Music Therapy in the Treatment of Dementia: A Systematic Review and Meta-Analysis

Abstract

Background: Dementia is a neurological condition characterized by deterioration in cognitive, behavioral, social, and emotional functions. Pharmacological interventions are available but have limited effect in treating many of the disease's features. Several studies have proposed therapy with music as a possible strategy to slow down cognitive decline and behavioral changes associated with aging in combination with the pharmacological therapy. Objective: We performed a systematic review and subsequent meta-analysis to check whether the application of music therapy in people living with dementia has an effect on cognitive function, quality of life, and/or depressive state. Methods: The databases used were Medline, PubMed Central, Embase, PsycINFO, and the Cochrane Library. The search was made up of all the literature until present. For the search, key terms, such as "music," "brain," "dementia," or "clinical trial," were used. Results: Finally, a total of eight studies were included. All the studies have an acceptable quality based on the score on the Physiotherapy Evidence Database (PEDro) and Critical Appraisal Skills Program (CASP) scales. After meta-analysis, it was shown that the intervention with music improves cognitive function in people living with dementia, as well as quality of life after the intervention and long-term depression. Nevertheless, no evidence was shown of improvement of quality of life in long-term and shortterm depression. Conclusion: Based on our results, music could be a powerful treatment strategy. However, it is necessary to develop clinical trials aimed to design standardized protocols depending on the nature or stage of dementia so that they can be applied together with current cognitive-behavioral and pharmacological therapies.

Impacts of Music Intervention on Dementia: A Review Using Meta-Narrative Method and Agenda for Future Research

“…Previous studies have identified some areas that need to be covered to draw clear conclusions on music’s efficacy for PWD. Some of the suggested areas such as combining MT with other activities [ 10 , 47 , 49 ], doing further research and methodological design [ 2 , 14 , 19 , 20 , 21 , 36 , 39 , 46 , 49 ], using a larger sample of randomized clinical trials [ 36 , 40 , 41 , 49 , 50 ], and considering the impact of music on different types and stages of dementia [ 49 ] are aligned with the items that we are going to discuss. Based on our investigation, the following gaps need to be addressed in experiment design and methodologies in future studies to have more reliable and evidence-based results.…”

Cognitive Impairment and Dementia in Primary Care: Current Knowledge and Future Directions Based on Findings From a Large Cross-Sectional Study in Crete, Greece

“…The nature and the complexity of the disease require a collaborative approach in the management of patients with dementia (61). A plethora of health care professionals could be involved in the process including dieticians (62), occupational therapists (63), speech therapists (64), music therapists (65), and others. In Greece, a recent health care reform took place with the introduction of integrated health care teams in urban primary care settings (66).…”

Promoting well-being among people with early-stage dementia and their family carers through community-based group singing: a phenomenological study

“…Dementia is a chronic disease syndrome characterised by deterioration in memory and thinking, behavioural changes, loss of ability to perform routine tasks, and impaired wellbeing (Draper, 2013). The physical, psychological, social, and economic impacts also affect families, carers, and society ("Dementia", 2019;Moreno-Morales et al, 2020). Most people living with dementia (PLWD) live at home, supported and cared for by their family (Dickinson et al, 2017).…”

“…A randomised-controlled trial (RCT) found that a music therapy singing group improved quality of life and affect in PLWD in long-term care settings, more than a "music medicine listening group" (Cho, 2018). In contrast, a systematic review of music therapy for dementia found music listening to have the greatest effect on patients, followed by singing (Moreno-Morales et al, 2020). Individualised singing interventions facilitated by family carers at home can reduce symptoms of depression and improve mood in PLWD, and increase family carer well-being, compared with usual care (Särkämö et al, 2014).…”

“…However, further research is warranted due to methodological limitations of existing studies and heterogeneity of study designs (Blackburn et al, 2014;Moreno-Morales et al, 2020;Van der Steen et al, 2018). Additionally, no universal model for, or definition of, "well-being" exists.…”