Individual music therapy for agitation in dementia: an exploratory randomized controlled trial

Abstract

Objectives: Agitation in nursing home residents with dementia leads to increase in psychotropic medication, decrease in quality of life, and to patient distress and caregiver burden. Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been methodologically insufficient. The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes, and to explore its effect on psychotropic medication and quality of life. Method: In a crossover trial, 42 participants with dementia were randomized to a sequence of six weeks of individual music therapy and six weeks of standard care. Outcome measures included agitation, quality of life and medication. Results: Agitation disruptiveness increased during standard care and decreased during music therapy. The difference at −6.77 (95% CI (confidence interval): −12.71, −0.83) was significant (p = 0.027), with a medium effect size (0.50). The prescription of psychotropic medication increased significantly more often during standard care than during music therapy (p = 0.02). Conclusion: This study shows that six weeks of music therapy reduces agitation disruptiveness and prevents medication increases in people with dementia. The positive trends in relation to agitation frequency and quality of life call for further research with a larger sample.

Efficacy of music therapy in the neuropsychiatric symptoms of dementia: systematic review

“…It is a 5-point scale in which CDR-0 connotes no cognitive impairment, CDR-0.5 = very mild dementia, CDR-1 = mild, CDR-2 = moderate, CDR-3 = severe. 11,12,18,19 GDS 29 provides caregivers an overview of the stages of cognitive function for those suffering from a primary degenerative dementia such as Alzheimer's disease. It is broken down into 7 different stages.…”

“…Seven out of the 12 studies used a randomized method [9][10][11][12][13]16,19 , and the other trials used various designs such as withinsubject design 15 , controlled trial 17 , a longitudinal repeated measures design with an experimental and control group 18 , crossover study 20 . One study did not mention the method applied 14 .…”

“…The studies showed the use of active group 10,[12][13][14][17][18][19][20] , active individual 9,11 , receptive group 19 and receptive individual 9,15,16 MT interventions.…”

“…Elderly with uncategorized dementia [9][10][11][12][13] , AD 14 , vascular dementia 14,17,20 , mixed 17 dementia, in mild 16 , moderate 9,11,13,15,[18][19][20] and severe 9,11,13,15,[18][19][20] stages, male and female, living in nursing [9][10][11][12][13][16][17][18][19] or residential 20 homes and in treatment in-day center 20 , tertiary hospital 14 and hospice program 15 . …”

“…Most studies exploring the benefits and efficacy of MT interventions among PwD are focused on the context of neuropsychiatric symptoms [9][10][11][12][13][14][15][16][17][18][19][20] , such as agitation 11,12,18,20 , depression 10,16 or anxiety 16,19 . Other studies are focused on cognitive functions 21,22 , quality of life (QoL) 23 and wellbeing 24 .…”