Music Breathing in Enhancing Resilience Among Elders at Risk of Mental Health Problems

June 5, 2026 updated by: Cheung Tan, Chinese University of Hong Kong

Effects of a Mindfulness-based Music Breathing Intervention in Enhancing Resilience Among Community-dwelling Elders at Risk of Mental Health Problems: A Pilot Randomised Controlled Trial

The goal of this pilot randomised controlled trial is to examine the effects of a mindfulness-based music breathing intervention in enhancing resilience (primary outcome), and in reducing anxiety, depressive symptoms, loneliness, and improving health-related quality of life (secondary outcomes) among community-dwelling older adults at risk of mental health problems.

It is hypothesised that compared with the control group, participants in the intervention group will report enhanced resilience, reduced anxiety, depressive symptoms, and loneliness, and improved health-related quality of life immediately post-intervention.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Background:

Evidence shows that community-dwelling elders experience a myriad of life challenges related to psychosocial well-being, including loneliness, social isolation, and reduced social participation, which are associated with anxiety, depressive symptoms, jeopardising their overall quality of life. Resilience, the capacity to adapt and maintain psychological well-being in stressful events, is a protective factor against emotional dysregulation and negative emotions. Music and mindfulness-based interventions have emerged as promising strategies for promoting psychological well-being among diverse populations. However, no research has yet been conducted to assess the effectiveness of an integrated music and mindfulness-based breathing intervention in enhancing resilience among elders at risk of mental health problems.

Design and subjects: A single-blind, two-arm parallel-group, prospective randomised controlled trial of a mindfulness-based music breathing intervention will be conducted in accordance with the CONSORT guidelines. 40 community-dwelling elders aged 65 years or above who has mild to moderate anxiety and/or depressive symptoms, based on the Hospital Anxiety and Depression Scale (HADS) (i.e., a score of 8 or higher on either the anxiety or depression subscale) will be randomised 1:1 to intervention and control groups.

Instruments: Validated questionnaires, including the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC-25), the Chinese version of HADS, the Chinese version of the EQ-5D-3L and the Chinese version of the 3-item UCLA Loneliness Scale.

Interventions: Participants in the intervention group will receive a 4-week music plus mindfulness-based breathing program, consisting of one 60-minute face-to-face session per week. The sessions will be delivered in small groups (8-10 older adults per group) by a qualified music breathing practitioner. The intervention will follow a structured protocol developed by the research team and reviewed by a certified music-breathing therapist. Participants in the control group will receive usual care, which may include access to existing community-based services, health education, or leisure activities.

Main outcome measure: Data collection will be conducted at baseline (T0) and immediately post-intervention (T1). The primary outcome is levels of resilience. Secondary outcomes include anxiety levels and depressive symptoms, loneliness, and health-related quality of life.

Study Type

Interventional

Enrollment (Estimated)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Aged 65 years or above
  • Able to read Chinese and communicate in Cantonese/Mandarin.
  • Has mild to moderate anxiety and/or depressive symptoms, based on the - Hospital Anxiety and Depression Scale (HADS) (i.e., a score of 8 or higher on either the anxiety or depression subscale)

Exclusion Criteria:

  • Partcipants will be excluded if they have cognitive impairment, hearing loss, severe depression, known mental illness, or chronic illness.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Mindfulness-based music breathing intervention
Participants in the intervention group will receive a 4-week music plus mindfulness-based breathing program, consisting of one 60-minute face-to-face session per week. The sessions will be delivered in small groups (8-10 older adults per group) by a qualified music breathing practitioner. The intervention will follow a structured protocol developed by the research team and reviewed by a certified music-breathing therapist.
Behavioral: Mindfulness-based music breathing intervention

Participants in the intervention group will receive a 4-week music plus mindfulness-based breathing program, consisting of one 60-minute face-to-face session per week. The sessions will be delivered in small groups by a qualified music breathing practitioner. The intervention will follow a structured protocol developed by the research team and reviewed by a certified trained music-breathing therapist.

Each session will consist of four progressive breathing phases, including:

I. Discovery Breathing - to increase awareness of breath and bodily sensations II. Triangular Breathing - to cultivate control and balance through rhythm III. Silent Breathing - to promote stillness and internal reflection IV. Music Breathing - to combine guided music listening with mindful breathing for emotional regulation
Placebo Comparator: Control group
Participants in the control group will receive usual care, which may include access to existing community-based services, health education, or leisure activities, but will not involve any structured music or mindfulness-based intervention.
Behavioral: control group
Participants in the control group will receive usual care, which may include access to existing community-based services, health education, or leisure activities, but will not involve any structured music or mindfulness-based intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Resilience
Time Frame: Change from baseline to post-intervention (at 4-week follow-up).
Elders' resilience will be measured by the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC). Total scores range from 0 to 100, with higher scores indicating higher level of resilience.
Change from baseline to post-intervention (at 4-week follow-up).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Anxiety and depressive symptoms
Time Frame: Change from baseline to post-intervention (at 4-week follow-up).
The Chinese version of the Hospital Anxiety and Depression Scale (HADS) will be employed to evaluate anxiety and depressive symptoms. Total scores range from 0 to 41, with higher scores indicating high levels of anxiety and depressive symptoms.
Change from baseline to post-intervention (at 4-week follow-up).
Health-related quality of life
Time Frame: Change from baseline to post-intervention (at 4-week follow-up).
The European Quality of Life-5 Dimensions questionnaire (EQ-5D-3L) will be used to evaluate the participants' health-related quality of life. The visual analogue scale will be used to measure the participant's perception of their overall health status from 0 to 100, with 0 being the worst imaginable health and 100 the best health.
Change from baseline to post-intervention (at 4-week follow-up).
Loneliness
Time Frame: Change from baseline to post-intervention (at 4-week follow-up).
The UCLA Loneliness Scale will be used to assess elders' levels of loneliness. Total score ranges from 20 to 80. A higher total score indicates a greater degree of subjective loneliness and social isolation.
Change from baseline to post-intervention (at 4-week follow-up).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Chinese University of Hong Kong

Investigators

  • Principal Investigator: Ankie Tan Cheung, PhD, MPhil, BN, Chinese University of Hong Kong

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 10, 2026

Primary Completion (Estimated)

August 31, 2026

Study Completion (Estimated)

August 31, 2026

Study Registration Dates

First Submitted

June 1, 2026

First Submitted That Met QC Criteria

June 5, 2026

First Posted (Actual)

June 8, 2026

Study Record Updates

Last Update Posted (Actual)

June 8, 2026

Last Update Submitted That Met QC Criteria

June 5, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025.394

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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