, forget everyday worries Outlet for emotional expression, world disappears Advice from choir members, breathing & relaxation, physical exercise during choir Attendance at concerts, theater, dance, exhibitions 2. Relaxation 3. Emotional expression 4. Self-reported health benefits of choir 5. Cultural activities Sample Size 117 Age (years) 72 years old range = 58-93 WHO Quality of Life summary scores % male 64% male Living Status Years in choir(s) Married / cohabitating Alone Relatives / Friends 75% 21% 3% 33 years range = 1-70 M ean score 5 4 3 2 1 0 Overall QOL Overall Health Physical Psychological Social Enivonment Question or Domain 7
Good or Very Good How would you rate your quality of life? (%) 86% Satisfied or Very Satisfied How satisfied are you with your health? (%) 86% Questionnaire Mean scores Geriatric Depression Scale (0-15) 1.2 Resilience Scale (0-100) 70 Agree or Totally Agree After rehearsal, I feel refreshed 97% During rehearsal, I forget everyday worries Choir singing makes me feel balanced and peaceful 95% 99% Agree or Totally Agree In choir, I can express emotions by singing. 87% Choir singing has a strong effect on my emotional life. I often have strong emotional experiences in choir concerts. 88% 89% 8
Correlation between QOL and Choir Factors Cultural Activity Group Support Relaxation Health Emotions WHO QOL Overall QOL 0.24* 0.21* 0.23*.32** 0.29* Overall satisfaction with Health 0.12 0.001 0.12 0.16-0.09 Physical Domain 0.13 0.51-0.04-0.03-0.08 Psychological Domain 0.27** 0.24** -0.03 0.14 0.20* Social Relations Domain 0.03 0.30** 0.24** 0.27** 0.24** SF-36 Environment Domain 0.26** 0.15 0.27** 0.16 0.24* Physical Component 0.08-0.06 0.009-0.01-0.11 Mental Component 0.21* -0.07 0.05 0.12-0.07 Group support Relaxation Emotional Expression Health benefits Cultural Activity? Health satisfaction Quality of Life Resilience Dependent Variable Independent Variable standard ß p Adj value R 2 R 2 Overall QOL 0.23 0.19 Choir singers who report benefits of singing for their health have higher overall quality of life. Age -0.27 0.02* Health factor 0.22 0.03* Sing for better QOL 9
Dependent Variable Social Relations QOL Domain Independent Variable standard ß Age 0.23 0.01* p Adj value R 2 R 2 0.20 0.15 Choir singers who report high group support from choir have high social quality of life Group Support 0.21 0.03* Sing for group support Dependent Variable Psychological QOL Domain Independent Variable standard ß Age -0.27 0.003* Group Support Cultural activity 0.19 0.04* 0.18 0.05 p Adj value R 2 R 2 0.19 0.15 Choir singers who report high group support from choir and more cultural activities have higher psychological quality of life 10
Older adult singers in Jyväskylä report high Quality of Life and low depressive symptoms. There is a relationship between choir singing and quality of life. Choir singing in Finland may help promote health and well-being. A few final thoughts Numerous studies document the importance of staying socially connected and active for healthy aging. Choir singing may be a good way to stay connected and active. Sirkat Vaput 11
Kannel-kuoro Vaajan Laulu Yliopiston Seniorikuoro Harmaat Herrat Vaput Harjun Laulu Jyväskylän Rautatieläisten Mieskuoro Jyväskylän Sotaveteraanikuoro Gerontology Research Center Department of Music University of Jyväskylä Jukka Louhivuori, PhD Sarianna Sipilä, PhD Taina Rantanen, PhD Pertti Era, PhD Petri Toiviainen, PhD Jaakko Erkkilä, PhD Fulbright Foundation (USA) Fulbright Center (Helsinki) Jyväskyläläinen kuorolaulaja ~Liisa Suomäki 12