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Thompson S, Holden SK, Ozkaynak M, Wilhelm L, Jones J. Proposed Mechanism of Action for Three Music-Based Interventions for Behavioral and Psychologic Symptoms of Dementia. MUSIC THERAPY PERSPECTIVES 2025; 43:miae025. [PMID: 40255677 PMCID: PMC12004236 DOI: 10.1093/mtp/miae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2025]
Abstract
While music-based interventions are recommended to address the behavioral and psychological symptoms of dementia, the specific aspects of the interventions that led to therapeutic change have yet to be identified. The purpose of this article is to discuss the proposed mechanisms of change of a music-based intervention for ambulation, sleep, and behavioral redirection, connecting basic science to clinical research. These proposed mechanisms of change provide a neuromechanistic framework for understanding what elements of music are essential for the intervention to achieve the desired outcome. The three interventions outlined in this article are part of a novel training program for informal caregivers of individuals with Alzheimer's disease.
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Affiliation(s)
- Sarah Thompson
- Graduate School, University of Colorado Anschutz, Aurora, CO, USA
| | - Samantha K Holden
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Mustafa Ozkaynak
- College of Nursing, University of Colorado Anschutz, Aurora, CO, USA
| | - Lindsey Wilhelm
- School of Music, Theatre and Dance, Colorado State University, Fort Collins, CO, USA
| | - Jacqueline Jones
- College of Nursing, University of Colorado Anschutz, Aurora, CO, USA
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Mei Z, Cai C, Wang T, Zhang Y, Zhao W, Lam C, Luo S, Shi Y, Luo S. Are mind-body therapies beneficial for older people with dementia? A Systematic Review and meta-analysis of randomized controlled trials. Front Psychiatry 2025; 16:1569709. [PMID: 40297332 PMCID: PMC12034943 DOI: 10.3389/fpsyt.2025.1569709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2025] [Accepted: 03/12/2025] [Indexed: 04/30/2025] Open
Abstract
Objective This systematic review and meta-analysis aimed to evaluate the potential multidomain benefits of mind-body therapies (MBTs) for behavioral and psychological symptoms of dementia (BPSD) in older people with dementia (OPWD). Methods Relevant randomized controlled trials (RCTs) were identified using electronic databases and manual searches. Two independent researchers evaluated the risk of bias in the included trials using the Revised Cochrane Risk-of-Bias tool for randomized trials. A standardized mean difference (SMD) with a 95% confidence interval (CI) was used to combine effect sizes. Results This review included 35 RCTs comprising 4,043 patients, of whom 24 were included in the meta-analyses. MBTs effectively improved BPSD (SMD = -0.33; 95% CI -0.49 to -0.16; p < 0.01), anxiety (SMD = -0.82; 95% CI -1.53 to -0.10; p = 0.02), and depression (SMD = -0.57; 95% CI -1.06 to -0.08; p = 0.02), with no significant improvements observed in agitation (SMD = -0.09; 95% CI -0.25 to 0.07; p = 0.27) among patients with dementia. The certainty of evidence across the outcomes ranged from low to very low, based on the Grading of Recommendations, Assessment, Development, and Evaluations ratings. Conclusion Effective nursing for patients with dementia is vital, as they are undergoing a major transition in their physical and mental health. In clinical practice, healthcare and social care therapists should develop personalized intervention programs based on patient individual differences and the actual dose-response relationship, which will help maximize the clinical benefits of non-pharmacological treatments in the context of limited medical resources. More high-quality RCTs could be conducted to compare the differential efficacy of non-pharmacological treatments on various aspects of BPSD in OPWD to provide a better evidence base to guide individual care and policy guidance. Systematic review registration PROSPERO, identifier CRD42024559809.
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Affiliation(s)
- Zhengyang Mei
- School of Physical Education, Southwest University, Chongqing, China
| | - Chenyi Cai
- School of Physical Education, Southwest University, Chongqing, China
| | - Tingfeng Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Yuanzhuo Zhang
- School of Physical Education, Southwest University, Chongqing, China
| | - Wen Zhao
- Faculty of Education, Southwest University, Chongqing, China
| | - Chifong Lam
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Shulai Luo
- School of Physical Education, Southwest University, Chongqing, China
| | - Yu Shi
- School of Physical Education, Southwest University, Chongqing, China
| | - Shi Luo
- School of Physical Education, Southwest University, Chongqing, China
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Hammink JC, van Buuren LL, Moor JN, Derks DD, Mohammadi MM. Evolving dementia care: An explorative study on the lived experience of older adults living with dementia in nursing homes using observational and biometric sensor data. DEMENTIA 2025; 24:456-479. [PMID: 39559952 DOI: 10.1177/14713012241301474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2024]
Abstract
IntroductionThis study explores the lived experiences of older adults with dementia in Dutch nursing homes, focusing on daily activities and emotional responses. With a growing number of older adults with dementia, gaining a deeper understanding of their lived experience is imperative.MethodsUsing a mixed-method narrative approach involving observations, informal interviews, and physiological monitoring through wearable sensors, the study engaged eight participants in psychogeriatric wards across two Dutch nursing homes. Observations and interviews aimed to provide context to daily activities, while wearable sensors tracked emotional responses through heart rate (HR) and heart rate variability (HRV).ResultsKey activities included eating, drinking, communication, mobility, and inactivity. Positive experiences were consistently observed during eating and drinking and communication, respectively influenced by the nursing home's social and organizational structures and social and personal contexts. In contrast, mobility and inactivity exhibited diverse physiological responses, reflecting a range of stress, concentration, or relaxation.Conclusion & DiscussionThis study offers valuable insights into the lived experiences of older adults with dementia in nursing homes. It highlights the generally positive nature of eating and drinking, shaped by social and organizational factors. Communication's impact varies with individual context. The study also reveals a complex interplay of emotions during activities related to mobility and inactivity, as evidenced by diverse physiological responses. Regarding implications for dementia care, the study emphasizes the need to redefine 'inactivity' as 'under-stimulation,' assess appropriate (in)activity levels, and acknowledge the significance of the nursing home's physical and organizational context. This redefinition should distinguish between 'physical' and 'mental' inactivity, address concerns related to under-stimulation, and cater to individual preferences. Recognizing the residents' restricted environment and reliance on care professionals and volunteers underscores the urgency of tailored approaches. Addressing these implications can provide fresh perspectives for evolving dementia care, creating a more supportive environment that promotes well-being.
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Affiliation(s)
- Jhw Coosje Hammink
- Research Group Architecture in Health, HAN University of Applied Sciences, The Netherlands
| | - Lpg Leonie van Buuren
- Chair Smart Architectural Technologies, Department of Built Environment, Eindhoven University of Technology, The Netherlands
| | - Ja Nienke Moor
- Research Group Architecture in Health, HAN University of Applied Sciences, The Netherlands
| | - Daja Daantje Derks
- Department of Social and Behavioral Sciences, Erasmus University Rotterdam, The Netherlands
| | - M Masi Mohammadi
- Chair Smart Architectural Technologies, Department of Built Environment, Eindhoven University of Technology, The Netherlands; Research Group Architecture in Health, HAN University of Applied Sciences, The Netherlands
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van der Steen JT, van der Wouden JC, Methley AM, Smaling HJA, Vink AC, Bruinsma MS. Music-based therapeutic interventions for people with dementia. Cochrane Database Syst Rev 2025; 3:CD003477. [PMID: 40049590 PMCID: PMC11884930 DOI: 10.1002/14651858.cd003477.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2025]
Abstract
BACKGROUND Dementia is a clinical syndrome with a number of different causes. It is characterised by deterioration in cognitive, behavioural, social and emotional functioning. Pharmacological interventions are available but have limited effect on many of the syndrome's features. However, receptivity to music may remain until the late phases of dementia, and music-based therapeutic interventions (which include, but are not limited to, music therapy) are suitable for people with advanced dementia. As there is uncertainty about the effectiveness of music-based therapeutic interventions, trials are being conducted to evaluate this. This review updates one last published in 2018 and examines the current evidence for the effects of music-based interventions for people with dementia. OBJECTIVES To assess the effects of music-based therapeutic interventions for people with dementia on emotional well-being (including quality of life), mood disturbance or negative affect (i.e. depressive symptoms and anxiety), behavioural problems (i.e. overall behavioural problems or neuropsychiatric symptoms, and more specifically agitation or aggression), social behaviour and cognition, at the end of therapy and four or more weeks after the end of treatment, and to assess any adverse effects. SEARCH METHODS We searched the Cochrane Dementia and Cognitive Improvement Group's Specialised Register, MEDLINE (Ovid SP), Embase (Ovid SP), PsycINFO (Ovid SP), CINAHL (EBSCOhost), Web of Science Core Collection (ISI Web of Science), LILACS (BIREME), ClinicalTrials.gov and the World Health Organisation's meta-register-the International Clinical Trials Registry Platform on 30 November 2023. SELECTION CRITERIA We included randomised controlled trials of music-based therapeutic interventions (of at least five sessions) for people with dementia that measured any of our outcomes of interest. Control groups either received usual care or other activities with or without music. DATA COLLECTION AND ANALYSIS Two review authors worked independently to screen the retrieved studies against the inclusion criteria and then to extract data from included studies and assess their risk of bias. If necessary, we contacted trial authors to ask for additional data, such as relevant subscales. We pooled data using the random-effects model. We assessed the certainty of the evidence for our two comparisons and our main outcomes of interest using GRADE. MAIN RESULTS We included 30 studies with 1720 randomised participants that were conducted in 15 countries. Twenty-eight studies with 1366 participants contributed data to meta-analyses. Ten studies contributed data to long-term outcomes. Participants had dementia of varying degrees of severity and resided in institutions in most of the studies. Seven studies delivered an individual intervention; the other studies delivered the intervention to groups. Most interventions involved both active and receptive elements of musical experience. The studies were at high risk of performance bias and some were at high risk of detection or other bias. For music-based therapeutic interventions compared to usual care, we found moderate-certainty evidence that, at the end of treatment, music-based therapeutic interventions probably improved depressive symptoms slightly (standardised mean difference (SMD) -0.23, 95% confidence interval (CI) -0.42 to -0.04; 9 studies, 441 participants), and we found low-certainty evidence that it may have improved overall behavioural problems (SMD -0.31, 95% CI -0.60 to -0.02; 10 studies, 385 participants). We found moderate-certainty evidence that music-based therapeutic interventions likely did not improve agitation or aggression (SMD -0.05, 95% CI -0.27 to 0.17; 11 studies, 503 participants). Low to very low certainty evidence showed that they did not improve emotional well-being (SMD 0.14, 95% CI -0.29 to 0.56; 4 studies, 154 participants), anxiety (SMD -0.15, 95% CI -0.39 to 0.09; 7 studies, 282 participants), social behaviour (SMD 0.22, 95% CI -0.14 to 0.57; 2 studies; 121 participants) or cognition (SMD 0.19, 95% CI -0.02 to 0.41; 7 studies, 353 participants). Low or very-low -certainty evidence showed that music-based therapeutic interventions may not have been more effective than usual care in the long term (four weeks or more after the end of treatment) for any of the outcomes. For music-based therapeutic interventions compared to other interventions, we found low-certainty evidence that, at the end of treatment, music-based therapeutic interventions may have been more effective than the other activities for social behaviour (SMD 0.52, 95% CI 0.08 to 0.96; 4 studies, 84 participants). We found very low-certainty evidence of a positive effect on anxiety (SMD -0.75, 95% CI -1.27 to -0.24; 10 studies, 291 participants). For all other outcomes, low-certainty evidence showed no evidence of an effect: emotional well-being (SMD 0.20, 95% CI -0.09 to 0.49; 9 studies, 298 participants); depressive symptoms (SMD -0.14, 95% CI -0.36 to 0.08; 10 studies, 359 participants); agitation or aggression (SMD 0.01, 95% CI -0.31 to 0.32; 6 studies, 168 participants); overall behavioural problems (SMD -0.08, 95% CI -0.33 to 0.17; 8 studies, 292 participants) and cognition (SMD 0.12, 95% CI -0.21 to 0.45; 5 studies; 147 participants). We found low or very-low certainty evidence that music-based therapeutic interventions may not have been more effective than other interventions in the long term (four weeks or more after the end of treatment) for any of the outcomes. Adverse effects were inconsistently measured or recorded, but no serious adverse events were reported. AUTHORS' CONCLUSIONS When compared to usual care, providing people with dementia with at least five sessions of a music-based therapeutic intervention probably improves depressive symptoms and may improve overall behavioural problems at the end of treatment. When compared to other activities, music-based therapeutic interventions may improve social behaviour at the end of treatment. No conclusions can be reached about the outcome of anxiety as the certainty of the evidence is very low. There may be no effects on other outcomes at the end of treatment. There was no evidence of long-term effects from music-based therapeutic interventions. Adverse effects may be rare, but the studies were inconsistent in their reporting of adverse effects. Future studies should examine the duration of effects in relation to the overall duration of treatment and the number of sessions.
