Background: Music-based psychosocial interventions may provide effective management of behavioral symptoms in persons with dementia (PWDs). However, there has been a paucity of studies that measured their effect on social engagement. This proof-of-concept study evaluates efficacy of the Musical Bridges to Memory (MBM) intervention on PWD’s social engagement, behavioral symptoms, and associated caregiver distress. Methods: Twenty-nine PWDs and caregivers (8 control dyads, 21 intervention) participated in this dyadically designed, prospective, blinded, 12-week controlled interventional study. The intervention consisted of weekly MBM sessions, led by board-certified music therapists and performers, including caregiver training, live performances, and social breakout groups. Outcomes were measured by the Verbal and Nonverbal Interaction Scale for Care Receivers (VNVIS-CR) to code interactions between PWDs and caregivers for verbal and nonverbal sociable and unsociable behaviors. Symptom severity and caregiver distress were measured using Neuropsychiatric Inventory. Results: Nonverbal sociable interactions significantly increased (P=0.012) in those who completed the MBM program as compared with a decrease observed in the control group. Family/caregiver distress associated with PWDs neuropsychiatric symptoms showed significant improvement in the experimental group as compared with controls (P=0.045). Conclusions: This study provides proof-of-concept that MBM improves nonverbal sociable content of PWDs interactions and reduces caregivers’ distress.
Background Music‐based interventions can reduce the severity of neuropsychiatric symptoms in persons with dementia (PWD), and in turn reduce the need for pharmacological interventions (e.g., psychotropic). However, few intervention trials have used a dyadic group approach. We determine the efficacy of a dyadic music‐based intervention on PWD neuropsychiatric symptoms and social engagement. Musical Bridges to Memory (MBM) uses both perceptive and expressive forms of music‐based intervention, administered in a dyadic group setting, to mediate PWD neuropsychiatric symptoms and improve social interaction between dyads (PWDs and their caregivers). Method Thirty‐one dyads were recruited from memory care facilities; twenty received the MBM intervention, ten were controls. Groups were comparable in age and level of education. All were assessed at baseline and post‐intervention. Caregiver‐reported PWD behavioral symptoms were assessed using the Neuropsychiatric Inventory (NPI). The Verbal and Nonverbal Interaction Scale (VNVIS) was used to rate PWDs social interactions (10min video recordings of dyads) on sociable, unsociable, verbal and nonverbal behaviors. The 12‐week intervention included weekly sessions, which consisted of caregiver training(30m), live concerts(45m), and breakout groups(30m). Music was chosen based on PWDs’ assessed preferences. Result Sociable interactions (e.g. positive affect, eye‐contact, apparent interest/focus), significantly increased (p=0.044) in the MBM intervention group as compared to controls. Caregivers reported a decrease in severity of PWD neuropsychiatric symptoms (p=0.089, indicating a trend) and symptom‐related distress in caregivers (p=0.005) decreased significantly. Analyses controlled for sex and global cognition (Mini Mental State Exam) score at baseline. Conclusion Our preliminary results indicate that a dyadic music‐based group intervention approach administered in a memory care facility is effective at improving PWD social engagement, mitigating PWD behavioral symptoms, and reducing associated caregiver distress. These results complement previous literature, highlighting music‐based interventions as a non‐pharmacological approach to managing neuropsychiatric interventions in PWD. In addition, our use of a dyadic group‐based approach and our reported increase in sociable engagement highlights the benefits of including caregiver participation in music‐based interventions. Future work will examine a larger cohort and directly examine caregiver burden.
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