The efficacy of music therapy for people with dementia: A meta‐analysis of randomised controlled trials

Chang, Yu Shiun; Chu, Hsin; Yang, Chyn Yng; Tsai, Jui Chen; Chung, Min Huey; Liao, Yuan Mei; Chi, Mei‐Ju; Liu, Megan F.; Chou, Kuei‐Ru

doi:10.1111/jocn.12976

Cited by 97 publications

(63 citation statements)

References 31 publications

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“…However, some stakeholders suggested that this intensity was unlikely to be feasible in most care homes in the UK. From the non-Namaste Care studies we found little empirical evidence on the optimal 'dose' of sensory interventions such as Namaste Care, although a meta-analysis 53 of music therapy found that sessions provided twice per week had a more statistically significant impact on disruptive behaviours, anxiety and mood than weekly sessions.…”

Section: Programme Theorymentioning

confidence: 99%

“…The selection process for studies is summarised in Figure 1. Further details of the Namaste Care studies are listed in additional file 3 of Bunn et al 32 With respect to research design, the 86 papers reported: l 17 evidence reviews (not Namaste Care) [51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68] l 59 papers reporting 51 primary studies (not Namaste Care) l 10 papers reporting 8 Namaste Care studies. 22,27,29,[44][45][46][47][48]50,130 REALIST REVIEW OF NAMASTE CARE AND OTHER MULTISENSORY INTERVENTIONS NIHR Journals Library www.journalslibrary.nihr.ac.uk…”

Section: Phasementioning

confidence: 99%

“…There was little evidence on the benefits of group versus one-to-one delivery. A meta-analysis 53 of music therapy for people with dementia found that group therapy had more positive effects on disruptive behaviours and anxiety than individual therapy. However, this analysis did not distinguish between those with and those without severe dementia.…”

Section: Programme Theorymentioning

confidence: 99%

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A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT

Froggatt

Best

Bunn

et al. 2020

Health Technol Assess

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Background People with advanced dementia who live and die in nursing homes experience variable quality of life, care and dying. There is a need to identify appropriate, cost-effective interventions that facilitate high-quality end-of-life care provision. Objectives To establish the feasibility and acceptability to staff and family of conducting a cluster randomised controlled trial of the Namaste Care intervention for people with advanced dementia in nursing homes. Design The study had three phases: (1) realist review and (2) intervention refinement to inform the design of (3) a feasibility cluster randomised controlled trial with a process evaluation and economic analysis. Clusters (nursing homes) were randomised in a 3 : 1 ratio to intervention or control (usual care). The nature of the intervention meant that blinding was not possible. Setting Nursing homes in England providing care for people with dementia. Participants Residents with advanced dementia (assessed as having a Functional Assessment Staging Test score of 6 or 7), their informal carers and nursing home staff. Intervention Namaste Care is a complex group intervention that provides structured personalised care in a dedicated space, focusing on enhancements to the physical environment, comfort management and sensory engagement. Main outcome measures The two contender primary outcome measures were Comfort Assessment in Dying – End of Life Care in Dementia for quality of dying (dementia) and Quality of Life in Late Stage Dementia for quality of life. The secondary outcomes were as follows: person with dementia, sleep/activity (actigraphy), neuropsychiatric symptoms, agitation and pain; informal carers, satisfaction with care at the end of life; staff members, person-centred care assessment, satisfaction with care at the end of life and readiness for change; and other data – health economic outcomes, medication/service use and intervention activity. Results Phase 1 (realist review; 86 papers) identified that a key intervention component was the activities enabling the development of moments of connection. In phase 2, refinement of the intervention enabled the production of a user-friendly 16-page A4 booklet. In phase 3, eight nursing homes were recruited. Two homes withdrew before the intervention commenced; four intervention and two control homes completed the study. Residents with advanced dementia (n = 32) were recruited in intervention (n = 18) and control (n = 14) homes. Informal carers (total, n = 12: intervention, n = 5; control, n = 7) and 97 staff from eight sites (intervention, n = 75; control, n = 22) were recruited over a 6-month period. Recruitment is feasible. Completion rates of the primary outcome questionnaires were high at baseline (100%) and at 4 weeks (96.8%). The Quality of Life in Late Stage Dementia was more responsive to change over 24 weeks. Even where economic data were missing, these could be collected in a full trial. The intervention was acceptable; the dose varied depending on the staffing and physical environment of each care home. Staff and informal carers reported changes for the person with dementia in two ways: increased social engagement and greater calm. No adverse events related to the intervention were reported. Conclusions A subsequent definitive trial is feasible if there are amendments to the recruitment process, outcome measure choice and intervention specification. Future work In a full trial, consideration is needed of the appropriate outcome measure that is sensitive to different participant responses, and of clear implementation principles for this person-centred intervention in a nursing home context. Trial registration Current Controlled Trials ISRCTN14948133. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 6. See the NIHR Journals Library website for further project information.