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Affiliation(s)
- Jenny T van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- Department of Primary and Community Care and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
- Cicely Saunders Institute, King's College London, London, UK
| | - Johannes C van der Wouden
- Department of General Practice and Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | | | - Hanneke J A Smaling
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, Netherlands
| | - Annemieke C Vink
- Music Therapy Department, ArtEZ University of the Arts, Enschede, Netherlands
| | - Manon S Bruinsma
- Muzis, Praktijk voor Muziektherapie, Amersfoort, Netherlands
- Department of Creative Arts Therapies, HU University of Applied Sciences Utrecht, Utrecht, Netherlands
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Fernie P, Street A, Fachner J, Muller L, Hsu MH, Di Campli San Vito P, Brewster S, Banerjee S, Farina N, Shaji H, Itaborai P, Kirke A, Miranda ER. Preferred music listening for people living with dementia: Two home-based case studies discussing compilation process, autobiographical and biophysical responses. Geriatr Nurs 2024; 59:440-452. [PMID: 39153462 DOI: 10.1016/j.gerinurse.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 07/03/2024] [Accepted: 07/22/2024] [Indexed: 08/19/2024]
Abstract
Neuropsychiatric symptoms (NPS) in dementia can be reduced through music listening. Little has been reported on home-based listening, compilation processes, or individual responses that include biophysiological data. We aim to provide new insights from two home-based case studies focused on specific music selections. Participants were part of a larger study, co-designing an automated radio, diary reminder and personal playlist system for NPS management. Playlists were compiled that would have the best possible chance of achieving this, based on participants' autobiographical, narrative, heart rate (HR) and videoed responses. Participant's responses to their music aligned with the genre they chose - dancing to up-beat music, contrasting with subtle responses to Beethoven. Repeated listens may help to establish consistency of responses and allow time to communicate their genuine preferences, not those others suggested. If all of these data converge, then they could help confirm the suitability of music for NPS management.
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Affiliation(s)
- Paul Fernie
- Cambridge Institute of Music Therapy Research, Anglia Ruskin University, UK.
| | - Alexander Street
- Cambridge Institute of Music Therapy Research, Anglia Ruskin University, UK
| | - Jörg Fachner
- Cambridge Institute of Music Therapy Research, Anglia Ruskin University, UK
| | - Leonardo Muller
- Cambridge Institute of Music Therapy Research, Anglia Ruskin University, UK
| | - Ming Hung Hsu
- Cambridge Institute of Music Therapy Research, Anglia Ruskin University, UK
| | | | | | - Sube Banerjee
- Faculty of Medicine and Health Sciences, University of Nottingham, UK
| | - Nicolas Farina
- Community and Primary Care Research Group, University of Plymouth, UK
| | - Hari Shaji
- Interdisciplinary Centre for Computer Music Research, University of Plymouth, UK
| | - Paulo Itaborai
- Interdisciplinary Centre for Computer Music Research, University of Plymouth, UK
| | - Alexis Kirke
- Interdisciplinary Centre for Computer Music Research, University of Plymouth, UK
| | - Eduardo Reck Miranda
- Interdisciplinary Centre for Computer Music Research, University of Plymouth, UK
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Raglio A. A novel music-based therapeutic approach: the Therapeutic Music Listening. Front Hum Neurosci 2023; 17:1204593. [PMID: 37520927 PMCID: PMC10375023 DOI: 10.3389/fnhum.2023.1204593] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
The therapeutic use of music is frequently based on active interventions that directly involve the patient through a sonorous-music interaction with the music therapist. In contrast, approaches based on musical listening are characterized by a relationship aimed at promoting an introspective work and processing of one's emotional experiences. Increasingly, the scientific literature has shown how even listening to music related to the patient's personal tastes (preferred music listening) and by-passing the direct relationship with the patient, can produce therapeutic effects in different clinical settings. However, in many cases, a clear therapeutic rationale and specific application protocols are still lacking. The paper introduces a novel approach based on music listening: the Therapeutic Music Listening. This approach integrates the subjective component of listening (patient's musical tastes) and structural and parametric characteristics of the music in relation to the therapeutic aims. The article defines theoretical-applicative bases as well as therapeutic and research perspectives of this music listening-based intervention.
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Tz-Han L, Wan-Ru W, I-Hui C, Hui-Chuan H. Reminiscence music intervention on cognitive, depressive, and behavioral symptoms in older adults with dementia. Geriatr Nurs 2023; 49:127-132. [PMID: 36495795 DOI: 10.1016/j.gerinurse.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
This study aimed to examine the efficacy and feasibility of a reminiscence music therapy program on improving cognition and decreasing depressive and behavioral symptoms in older adults with dementia. Participants in the reminiscence music therapy group participated in 60-minute reminiscence music therapy twice a week over a period of 4 weeks. Control group received usual care. Results showed that the intervention group exhibited a significant decrease in depressive symptoms compared to the control group (B=-5.30, p=.003). The reminiscence music therapy program exerted non-significant effects on cognition and behavioral symptoms in patients with dementia (p>.05). High adherence (96%) and positive participation data indicated that this reminiscence music program is feasible for people with dementia. Healthcare professionals in community or geriatric care units can create supportive environments and conduct regular reminiscence music activities that are related to festival features and reminiscence music for older adults with dementia to reduce depressive symptoms.
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Affiliation(s)
- Lin Tz-Han
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Wu Wan-Ru
- Department of Nursing, College of Medicine, Tzu Chi University, Hualien, Taiwan.
| | - Chen I-Hui
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Huang Hui-Chuan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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Raglio A, Maestri R, Robbi E, Pierobon A, La Rovere MT, Pinna GD. Effect of Algorithmic Music Listening on Cardiac Autonomic Nervous System Activity: An Exploratory, Randomized Crossover Study. J Clin Med 2022; 11:jcm11195738. [PMID: 36233606 PMCID: PMC9571939 DOI: 10.3390/jcm11195738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
It is proven that music listening can have a therapeutic impact in many clinical fields. However, to assume a curative value, musical stimuli should have a therapeutic logic. This study aimed at assessing short-term effects of algorithmic music on cardiac autonomic nervous system activity. Twenty-two healthy subjects underwent a crossover study including random listening to relaxing and activating algorithmic music. Electrocardiogram (ECG) and non-invasive arterial blood pressure were continuously recorded and were later analyzed to measure Heart Rate (HR) mean, HR variability and baroreflex sensitivity (BRS). Statistical analysis was performed using a general linear model, testing for carryover, period and treatment effects. Relaxing tracks decreased HR and increased root mean square of successive squared differences of normal-to-normal (NN) intervals, proportion of interval differences of successive NN intervals greater than 50 ms, low-frequency (LF) and high-frequency (HF) power and BRS. Activating tracks caused almost no change or an opposite effect in the same variables. The difference between the effects of the two stimuli was statistically significant in all these variables. No difference was found in the standard deviation of normal-to-normal RR intervals, LFpower in normalized units and LFpower/HFpower variables. The study suggests that algorithmic relaxing music increases cardiac vagal modulation and tone. These results open interesting perspectives in various clinical areas.
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Affiliation(s)
- Alfredo Raglio
- Music Therapy Research Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
- Correspondence: ; Tel.: +39-03825901
| | - Roberto Maestri
- Laboratory for the Study of Ventilatory Instability, Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Elena Robbi
- Laboratory for the Study of the Autonomic Nervous System and Cardiorespiratory Activity, Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Maria Teresa La Rovere
- Laboratory for the Study of the Autonomic Nervous System and Cardiorespiratory Activity, Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Gian Domenico Pinna
- Laboratory for the Study of Ventilatory Instability, Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
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Liu KY, Elliott T, Knowles M, Howard R. Heart rate variability in relation to cognition and behavior in neurodegenerative diseases: A systematic review and meta-analysis. Ageing Res Rev 2022; 73:101539. [PMID: 34883203 PMCID: PMC8783051 DOI: 10.1016/j.arr.2021.101539] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 11/05/2021] [Accepted: 12/03/2021] [Indexed: 12/24/2022]
Abstract
Neurodegenerative diseases, which frequently present with neuropsychiatric symptoms related to prefrontal cortical dysfunction, can alter the integrity of the neural networks involved in central autonomic nervous system regulation, which is proposed to be indexed by heart rate variability (HRV). We systematically reviewed the characteristics, methodology and outcomes of 27 studies of HRV in relation to measures of cognition and behavior in neurodegenerative conditions, and assessed the strength of this relationship, cross-sectionally, across 18 studies. A significant, moderate effect was observed (r = 0.25), such that higher HRV was related to better cognitive and behavioral scores, which was not influenced by mean age or cognitive status. There was no evidence of small-study effects but we could not rule out publication bias, and other factors may have contributed to heterogeneity between studies. Our findings support the proposal that HRV may be a marker of self-regulatory processes in neurodegenerative conditions, and further research on this association is needed in relation to neuropsychiatric symptoms and alongside neuroimaging methods.
Heart rate variability is proposed to be influenced by a neural network involved in autonomic regulation. Neurodegenerative processes alter the integrity of the central autonomic network. We reviewed studies of HRV and cognition/behavior in neurodegenerative diseases. We found a moderate correlation between HRV and measures of cognition/behavior.
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Conventional and Algorithmic Music Listening before Radiotherapy Treatment: A Randomized Controlled Pilot Study. Brain Sci 2021; 11:brainsci11121618. [PMID: 34942921 PMCID: PMC8699134 DOI: 10.3390/brainsci11121618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022] Open
Abstract
Music listening is a widespread approach in the field of music therapy. In this study, the effects of music listening on anxiety and stress in patients undergoing radiotherapy are investigated. Sixty patients with breast cancer who were candidates for postoperative curative radiotherapy were recruited and randomly assigned to three groups: Melomics-Health (MH) group (music listening algorithmically created, n = 20); individualized music listening (IML) group (playlist of preferred music, n = 20); no music group (n = 20). Music listening was administered for 15 min immediately before simulation and during the first five radiotherapy sessions. The State-Trait Anxiety Inventory (STAI) and the Psychological Distress Inventory (PDI) were administered before/after treatment. Cochran’s Q test and McNemar test for paired proportions were performed to evaluate if the proportion of subjects having an outcome score below the critical value by treatment and over time was different, and if there was a change in that proportion. The MH group improved in STAI and PDI. The IML group worsened in STAI at T1 and improved STAI-Trait at T2. The IML group worsened in PDI at T2. The No music group generally improved in STAI and PDI. Clinical and music listening-related implications are discussed defining possible research perspectives in this field.
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Fälth N, Brorsson A, Londos E. Choral Singing Enriches Everyday Life for People With Mild to Moderate Dementia and Their Family Caregivers. J Psychosoc Nurs Ment Health Serv 2021; 60:29-36. [PMID: 34677117 DOI: 10.3928/02793695-20211015-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Dementia causes substantial suffering for affected persons and their family caregivers. Because no cure is available, it is important to investigate how alternative therapies can improve life for these individuals. For the current study, persons with dementia (PwD) were recruited from a specialized Memory Clinic in Sweden to engage in a choral singing intervention for 1 hour per week for four semesters. PwD were encouraged to bring a family caregiver to the sessions; both were interviewed and data were analyzed using qualitative content analysis. The choral singing intervention appeared to become an important social context for PwD and family caregivers and had a positive impact on relationship, mental well-being, mood, and memory. The intervention appeared to act as an enriched environment for all participants. Choral singing interventions for PwD and their family caregivers is a simple means to create a social context and improve general well-being. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].
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Raglio A, De Maria B, Perego F, Galizia G, Gallotta M, Imbriani C, Porta A, Dalla Vecchia LA. Effects of Algorithmic Music on the Cardiovascular Neural Control. J Pers Med 2021; 11:jpm11111084. [PMID: 34834436 PMCID: PMC8618683 DOI: 10.3390/jpm11111084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 12/21/2022] Open
Abstract
Music influences many physiological parameters, including some cardiovascular (CV) control indices. The complexity and heterogeneity of musical stimuli, the integrated response within the brain and the limited availability of quantitative methods for non-invasive assessment of the autonomic function are the main reasons for the scarcity of studies about the impact of music on CV control. This study aims to investigate the effects of listening to algorithmic music on the CV regulation of healthy subjects by means of the spectral analysis of heart period, approximated as the time distance between two consecutive R-wave peaks (RR), and systolic arterial pressure (SAP) variability. We studied 10 healthy volunteers (age 39 ± 6 years, 5 females) both while supine (REST) and during passive orthostatism (TILT). Activating and relaxing algorithmic music tracks were used to produce possible contrasting effects. At baseline, the group featured normal indices of CV sympathovagal modulation both at REST and during TILT. Compared to baseline, at REST, listening to both musical stimuli did not affect time and frequency domain markers of both SAP and RR, except for a significant increase in mean RR. A physiological TILT response was maintained while listening to both musical tracks in terms of time and frequency domain markers, compared to baseline, an increase in mean RR was again observed. In healthy subjects featuring a normal CV neural profile at baseline, algorithmic music reduced the heart rate, a potentially favorable effect. The innovative music approach of this study encourages further research, as in the presence of several diseases, such as ischemic heart disease, hypertension, and heart failure, a standardized musical stimulation could play a therapeutic role.
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Affiliation(s)
- Alfredo Raglio
- IRCCS Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy; (A.R.); (C.I.)
| | - Beatrice De Maria
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | - Francesca Perego
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | | | - Matteo Gallotta
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | - Chiara Imbriani
- IRCCS Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy; (A.R.); (C.I.)
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
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Cibeira N, Maseda A, Lorenzo-López L, González-Abraldes I, López-López R, Rodríguez-Villamil JL, Millán-Calenti JC. Bright Light Therapy in Older Adults with Moderate to Very Severe Dementia: Immediate Effects on Behavior, Mood, and Physiological Parameters. Healthcare (Basel) 2021; 9:healthcare9081065. [PMID: 34442202 PMCID: PMC8394855 DOI: 10.3390/healthcare9081065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/15/2021] [Accepted: 08/16/2021] [Indexed: 11/21/2022] Open
Abstract
Bright light therapy (BLT) has demonstrated positive short- and long-term effects in people with cognitive impairment or dementia; however, the immediate impact of BLT sessions has been scarcely investigated. In this study, we aimed to explore the immediate effects of BLT on behavior, mood, and physiological parameters (oxygen saturation/heart rate) in a sample of institutionalized older adults with moderate to very severe dementia, with a median age of 85.0 (interquartile range, IQR, 82.0–90.0), being higher in men (87.0 years, IQR 80.0–94.0) than in women (84.5 years, IQR 82.0–89.5). The BLT protocol consisted of 30-min morning sessions of 10,000 lux, Monday through Friday, for 4 weeks. The physiological parameters were recorded immediately before and after each session by pulse oximetry. Mood and behavior were assessed before, after, and during the sessions using the Interact scale. Post-session Interact scores showed a significant decrease in the items Tearful/sad and Talked spontaneously, and a significant increase in the items Enjoying self, active or alert, and Relaxed, content or sleeping appropriately. Interact scores during the sessions reflected a significant decrease in the speech-related items. Both physiological parameters changed positively from before to after sessions. Our results suggest that BLT provides immediate positive effects on mood, stimulation level, and physiological parameters, as well as a trend toward decreased speech. More robust research is needed to further explore the immediate impact of BLT. This study is registered with Clinicaltrials.gov (NCT04949984).
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Affiliation(s)
| | - Ana Maseda
- Correspondence: (A.M.); (J.C.M.-C.); Tel.: +34-881-01-58-65 (J.C.M.-C.)
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Sun Y, Baird A, Gelding R, de Wit B, Thompson WF. Can music enhance awareness in unresponsive people with severe dementia? An exploratory case series using behavioral, physiological and neurophysiological measures. Neurocase 2021; 27:354-365. [PMID: 34455925 DOI: 10.1080/13554794.2021.1966045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In five people with severe dementia, we measured their behavioral and physiological responses to familiar/unfamiliar music and speech, and measured ERP responses to subject's own name (SON) after exposure to familiar/unfamiliar music or noise. We observed more frequent behavioral responses to personally-significant stimuli than non-personally-significant stumuli, and higher skin temperatures for music than non-music conditions. The control group showed typical ERPs to SON, regardless of auditory exposure. ERP measures were unavailable for the dementia group given challenges of measuring EEG in this population. The study highlights the potential for personally-significant auditory stimuli in enhancing responsiveness of people with severe dementia.
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Affiliation(s)
- Yanan Sun
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Amee Baird
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Rebecca Gelding
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Bianca de Wit
- School of Psychological Sciences, Macquarie University, Sydney, Australia
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Nelson KL, Lu SE, Oken T, Lehrer PM, Feldman JM. Further Exploration of Treatment Response in Latinos with Comorbid Asthma and Panic Disorder: A Brief Report of HRV and ETCO2 as Potential Mediators of Treatment Response. Appl Psychophysiol Biofeedback 2021; 45:67-74. [PMID: 32193714 DOI: 10.1007/s10484-020-09454-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Heart rate variability (HRV) and end tidal CO2 (ETCO2) in relation to treatment response have not been studied in Latino populations or in comorbid asthma and panic disorder (PD). An extension of previously published research, the current study explored psychophysiological variables as possible mediators of treatment response. Latino treatment completers (N = 32) in the Bronx with asthma-PD received either Cognitive-Behavioral Psychophysiological Therapy (CBPT) or Music Relaxation Therapy (MRT). CBPT included HRV-biofeedback (HRVB); in-the-moment heart rate data to help an individual learn to influence his/her own heart rate. The sample was primarily female (93.8%) and Puerto Rican (81.25%). Treatment groups did not differ on demographics, except for less education in CBPT. The Panic Disorder Severity Scale (PDSS) and Asthma Control Questionnaire (ACQ) assessed changes in symptoms. HRV and ETCO2 were measured at four of eight therapy sessions. Baseline ETCO2 and changes in HRV from first to last of psychophysiology sessions were investigated as mediators of change on ACQ and PDSS. Mixed model analyses indicated in the CPBT group, changes in both asthma control and PD severity were not mediated by changes in HRV. In the CBPT and MRT groups combined, changes in PD severity were not mediated by baseline ETCO2. These findings may be due to the brevity of HRVB in CBPT, multiple treatment components, ETCO2 not directly targeted, and/or unique physiological pathways in Latinos with asthma-PD.