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Section: Programme Theorymentioning

confidence: 99%

Section: Phasementioning

confidence: 99%

Section: Programme Theorymentioning

confidence: 99%

See 1 more Smart Citation

A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT

Froggatt

Best

Bunn

et al. 2020

Health Technol Assess

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“…Previously, meta-analyses found that music-related interventions were associated with reductions in depression, 15 anxiety 30 and BPSD 15,30 among individuals with dementia. However, these findings were not specific to the NH population.…”

Section: Discussionmentioning

confidence: 99%

Individualized Music Program is Associated with Improved Outcomes for U.S. Nursing Home Residents with Dementia

Thomas

Baier

Kosar

et al. 2017

The American Journal of Geriatric Psychiatry

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Objectives The objective of this study was to compare resident outcomes before and after implementation of an individualized music program, MUSIC & MEMORYSM (M&M), designed to address the behavioral and psychological symptoms associated with dementia (BPSD). Design: Setting 98 nursing homes (NHs) trained in the M&M program during 2013 and 98 matched-pair comparisons. Participants Long-stay residents with Alzheimer’s disease and related dementias (ADRD) residing in M&M participating facilities (n=12,905) and comparison facilities (n=12,811) during 2012–2013. Intervention M&M is a facility-level quality improvement program that provides residents with music specific to their personal histories and preferences. Measurements Discontinuation of anxiolytic and antipsychotic medications, and reductions in behavioral problems and depressed mood in 2012 (pre-intervention) and 2013 (intervention), calculated using Minimum Data Set (MDS) assessments. Results The proportion of residents who discontinued antipsychotic medication use over a six-month period increased from 17.6% to 20.1% among M&M facilities, while remaining stable among comparison facilities (15.9% to 15.2%). The same trend was observed for anxiolytic medications: discontinuation of anxiolytics increased in M&M facilities (23.5% to 24.4%), while decreased among comparison facilities (24.8% to 20.0%). M&M facilities also demonstrated increased rates of reduction in behavioral problems (50.9% to 56.5%) vs. comparison facilities (55.8% to 55.9%). No differences were observed for depressed mood. Conclusions These results offer the first evidence that the M&M individualized music program is associated with reductions in antipsychotic medication use, anxiolytic medication use, and BPSD symptoms among long-stay NH residents with ADRD.

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“…Since MT is regarded as one of the major components for social and behavioral therapy in patients with cognitive decline [23] and widely accepted as beneficial for the psychological well-being of people with dementia [24], it should be noted that musical ability is not necessarily preserved during this process. However, according to a recent metaanalysis, MT exerted a moderately large effect on disruptive behaviors of people with dementia, a moderate effect on anxiety levels and depressive moods, and a small effect on cognitive functioning [25]. These effects are probably independent from musical ability of the patients themselves.…”

Section: Music Therapymentioning

confidence: 99%

The impact of mild cognitive impairment on musical ability

Agren¹,

Frese²,

Summ³

et al. 2019

Nervenheilkunde

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ZUSAMMENFASSUNG Hintergrund: Patienten mit einer Alzheimer-Erkrankung zeigen Beeinträchtigungen kognitiver Prozesse einschließlich der Verarbeitung musikalischer Reize. Wir haben untersucht, ob der Rückgang der musikalischen Verarbeitung schon im Stadium der mild cognitive impairment (MCI) beginnt. Methodik: Wir haben 18 Patienten mit MCI und ohne eine andere neurologische oder psychiatrische Erkrankung eingeschlossen. Es wurde ein selbst entwickelter Musikalitätstest angewendet, der folgende Fähigkeiten misst: Identifikation von Melodien; Tonhöhenerkennung; Rhythmuserkennung; emotionaler Ausdruck der Musik. Zusätzlich haben wir Marker einer dementiellen Entwicklung im Liquor bestimmt. Wir haben die Ergebnisse der Patienten verglichen mit den Ergebnissen einer nach Alter und Geschlecht parallelisierten gesunden Vergleichsgruppe. Alle Patienten und Kontrollen hatten keine spezifische musikalische Ausbildung. Ergebnisse: Patienten mit MCI zeigten signifikant niedrigere Ergebnisse beim Rhythmus, Metrum und emotionalen Subtests und im gesamten Test-Score. Der Gesamt-Score war invers korreliert mit dem Level von Gesamt-Tau im Liquor. Diskussion: Unsere Daten deuten darauf hin, dass einige Domänen der Musikalität bei Patienten mit MCI signifikant beeinträchtigt sind. Dies bedeutet jedoch nicht notwendigerweise, dass die Produktion von und die Freude an Musik beeinträchtigt sind. Dennoch sollte die Beeinträchtigung von Teilen der Musikalität beim Einsatz von Musiktherapie bei diesen Patienten berücksichtigt werden.

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The efficacy of music therapy for people with dementia: A meta‐analysis of randomised controlled trials

Cited by 97 publications

References 31 publications

A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT

A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT

Individualized Music Program is Associated with Improved Outcomes for U.S. Nursing Home Residents with Dementia

The impact of mild cognitive impairment on musical ability

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