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Affiliation(s)
- Krista L Nelson
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA
| | - Shou-En Lu
- Rutgers - School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
| | - Tanya Oken
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA
| | - Paul M Lehrer
- Department of Psychiatry, Rutgers - Robert Wood Johnson Medical School, 671 Hoes Lane, Piscataway, NJ, 08854, USA
| | - Jonathan M Feldman
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA.
- Department of Pediatrics (Academic General Pediatrics), Albert Einstein College of Medicine/Children's Hospital at Montefiore, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
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Dorris JL, Neely S, Terhorst L, VonVille HM, Rodakowski J. Effects of music participation for mild cognitive impairment and dementia: A systematic review and meta-analysis. J Am Geriatr Soc 2021; 69:2659-2667. [PMID: 34008208 DOI: 10.1111/jgs.17208] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine randomized controlled trials with active music-making interventions, in which older adults with probable mild cognitive impairment (MCI) or dementia physically participate in music, and their effects on cognitive functioning, emotional well-being, and social engagement. Participating in music-making is engaging and has shown diverse benefits. Additionally, this review categorized the music activities of each intervention. DESIGN Systematic review and meta-analysis. SETTING Long-term care facilities, day centers, specialty outpatient units, and community. METHODS Published randomized controlled trials of active music-making interventions to support older adults with probable MCI or dementia were identified (to March 15, 2021) using searches on Medline (Ovid), APA PsycInfo (Ovid), CINAHL (Ebsco), and Embase (Elsevier). The outcomes were cognitive functioning, emotional well-being, and social engagement, including self- and clinician-reported measures such as the Mini-Mental State Examination, Positive and Negative Affect Schedule, and the Beck Depression Inventory. Studies were critically appraised and studies with similar methodology were meta-analyzed. PARTICIPANTS Older adults with probable MCI and mild or moderate dementia. RESULTS A total of 21 studies with 1472 participants were analyzed for potential effect sizes and intervention activities. Of the 21 studies, nine studies recruiting a total of 495 participants were used to produce a random-effects meta-analytic model for cognitive functioning. Music showed a small, positive effect on cognitive functioning; the combined standard mean difference for the experimental and control group was 0.30 (95% confidence interval [CI] 0.10, 0.51). There was low study heterogeneity, with an I2 of 24% (p = 0.004). Individual studies for emotional well-being in terms of quality of life and mood showed positive effect sizes, d = 1.08 and d = 1.74, respectively. [Corrections added on July 8, 2021, after first online publication: The preceding sentences were revised from: "… control group was 0.31 (95% confidence interval [CI] 0.10,0.52). There was low study heterogeneity, with an I2 of 25% (p = 0.004)."] CONCLUSION: This review shows that music-making has a small but statistically significant effect on cognitive functioning for older adults with probable MCI or dementia. Future music interventions can benefit from rigorous intervention protocols that isolate specific activities.
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Affiliation(s)
- Jennie L Dorris
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Stephen Neely
- School of Music, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Helena M VonVille
- Health Sciences Library System, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Juleen Rodakowski
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Sittler MC, Worschech F, Wilz G, Fellgiebel A, Wuttke-Linnemann A. Psychobiological mechanisms underlying the health-beneficial effects of music in people living with dementia: A systematic review of the literature. Physiol Behav 2021; 233:113338. [DOI: 10.1016/j.physbeh.2021.113338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/23/2020] [Accepted: 01/21/2021] [Indexed: 01/06/2023]
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Hohneck A, Reyser C, Merx K, Weingärtner S, Mavratzas A, Schumacher G, Linhuber C, Hofmann WK, Burkholder I, Hofheinz RD. Differential Effects of Sound Intervention and Rest on Cardiovascular Parameters in Cancer Patients: A Randomized Cross-over Trial. Integr Cancer Ther 2021; 20:1534735421995239. [PMID: 33813930 PMCID: PMC8024455 DOI: 10.1177/1534735421995239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Music therapy or sound interventions were shown to confer beneficial effects in patients with cancer for instance in terms of pain or fear relief and improvement of other patient reported outcomes. Cardiovascular parameters, especially heart rate variability (HRV) were found to have prognostic implications in cancer patients. In this trial we aimed to investigate the effects of a sound intervention on cardiovascular parameters compared to rest in patients with cancer. Methods and results: Using a randomized cross-over design, 52 patients (male 13, female 39) with cancer were recruited to receive both a 15-minute sound intervention and a 15-minute rest intervention within 4 weeks with at least a one-week blanking period. Cardiovascular parameters (among others HRV, aortic pulse wave velocity [PWV], augmentation index [Aix], aortic blood pressure [BP], heart rate [HR]) were assessed immediately before (pre) and after (post) the intervention had taken place. HRV (Root mean square of successive RR interval differences [RMSSD, ms]) significantly increased, during sound intervention (median RMSSD pre 24 [range 5-112] vs post 22 [range 9-141], P = .03). Likewise, median PWV, as a direct marker of arterial stiffness, was significantly reduced by sound intervention ([m/s] pre 8.5 [range 5.6-19.6] vs post 8.3 [range 5.6-15.6], P = .04). For both parameters no statistically significant change during rest was observed. HR was lowered by both, rest (P < .0001) and sound intervention (P = .02), with a more pronounced effect by rest. A significant increase in systolic aortic blood pressure was shown by rest ([mmHg] median 101 [range 78-150] vs post median 103 [range 71-152], P = .04) but not during sound intervention (P = .59), while rest intervention led to a decrease in resistance index (pre median 33 [range 13-92] vs post median 32 [11-84], P = .02). Conclusion: In comparison with rest, a single sound intervention in patients with cancer improved cardiovascular parameters commonly associated with increased stress levels. Studies with longer follow-up and multiple interventions are warranted. Trial Registration: ISRCTN registry 70947363.
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Affiliation(s)
- Anna Hohneck
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christina Reyser
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Kirsten Merx
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Simone Weingärtner
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Athanasios Mavratzas
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | | | - Wolf-Karsten Hofmann
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Iris Burkholder
- University of Applied Sciences of the Saarland, Saarbrucken, Germany
| | - Ralf-Dieter Hofheinz
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Watt JA, Goodarzi Z, Veroniki AA, Nincic V, Khan PA, Ghassemi M, Lai Y, Treister V, Thompson Y, Schneider R, Tricco AC, Straus SE. Comparative efficacy of interventions for reducing symptoms of depression in people with dementia: systematic review and network meta-analysis. BMJ 2021; 372:n532. [PMID: 33762262 PMCID: PMC7988455 DOI: 10.1136/bmj.n532] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To describe the comparative efficacy of drug and non-drug interventions for reducing symptoms of depression in people with dementia who experience depression as a neuropsychiatric symptom of dementia or have a diagnosis of a major depressive disorder. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline, Embase, the Cochrane Library, CINAHL, PsycINFO, and grey literature between inception and 15 October 2020. ELIGIBILITY CRITERIA FOR STUDY SELECTION Randomised trials comparing drug or non-drug interventions with usual care or any other intervention targeting symptoms of depression in people with dementia. MAIN OUTCOME MEASURES Pairs of reviewers screened studies, abstracted aggregate level data, and appraised risk of bias with the Cochrane risk of bias tool, which facilitated the derivation of standardised mean differences and back transformed mean differences (on the Cornell scale for depression in dementia) from bayesian random effects network meta-analyses and pairwise meta-analyses. RESULTS Of 22 138 citations screened, 256 studies (28 483 people with dementia) were included. Missing data posed the greatest risk to review findings. In the network meta-analysis of studies including people with dementia without a diagnosis of a major depressive disorder who were experiencing symptoms of depression (213 studies; 25 177 people with dementia; between study variance 0.23), seven interventions were associated with a greater reduction in symptoms of depression compared with usual care: cognitive stimulation (mean difference -2.93, 95% credible interval -4.35 to -1.52), cognitive stimulation combined with a cholinesterase inhibitor (-11.39, -18.38 to -3.93), massage and touch therapy (-9.03, -12.28 to -5.88), multidisciplinary care (-1.98, -3.80 to -0.16), occupational therapy (-2.59, -4.70 to -0.40), exercise combined with social interaction and cognitive stimulation (-12.37, -19.01 to -5.36), and reminiscence therapy (-2.30, -3.68 to -0.93). Except for massage and touch therapy, cognitive stimulation combined with a cholinesterase inhibitor, and cognitive stimulation combined with exercise and social interaction, which were more efficacious than some drug interventions, no statistically significant difference was found in the comparative efficacy of drug and non-drug interventions for reducing symptoms of depression in people with dementia without a diagnosis of a major depressive disorder. Clinical and methodological heterogeneity precluded network meta-analysis of studies comparing the efficacy of interventions specifically for reducing symptoms of depression in people with dementia and a major depressive disorder (22 studies; 1829 patients). CONCLUSIONS In this systematic review, non-drug interventions were found to be more efficacious than drug interventions for reducing symptoms of depression in people with dementia without a major depressive disorder. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017050130.
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Affiliation(s)
- Jennifer A Watt
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Zahra Goodarzi
- Department of Medicine, University of Calgary, Foothills Medical Centre, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
| | - Areti Angeliki Veroniki
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
- Institute of Reproductive and Developmental Biology, Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK
| | - Vera Nincic
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Paul A Khan
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Marco Ghassemi
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Yonda Lai
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Victoria Treister
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Yuan Thompson
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Raphael Schneider
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- St Michael's Hospital, Toronto, ON, Canada
| | - Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sharon E Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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Can music influence cardiac autonomic system? A systematic review and narrative synthesis to evaluate its impact on heart rate variability. Complement Ther Clin Pract 2020; 39:101162. [DOI: 10.1016/j.ctcp.2020.101162] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 12/11/2022]
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Gok Ugur H, Orak OS, Yaman Aktas Y, Enginyurt O, Saglambilen O. [Effects of Music Therapy on the Care Burden of In-Home Caregivers and Physiological Parameters of Their In-Home Dementia Patients: A Randomized Controlled Trial]. Complement Med Res 2018; 26:22-30. [PMID: 30497077 DOI: 10.1159/000490348] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES This study was conducted to explore the effects of classical Turkish music therapy on both the caregiver burden and physiological parameters of patients with dementia. METHODS The study was a randomized controlled trial. It was conducted with dementia patients (n = 75) and their caregivers who were registered at in-home care services of the General Secretariat of the Association of Public Hospitals in Ordu. The study sample consisted of 30 control and 30 music group patients and their caregivers who satisfied the inclusion criteria for the study conducted between April 2015 and April 2016. The primary outcome of the study was to measure the care burden of in-home caregivers, and the secondary outcome was to measure physiological parameters, including systolic and diastolic blood pressure, heart rate, and respiration rate in patients with dementia. RESULTS The mean scores of the post-test caregiver burden in the music group were found to be significantly lower than those of the control group (t = -4.478, p = 0.001). The differences in the post-test systolic and diastolic blood pressures between the patient groups were found to be statistically significant (t = -4.603, p = 0.001; t = -2.656, p = 0.010). CONCLUSIONS Classical Turkish music intervention in in-home dementia patients decreased the care burden of caregivers and the patients' blood pressures were brought under control. In parallel with these results, it is recommended that more studies to reveal the effects of classical Turkish music on care burden should be conducted.
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Chan JY, Tsoi KK. Response to the Letter to the Editor “Music Listening for People Living With Dementia”. J Am Med Dir Assoc 2018; 19:723-724. [DOI: 10.1016/j.jamda.2018.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 05/25/2018] [Indexed: 10/28/2022]
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van der Steen JT, Smaling HJA, van der Wouden JC, Bruinsma MS, Scholten RJPM, Vink AC, Cochrane Dementia and Cognitive Improvement Group. Music-based therapeutic interventions for people with dementia. Cochrane Database Syst Rev 2018; 7:CD003477. [PMID: 30033623 PMCID: PMC6513122 DOI: 10.1002/14651858.cd003477.pub4] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Dementia is a clinical syndrome with a number of different causes which is characterised by deterioration in cognitive, behavioural, social and emotional functions. Pharmacological interventions are available but have limited effect to treat many of the syndrome's features. Less research has been directed towards non-pharmacological treatments. In this review, we examined the evidence for effects of music-based interventions. OBJECTIVES To assess the effects of music-based therapeutic interventions for people with dementia on emotional well-being including quality of life, mood disturbance or negative affect, behavioural problems, social behaviour and cognition at the end of therapy and four or more weeks after the end of treatment. SEARCH METHODS We searched ALOIS, the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG) on 19 June 2017 using the terms: music therapy, music, singing, sing, auditory stimulation. Additional searches were carried out on 19 June 2017 in the major healthcare databases MEDLINE, Embase, PsycINFO, CINAHL and LILACS; and in trial registers and grey literature sources. SELECTION CRITERIA We included randomised controlled trials of music-based therapeutic interventions (at least five sessions) for people with dementia that measured any of our outcomes of interest. Control groups either received usual care or other activities with or without music. DATA COLLECTION AND ANALYSIS Two review authors worked independently to screen the retrieved studies against the inclusion criteria and then to extract data and assess methodological quality of the included studies. If necessary, we contacted trial authors to ask for additional data, including relevant subscales, or for other missing information. We pooled data using random-effects models. MAIN RESULTS We included 22 studies with 1097 randomised participants. Twenty-one studies with 890 participants contributed data to meta-analyses. Participants in the studies had dementia of varying degrees of severity, and all were resident in institutions. Seven studies delivered an individual music intervention; the other studies delivered the intervention to groups of participants. Most interventions involved both active and receptive musical elements. The methodological quality of the studies varied. All were at high risk of performance bias and some were at high risk of detection or other bias.At the end of treatment, we found low-quality evidence that the interventions may improve emotional well-being and quality of life (standardised mean difference (SMD) 0.32, 95% confidence interval (CI) 0.02 to 0.62; 9 studies, 348 participants) and reduce anxiety (SMD -0.43, 95% CI -0.72 to -0.14; 13 studies, 478 participants). We found low-quality evidence that music-based therapeutic interventions may have little or no effect on cognition (SMD 0.15, 95% CI -0.06 to 0.36; 7 studies, 350 participants). There was moderate-quality evidence that the interventions reduce depressive symptoms (SMD -0.27, 95% CI -0.45 to -0.09; 11 studies, 503 participants) and overall behaviour problems (SMD -0.23, 95% CI -0.46 to -0.01; 10 studies, 442 participants), but do not decrease agitation or aggression (SMD -0.07, 95% CI -0.24 to 0.10; 14 studies, 626 participants). The quality of the evidence on social behaviour was very low, so effects were very uncertain.The evidence for long-term outcomes measured four or more weeks after the end of treatment was of very low quality for anxiety and social behaviour, and for the other outcomes, it was of low quality for little or no effect (with small SMDs, between 0.03 and 0.34). AUTHORS' CONCLUSIONS Providing people with dementia who are in institutional care with at least five sessions of a music-based therapeutic intervention probably reduces depressive symptoms and improves overall behavioural problems at the end of treatment. It may also improve emotional well-being and quality of life and reduce anxiety, but may have little or no effect on agitation or aggression or on cognition. We are uncertain about effects on social behaviour and about long-term effects. Future studies should examine the duration of effects in relation to the overall duration of treatment and the number of sessions.
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Affiliation(s)
- Jenny T van der Steen
- Leiden University Medical CenterDepartment of Public Health and Primary CareHippocratespad 21, Gebouw 3PO Box 9600LeidenNetherlands2300RC
| | - Hanneke JA Smaling
- VU University Medical CenterDepartment of Public and Occupational Health, Amsterdam Public Health Research InstituteVan der Boechorststraat 7AmsterdamNetherlands1081 BT
| | - Johannes C van der Wouden
- VU University Medical CenterDepartment of General Practice and Elderly Care Medicine, Amsterdam Public Health Research InstitutePO Box 7057AmsterdamNetherlands1007 MB
| | - Manon S Bruinsma
- Muzis, Praktijk voor MuziektherapieGrote Beer 3DAmersfoortNetherlands3813VT
- Music and Memory160 First StreetMineolaNYUSA11501
| | - Rob JPM Scholten
- Julius Center for Health Sciences and Primary Care / University Medical Center UtrechtCochrane NetherlandsRoom Str. 6.126P.O. Box 85500UtrechtNetherlands3508 GA
| | - Annemiek C Vink
- ArtEZ School of MusicMusic Therapy DepartmentVan Essengaarde 10EnschedeNetherlands7511 PN
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Raglio A, Pavlic E, Bellandi D. Music Listening for People Living With Dementia. J Am Med Dir Assoc 2018; 19:722-723. [PMID: 30056951 DOI: 10.1016/j.jamda.2018.05.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 05/08/2018] [Accepted: 05/11/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - Ester Pavlic
- Fondazione Istituto Ospedaliero di Sospiro, Sospiro (CR), Italy
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Gök Ugur H, Yaman Aktaş Y, Orak OS, Saglambilen O, Aydin Avci İ. The effect of music therapy on depression and physiological parameters in elderly people living in a Turkish nursing home: a randomized-controlled trial. Aging Ment Health 2017; 21:1280-1286. [PMID: 27592520 DOI: 10.1080/13607863.2016.1222348] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study was carried out in an effort to determine the effect of music therapy on depression and physiological parameters in elderly people who were living in a nursing home. METHOD The study was a randomized controlled trial. The study sample consisted of 64 elderly people who complied with the criteria of inclusion for the study. The data were collected using the 'Elderly Information Form' and 'Geriatric Depression Scale'. The music group listened to music three days in a week during 8 weeks. The depression levels were assessed at baseline (week 0) and follow-up in the eight week. RESULTS It was found that the difference between post-test depression scores of the two groups was found to be statistically significant (t = -2.86, p <.01). The mean scores of post-test systolic blood pressure in the music group were found to be significantly lower than those of the control group (t = -3.11, p < .05). CONCLUSION It was concluded that music therapy decreased the depression level and systolic blood pressure in elderly people. The study results implies that music therapy can be an effective practice for public health and home care nurses attempting to reduce depression and control physiological parameters of elderly people.
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Affiliation(s)
- Hacer Gök Ugur
- a Department of Public Health Nursing, School of Health Sciences , Ordu University , Ordu , Turkey
| | - Yeşim Yaman Aktaş
- b Department of Surgical Nursing, Faculty of Health Sciences , Giresun University , Giresun , Turkey
| | - Oya Sevcan Orak
- c Department of Psychiatric Nursing, School of Health Sciences , Ordu University , Ordu , Turkey
| | - Okan Saglambilen
- d Music Department, Faculty of Music and Performing Arts , Ordu University , Ordu , Turkey
| | - İlknur Aydin Avci
- e Department of Public Health Nursing, Samsun School of Health , Ondokuz Mayıs University , Samsun , Turkey
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Measuring physiological responses to the arts in people with a dementia. Int J Psychophysiol 2017; 123:64-73. [PMID: 29158118 DOI: 10.1016/j.ijpsycho.2017.11.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/24/2017] [Accepted: 11/10/2017] [Indexed: 01/29/2023]
Abstract
The dementias are a group of progressive symptoms that have multiple causes, usually caused by disease or injury of the brain, affecting higher brain functions such as language, perception, memory, reasoning and mood; they can also be associated with changes in personality. Arts interventions and interaction with the arts can create meaningful, positive experiences for people with a dementia, as well as improve quality of life. Qualitative research in particular, has been able to describe the emotional responses the arts can produce, but quantifiable changes have not been well documented. Physiological measurements such as stress hormone levels and galvanic skin response show promise in being able to quantify such responses. When taken together, these can give a picture of the kinds of physiological outcomes that are associated with positive affect and improvements in mental wellbeing in the context of arts interventions. This review provides a critical overview of the studies which measure some form of physiological outcome in response to the arts or an arts intervention in people with dementia, and indicates how future research in this area can help to broaden our understanding of the effects of the arts in dementia research and care.
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van der Steen JT, van Soest‐Poortvliet MC, van der Wouden JC, Bruinsma MS, Scholten RJPM, Vink AC. Music-based therapeutic interventions for people with dementia. Cochrane Database Syst Rev 2017; 5:CD003477. [PMID: 28462986 PMCID: PMC6481517 DOI: 10.1002/14651858.cd003477.pub3] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Dementia is a clinical syndrome with a number of different causes which is characterised by deterioration in cognitive, behavioural, social and emotional functions. Pharmacological interventions are available but have limited effect to treat many of the syndrome's features. Less research has been directed towards non-pharmacological treatments. In this review, we examined the evidence for effects of music-based interventions as a treatment. OBJECTIVES To assess the effects of music-based therapeutic interventions for people with dementia on emotional well-being including quality of life, mood disturbance or negative affect, behavioural problems, social behaviour, and cognition at the end of therapy and four or more weeks after the end of treatment. SEARCH METHODS We searched ALOIS, the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG) on 14 April 2010 using the terms: music therapy, music, singing, sing, auditory stimulation. Additional searches were also carried out on 3 July 2015 in the major healthcare databases MEDLINE, Embase, psycINFO, CINAHL and LILACS; and in trial registers and grey literature sources. On 12 April 2016, we searched the major databases for new studies for future evaluation. SELECTION CRITERIA We included randomized controlled trials of music-based therapeutic interventions (at least five sessions) for people with dementia that measured any of our outcomes of interest. Control groups either received usual care or other activities. DATA COLLECTION AND ANALYSIS Two reviewers worked independently to screen the retrieved studies against the inclusion criteria and then to extract data and assess methodological quality of the included studies. If necessary, we contacted trial authors to ask for additional data, including relevant subscales, or for other missing information. We pooled data using random-effects models. MAIN RESULTS We included 17 studies. Sixteen studies with a total of 620 participants contributed data to meta-analyses. Participants in the studies had dementia of varying degrees of severity, but all were resident in institutions. Five studies delivered an individual music intervention; in the others, the intervention was delivered to groups of participants. Most interventions involved both active and receptive musical elements. The methodological quality of the studies varied. All were at high risk of performance bias and some were at high risk of detection or other bias. At the end of treatment, we found low-quality evidence that music-based therapeutic interventions may have little or no effect on emotional well-being and quality of life (standardized mean difference, SMD 0.32, 95% CI -0.08 to 0.71; 6 studies, 181 participants), overall behaviour problems (SMD -0.20, 95% CI -0.56 to 0.17; 6 studies, 209 participants) and cognition (SMD 0.21, 95% CI -0.04 to 0.45; 6 studies, 257 participants). We found moderate-quality evidence that they reduce depressive symptoms (SMD -0.28, 95% CI -0.48 to -0.07; 9 studies, 376 participants), but do not decrease agitation or aggression (SMD -0.08, 95% CI -0.29 to 0.14; 12 studies, 515 participants). The quality of the evidence on anxiety and social behaviour was very low, so effects were very uncertain. The evidence for all long-term outcomes was also of very low quality. AUTHORS' CONCLUSIONS Providing people with dementia with at least five sessions of a music-based therapeutic intervention probably reduces depressive symptoms but has little or no effect on agitation or aggression. There may also be little or no effect on emotional well-being or quality of life, overall behavioural problems and cognition. We are uncertain about effects on anxiety or social behaviour, and about any long-term effects. Future studies should employ larger sample sizes, and include all important outcomes, in particular 'positive' outcomes such as emotional well-being and social outcomes. Future studies should also examine the duration of effects in relation to the overall duration of treatment and the number of sessions.
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Affiliation(s)
- Jenny T van der Steen
- Leiden University Medical CenterDepartment of Public Health and Primary CareHippocratespad 21, Gebouw 3PO Box 9600LeidenNetherlands2300RC
| | | | - Johannes C van der Wouden
- VU University Medical CenterDepartment of General Practice and Elderly Care Medicine, Amsterdam Public Health Research InstitutePO Box 7057AmsterdamNetherlands1007 MB
| | | | - Rob JPM Scholten
- Julius Center for Health Sciences and Primary Care / University Medical Center UtrechtCochrane NetherlandsRoom Str. 6.126P.O. Box 85500UtrechtNetherlands3508 GA
| | - Annemiek C Vink
- ArtEZ School of MusicMusic Therapy Dept.Van Essengaarde 10EnschedeNetherlands7511 PN
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Abraha I, Rimland JM, Trotta FM, Dell'Aquila G, Cruz-Jentoft A, Petrovic M, Gudmundsson A, Soiza R, O'Mahony D, Guaita A, Cherubini A. Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series. BMJ Open 2017; 7:e012759. [PMID: 28302633 PMCID: PMC5372076 DOI: 10.1136/bmjopen-2016-012759] [Citation(s) in RCA: 279] [Impact Index Per Article: 34.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/05/2016] [Accepted: 10/04/2016] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD). DESIGN Systematic overview of reviews. DATA SOURCES PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009-March 2015). ELIGIBILITY CRITERIA Systematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD. DATA EXTRACTION Eligible studies were selected and data extracted independently by 2 reviewers.The AMSTAR checklist was used to assess the quality of the SRs. DATA ANALYSIS Extracted data were synthesised using a narrative approach. RESULTS 38 SRs and 129 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (25 SRs, 66 primary studies) that encompassed: shiatsu and acupressure, aromatherapy, massage/touch therapy, light therapy, sensory garden and horticultural activities, music/dance therapy, dance therapy, snoezelen multisensory stimulation therapy, transcutaneous electrical nerve stimulation; (2) cognitive/emotion-oriented interventions (13 SRs; 26 primary studies) that included cognitive stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 22 primary studies); (4) Multicomponent interventions (3 SR; four primary studies); (5) other therapies (5 SRs, 15 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions. CONCLUSIONS A large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD.
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Affiliation(s)
- Iosief Abraha
- Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy
| | - Joseph M Rimland
- Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy
| | - Fabiana Mirella Trotta
- Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy
| | - Giuseppina Dell'Aquila
- Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy
| | | | - Mirko Petrovic
- Department of Internal Medicine (Geriatrics), Ghent University,Ghent, Belgium
| | | | - Roy Soiza
- Department of Medicine for the Elderly, Woodend Hospital, Aberdeen, UK
| | - Denis O'Mahony
- Department of Medicine, University College Cork, Cork, Ireland
| | | | - Antonio Cherubini
- Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy
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Werner J, Wosch T, Gold C. Effectiveness of group music therapy versus recreational group singing for depressive symptoms of elderly nursing home residents: pragmatic trial. Aging Ment Health 2017; 21:147-155. [PMID: 26457893 DOI: 10.1080/13607863.2015.1093599] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Several studies have suggested positive effects of music therapy in dementia, but research on age-related depression has been limited and of insufficient quality. The aim of this study was to examine the effect of interactive group music therapy versus recreational group singing on depressive symptoms in elderly nursing home residents. METHOD Residents of two German nursing homes with sufficient length of stay who were not bedridden were invited to participate in a pragmatic trial. A total of 117 participants, grouped into four clusters (based on their wards), were randomised to interactive group music therapy (n = 62; 20 units of 40 minutes, 2×/week) or recreational group singing (n = 55; 10 units of 90 minutes, 1×/week). The level of depressive symptoms was assessed using the Montgomery-Åsberg Depression Rating Scale at baseline (47% with at least mild depression) and follow-up in the 6th and 12th weeks. There was no blinding of assessors. RESULTS The level of depressive symptoms improved significantly more in those assigned to music therapy (n = 60) than in recreational singing (n = 53), both in 6th week (mean difference 3.0 scores, 95% CI 1.21 to 4.79, p = 0.001) and 12th week (mean difference 4.50 scores, 95% CI 2.51 to 6.50, p < 0.001). CONCLUSION The results suggest that music therapy decreases depressive symptoms in elderly people in nursing homes more effectively than recreational singing.
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Affiliation(s)
| | - Thomas Wosch
- b Faculty of Applied Social Sciences , University of Applied Sciences Würzburg - Schweinfurt , Würzburg , Germany
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Baird A, Samson S, Miller L, Chalmers K. Does music training facilitate the mnemonic effect of song? An exploration of musicians and nonmusicians with and without Alzheimer's dementia. J Clin Exp Neuropsychol 2016; 39:9-21. [PMID: 27309634 DOI: 10.1080/13803395.2016.1185093] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The efficacy of using sung words as a mnemonic device for verbal memory has been documented in persons with probable Alzheimer's dementia (AD), but it is not yet known whether this effect is related to music training. Given that music training can enhance cognitive functioning, we explored the effects of music training and modality (sung vs. spoken) on verbal memory in persons with and without AD. METHOD We used a mixed factorial design to compare learning (5 trials), delayed recall (30-min and, 24-hour), and recognition of sung versus spoken information in 22 healthy elderly (15 musicians), and 11 people with AD (5 musicians). RESULTS Musicians with AD showed better total learning (over 5 trials) of sung information than nonmusicians with AD. There were no significant differences in delayed recall and recognition accuracy (of either modality) between musicians with and without AD, suggesting that music training may facilitate memory function in AD. Analysis of individual performances showed that two of the five musicians with AD were able to recall some information on delayed recall, whereas the nonmusicians with AD recalled no information on delay. The only significant finding in regard to modality (sung vs. spoken) was that total learning was significantly worse for sung than spoken information for nonmusicians with AD. This may be due to the need to recode information presented in song into spoken recall, which may be more cognitively demanding for this group. CONCLUSIONS This is the first study to demonstrate that music training modulates memory of sung and spoken information in AD. The mechanism underlying these results is unclear, but may be due to music training, higher cognitive abilities, or both. Our findings highlight the need for further research into the potentially protective effect of music training on cognitive abilities in our aging population.
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Affiliation(s)
- Amee Baird
- a ARC Centre of Excellence in Cognition and its Disorders , Sydney , NSW , Australia.,b Psychology Department , Macquarie University , Sydney , NSW , Australia
| | - Séverine Samson
- c Neuropsychology: Audition, Cognition, Action, Laboratory PSITEC (EA 4072) , University of Lille , Lille , France.,d La Pitié-Salpêtrière Hospital , Paris , France
| | - Laurie Miller
- a ARC Centre of Excellence in Cognition and its Disorders , Sydney , NSW , Australia.,e Neuropsychology Department , Royal Prince Alfred Hospital and Central Medical School, University of Sydney , Sydney , NSW , Australia
| | - Kerry Chalmers
- f School of Psychology , University of Newcastle , Newcastle , NSW , Australia
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Archana R, Mukilan R. Beneficial Effect of Preferential Music on Exercise Induced Changes in Heart Rate Variability. J Clin Diagn Res 2016; 10:CC09-11. [PMID: 27437208 DOI: 10.7860/jcdr/2016/18320.7740] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 03/15/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Music is known to reduce pain, anxiety and fear in several stressful conditions in both males and females. Further, listening to preferred music enhances the endurance during running performance of women rather than listening to non-preferred music. In recent years Heart Rate Variability (HRV) has been used as an indicator of autonomic nervous activity. AIM This study was aimed to assess the effectiveness of preferential music on HRV after moderate exercise. MATERIALS AND METHODS This was an experimental study done in 30 healthy students aged between 20-25 years, of either sex. HRV was measured at rest, 15 minutes of exercise only and 15 minutes of exercise with listening preferential music in same participants. Data was analysed by One-Way ANOVA and Tukey HSD Post-hoc Test. Statistical significance was taken to be a p-value of less than 0.05. RESULTS Low frequency and high frequency component was significantly increased followed by only exercise. Music minimized increase in both high and low frequency component followed by exercise. However, only high frequency change was statistically significant. LF/HF ratio was significantly increased followed by only exercise. Music significantly minimized increase in LF/HF ratio. CONCLUSION This study provides the preliminary evidence that listening to preferential music could be an effective method of relaxation, as indicated by a shift of the autonomic balance towards the parasympathetic activity among medical students.
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Affiliation(s)
- R Archana
- Professor, Department of Physiology, Saveetha Medical College , Chennai, Tamil Nadu, India
| | - R Mukilan
- Senior Lecturer, Department of Physiology, CSI College of Dental Sciences and Research , Madurai, Tamil Nadu, India
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Strøm BS, Ytrehus S, Grov EK. Sensory stimulation for persons with dementia: a review of the literature. J Clin Nurs 2016; 25:1805-34. [PMID: 27030571 DOI: 10.1111/jocn.13169] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2015] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To provide an overview of available sensory stimulation interventions, and their effect on persons with dementia and to present theoretical and methodological characteristics of the studies included. BACKGROUND Different sensory stimulation interventions are used for persons with dementia to increase alertness, reduce agitation and improve quality of life. However, the effect of these interventions is not clear, neither are their characteristics. DESIGN A systematic search and review of the literature with description of the content and an evaluation of theoretical and methodological approaches. METHODS Systematic searches in CINAHL, PubMed (Medline), The Cochrane library and PsycINFO. Studies included have been subject to quality assessment by means of Critical Appraisal Skills Programme. RESULTS Fifty-five studies were included and thirty of these documented significant effect. The effect of the sensory stimulation interventions mainly reported on negative behaviours, except from five studies assessing quality of life and well-being. The majority of the studies had methodological limitations. The different sensory stimulation interventions were organised into eight categories: music, light therapy, acupressure/reflexology, massage/aromatherapy and doll therapy/pet therapy/toy therapy, the Sonas programme and Snoezelen. CONCLUSIONS More studies are needed to clarify appropriate substantial background for the specific interventions. However, most of the studies based their interventions on a theoretical foundation. Furthermore, more research is needed to measure the effect of sensory stimulation on communication as well as quality of life. In addition, studies are to focus on whether the effect depends on the stage of dementia. RELEVANCE TO CLINICAL PRACTICE Nurses are to be aware of sensory stimulation as a possible intervention to improve persons' quality of life.
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Affiliation(s)
- Benedicte S Strøm
- Center of Diakonia and Professional Practice, VID Specialized University, Oslo, Norway
| | - Siri Ytrehus
- Department of Nursing and Health, VID Specialized University, Oslo, Norway
| | - Ellen-Karine Grov
- Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Burgener SC, Jao YL, Anderson JG, Bossen AL. Mechanism of Action for Nonpharmacological Therapies for Individuals With Dementia: Implications for Practice and Research. Res Gerontol Nurs 2015; 8:240-59. [DOI: 10.3928/19404921-20150429-02] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 02/02/2015] [Indexed: 12/17/2022]
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Hsu MH, Flowerdew R, Parker M, Fachner J, Odell-Miller H. Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: a cluster randomised controlled feasibility study. BMC Geriatr 2015; 15:84. [PMID: 26183582 PMCID: PMC4506459 DOI: 10.1186/s12877-015-0082-4] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 07/06/2015] [Indexed: 11/12/2022] Open
Abstract
Background Previous research highlights the importance of staff involvement in psychosocial interventions targeting neuropsychiatric symptoms of dementia. Music therapy has shown potential effects, but it is not clear how this intervention can be programmed to involve care staff within the delivery of patients’ care. This study reports initial feasibility and outcomes from a five month music therapy programme including weekly individual active music therapy for people with dementia and weekly post-therapy video presentations for their carers in care homes. Methods 17 care home residents and 10 care staff were randomised to the music therapy intervention group or standard care control group. The cluster randomised, controlled trial included baseline, 3-month, 5-month and post-intervention 7-month measures of residents’ symptoms and well-being. Carer-resident interactions were also assessed. Feasibility was based on carers’ feedback through semi-structured interviews, programme evaluations and track records of the study. Results The music therapy programme appeared to be a practicable and acceptable intervention for care home residents and staff in managing dementia symptoms. Recruitment and retention data indicated feasibility but also challenges. Preliminary outcomes indicated differences in symptoms (13.42, 95 % CI: [4.78 to 22.07; p = 0.006]) and in levels of wellbeing (−0.74, 95 % CI: [−1.15 to −0.33; p = 0.003]) between the two groups, indicating that residents receiving music therapy improved. Staff in the intervention group reported enhanced caregiving techniques as a result of the programme. Conclusion The data supports the value of developing a music therapy programme involving weekly active individual music therapy sessions and music therapist-carer communication. The intervention is feasible with modifications in a more rigorous evaluation of a larger sample size. Trial registration Clinicaltrials.gov, number NCT01744600.
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Affiliation(s)
- Ming Hung Hsu
- Methodist Homes (MHA), Derby, UK. .,Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
| | | | - Michael Parker
- Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK.
| | - Jörg Fachner
- Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
| | - Helen Odell-Miller
- Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
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Hsu MH, Flowerdew R, Parker M, Fachner J, Odell-Miller H. Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: a cluster randomised controlled feasibility study. BMC Geriatr 2015. [PMID: 26183582 DOI: 10.1186/s12877‐015‐0082‐4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research highlights the importance of staff involvement in psychosocial interventions targeting neuropsychiatric symptoms of dementia. Music therapy has shown potential effects, but it is not clear how this intervention can be programmed to involve care staff within the delivery of patients' care. This study reports initial feasibility and outcomes from a five month music therapy programme including weekly individual active music therapy for people with dementia and weekly post-therapy video presentations for their carers in care homes. METHODS 17 care home residents and 10 care staff were randomised to the music therapy intervention group or standard care control group. The cluster randomised, controlled trial included baseline, 3-month, 5-month and post-intervention 7-month measures of residents' symptoms and well-being. Carer-resident interactions were also assessed. Feasibility was based on carers' feedback through semi-structured interviews, programme evaluations and track records of the study. RESULTS The music therapy programme appeared to be a practicable and acceptable intervention for care home residents and staff in managing dementia symptoms. Recruitment and retention data indicated feasibility but also challenges. Preliminary outcomes indicated differences in symptoms (13.42, 95 % CI: [4.78 to 22.07; p = 0.006]) and in levels of wellbeing (-0.74, 95 % CI: [-1.15 to -0.33; p = 0.003]) between the two groups, indicating that residents receiving music therapy improved. Staff in the intervention group reported enhanced caregiving techniques as a result of the programme. CONCLUSION The data supports the value of developing a music therapy programme involving weekly active individual music therapy sessions and music therapist-carer communication. The intervention is feasible with modifications in a more rigorous evaluation of a larger sample size. TRIAL REGISTRATION Clinicaltrials.gov, number NCT01744600.
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Affiliation(s)
- Ming Hung Hsu
- Methodist Homes (MHA), Derby, UK. .,Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
| | | | - Michael Parker
- Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK.
| | - Jörg Fachner
- Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
| | - Helen Odell-Miller
- Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
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Raglio A, Attardo L, Gontero G, Rollino S, Groppo E, Granieri E. Effects of music and music therapy on mood in neurological patients. World J Psychiatry 2015; 5:68-78. [PMID: 25815256 PMCID: PMC4369551 DOI: 10.5498/wjp.v5.i1.68] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/12/2015] [Accepted: 02/11/2015] [Indexed: 02/05/2023] Open
Abstract
Mood disorder and depressive syndromes represent a common comorbid condition in neurological disorders with a prevalence rate that ranges between 20% and 50% of patients with stroke, epilepsy, multiple sclerosis, and Parkinson’s disease. Notwithstanding, these conditions are often under-diagnosed and under-treated in the clinical practice and negatively affect the functional recovery, the adherence to treatment, the quality of life, and even the mortality risk. In addition, a bidirectional association between depression and neurological disorders may be possible being that depressive syndromes may be considered as a risk factor for certain neurological diseases. Despite the large amount of evidence regarding the effects of music therapy (MT) and other musical interventions on different aspects of neurological disorders, no updated article reviewing outcomes such as mood, emotions, depression, activity of daily living and so on is actually available; for this reason, little is known about the effectiveness of music and MT on these important outcomes in neurological patients. The aim of this article is to provide a narrative review of the current literature on musical interventions and their effects on mood and depression in patients with neurological disorders. Searching on PubMed and PsycInfo databases, 25 studies corresponding to the inclusion criteria have been selected; 11 of them assess the effects of music or MT in Dementia, 9 explore the efficacy on patients with Stroke, and 5 regard other neurological diseases like Multiple Sclerosis, Amyotrophic Lateral Sclerosis/motor neuron disease, Chronic quadriplegia, Parkinson’s Disease, and Acquired Brain dysfunctions. Selected studies are based on relational and rehabilitative music therapy approaches or concern music listening interventions. Most of the studies support the efficacy of MT and other musical interventions on mood, depressive syndromes, and quality of life on neurological patients.
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Abstract
There is an increasing incidence of dementia in our aging population, and consequently an urgent need to develop treatments and activities that may alleviate the symptoms of dementia. Accumulating evidence shows that persons with dementia enjoy music, and their ability to respond to music is potentially preserved even in the late or severe stages of dementia when verbal communication may have ceased. Media interest in this topic has contributed to the public perception that music abilities are an "island of preservation" in an otherwise cognitively impaired person with dementia. In this chapter, we review the current literature on music cognition in dementia and show that there has been very scarce rigorous scientific investigation of this issue, and that various types of music memory exist and are differentially impaired in the different types of dementia. Furthermore, we discuss the recent development of music activities as a nonpharmacological treatment for dementia and highlight the methodological limitations of the current literature on this topic. While it has been reported that music activities can improve behavior, (particularly agitation), mood, and cognition in persons with dementia, recent large-scale randomized control studies have questioned the specificity of the effect of music and found that it is no more beneficial than other pleasant activities. Nevertheless, music is unique in its powerful ability to elicit both memories and emotions. This can provide an important link to individual's past and a means of nonverbal communication with carers, which make it an ideal stimulus for persons with dementia.
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Affiliation(s)
- Amee Baird
- ARC Centre of Excellence in Cognition and Its Disorders, Macquarie University, Sydney, Australia; Hunter Brain Injury Service, Newcastle, New South Wales, Australia
| | - Séverine Samson
- PSITEC Laboratory-EA 4072, Neuropsychology: Auditory, Cognition and Action Group, Department of Psychology, University of Lille, Lille, France; Pitié-Salpêtrière Hospital, Paris, France.
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Raglio A, Filippi S, Bellandi D, Stramba-Badiale M. Global music approach to persons with dementia: evidence and practice. Clin Interv Aging 2014; 9:1669-76. [PMID: 25336931 PMCID: PMC4199985 DOI: 10.2147/cia.s71388] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Music is an important resource for achieving psychological, cognitive, and social goals in the field of dementia. This paper describes the different types of evidence-based music interventions that can be found in literature and proposes a structured intervention model (global music approach to persons with dementia, GMA-D). The literature concerning music and dementia was considered and analyzed. The reported studies included more recent studies and/or studies with relevant scientific characteristics. From this background, a global music approach was proposed using music and sound-music elements according to the needs, clinical characteristics, and therapeutic-rehabilitation goals that emerge in the care of persons with dementia. From the literature analysis the following evidence-based interventions emerged: active music therapy (psychological and rehabilitative approaches), active music therapy with family caregivers and persons with dementia, music-based interventions, caregivers singing, individualized listening to music, and background music. Characteristics of each type of intervention are described and discussed. Standardizing the operational methods and evaluation of the single activities and a joint practice can contribute to achieve the validation of the application model. The proposed model can be considered a low-cost nonpharmacological intervention and a therapeutic-rehabilitation method for the reduction of behavioral disturbances, for stimulation of cognitive functions, and for increasing the overall quality of life of persons with dementia.
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Affiliation(s)
- Alfredo Raglio
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- APSP “Margherita Grazioli”, Povo, Trento, Italy
| | | | - Daniele Bellandi
- Geriatric Department, Sospiro Foundation, Sospiro, Cremona, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
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The Effect of Group Musical Therapy on Depression and Activities on Daily Living in Patients with Cognitive Decline. Dement Neurocogn Disord 2014. [DOI: 10.12779/dnd.2014.13.4.107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Vasionytė I, Madison G. Musical intervention for patients with dementia: a meta-analysis. J Clin Nurs 2013; 22:1203-16. [PMID: 23574287 DOI: 10.1111/jocn.12166] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2012] [Indexed: 01/27/2023]
Abstract
AIMS AND OBJECTIVES To provide a meta-analysis of the effects of music interventions on patients with dementia, separating, for the first time, between different types of interventions and different outcome measures, namely affective, behavioural, cognitive and physiological. BACKGROUND Music therapy is an attractive form of intervention for the growing number of demented patients, for whom pharmacological interventions are not always effective and may lead to undesired side effects. While music is more frequently applied in clinical settings for each year, no meta-analysis has considered effects of music interventions on affective, behavioural, cognitive and physiological outcomes separately. DESIGN A standard meta-analysis approach was applied. METHODS We include all original studies found for the key words music and dementia. Mean effect sizes and confidence intervals are computed from study effect sizes according to standard methods, and these are considered for various common types of music interventions separately. RESULTS Nineteen studies with a total of 478 dementia patients exhibit effect sizes ranging from 0·04-4·56 (M = 1·04). Many of these indicate large positive effects on behavioural, cognitive and physiological outcome measures, and medium effects on affective measures. CONCLUSIONS Music interventions seem to be effective and have the potential of increasing the quality of life for patients with dementia. Many studies in this area suffer from poor methodological quality, which limits the reach of meta-analysis and the strength and generalisability of these conclusions. RELEVANCE TO CLINICAL PRACTICE Being inexpensive and largely without adverse side effects, current knowledge seems to indicate that music interventions can be recommended for patients in all stages of dementia.
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Affiliation(s)
- Ieva Vasionytė
- Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
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Vink AC, Zuidersma M, Boersma F, de Jonge P, Zuidema SU, Slaets JPJ. The effect of music therapy compared with general recreational activities in reducing agitation in people with dementia: a randomised controlled trial. Int J Geriatr Psychiatry 2013; 28:1031-8. [PMID: 23280604 DOI: 10.1002/gps.3924] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 12/03/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study aimed to compare the effects of music therapy with general recreational day activities in reducing agitation in people with dementia, residing in nursing home facilities. METHODS In a randomised controlled design, residents with dementia (n = 94) were allocated to either music therapy or recreational activities. Both music therapy and general activities were offered twice weekly for 4 months. Changes in agitation were measured with a modified Cohen-Mansfield Agitation Inventory (CMAI) at four intervals on each intervention day. A mixed model analysis was used to evaluate the effectiveness of music therapy, compared with general activities, on CMAI scores at 4 h after the intervention, controlled for CMAI scores at 1 h before the session and session number. RESULTS Data were analysed for 77 residents (43 randomised to music therapy and 34 to general activities). In both groups, the intervention resulted in a decrease in agitated behaviours from 1 h before to 4 h after each session. This decrease was somewhat greater in the music therapy group than in the general activities group, but this difference was statistically not significant (F = 2.885, p = 0.090) and disappeared completely after adjustment for Global Deterioration Scale stage (F = 1.500; p = 0.222). CONCLUSIONS Both music therapy and recreational activities lead to a short-term decrease in agitation, but there was no additional beneficial effect of music therapy over general activities. More research is required to provide insight in the effects of music therapy in reducing agitation in demented older people.
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Affiliation(s)
- A C Vink
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, The Netherlands; Department of Music Therapy, ArtEZ School of Music, Enschede, The Netherlands; KenVaK Research Centre Art Therapies, The Netherlands
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Abstract
OVERVIEW Hospitalized patients who are suffering from cognitive impairment, delirium, suicidal ideation, traumatic brain injury, or another behavior-altering condition are often placed under continuous observation by designated "sitters." These patients may become agitated, which can jeopardize their safety even when a sitter is present. This quality improvement project was based on the hypothesis that agitation can be decreased by engaging these patients in individualized therapeutic activities. The authors created a tool that allowed continuous observers to identify a patient's abilities and interests, and then offer such activities to the patient. Data were collected using a scale that measured patient agitation before, during, and after these activities. The authors found that during the activities, 73% of patients had decreased levels of agitation compared with baseline, and 64% remained less agitated for at least one hour afterward.The intervention appeared effective in reducing levels of agitation in selected patients who were receiving continuous observation on nonpsychiatric units at a large, urban level 1 trauma center. Many patients expressed gratitude for the diversion from their health issues. Further investigation into the effectiveness of this intervention and its impact on the use of medications or restraints is warranted.
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McDermott O, Crellin N, Ridder HM, Orrell M. Music therapy in dementia: a narrative synthesis systematic review. Int J Geriatr Psychiatry 2013; 28:781-94. [PMID: 23080214 DOI: 10.1002/gps.3895] [Citation(s) in RCA: 158] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 09/26/2012] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Recent reviews on music therapy for people with dementia have been limited to attempting to evaluate whether it is effective, but there is a need for a critical assessment of the literature to provide insight into the possible mechanisms of actions of music therapy. This systematic review uses a narrative synthesis format to determine evidence for effectiveness and provide insight into a model of action. METHOD The narrative synthesis framework consists of four elements: (i) theory development; (ii) preliminary synthesis of findings; (iii) exploration of relationships between studies; and (iv) assessment of the robustness of the synthesis. RESULTS Electronic and hand searches identified 263 potentially relevant studies. Eighteen studies met the full inclusion criteria. Three distinctive strands of investigations emerged: eight studies explored behavioural and psychological aspects, five studies investigated hormonal and physiological changes, and five studies focused on social and relational aspects of music therapy. The musical interventions in the studies were diverse, but singing featured as an important medium for change. CONCLUSIONS Evidence for short-term improvement in mood and reduction in behavioural disturbance was consistent, but there were no high-quality longitudinal studies that demonstrated long-term benefits of music therapy. Future music therapy studies need to define a theoretical model, include better-focused outcome measures, and discuss how the findings may improve the well-being of people with dementia.
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Affiliation(s)
- Orii McDermott
- Mental Health Sciences Unit, Faculty of Brain Sciences, University College London, London, UK.
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Raglio A, Bellelli G, Mazzola P, Bellandi D, Giovagnoli A, Farina E, Stramba-Badiale M, Gentile S, Gianelli M, Ubezio M, Zanetti O, Trabucchi M. Music, music therapy and dementia: A review of literature and the recommendations of the Italian Psychogeriatric Association. Maturitas 2012; 72:305-10. [DOI: 10.1016/j.maturitas.2012.05.016] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 05/31/2012] [Indexed: 10/28/2022]
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