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Yin Z, Li Y, Bao Q, Zhang X, Xia M, Zhong W, Wu K, Yao J, Chen Z, Sun M, Zhao L, Liang F. Comparative efficacy of multiple non-pharmacological interventions for behavioural and psychological symptoms of dementia: A network meta-analysis of randomised controlled trials. Int J Ment Health Nurs 2024; 33:487-504. [PMID: 38012101 DOI: 10.1111/inm.13254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/14/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
Non-pharmacological interventions can improve the behavioural and psychological symptoms of dementia (BPSD). However, the optimal non-pharmacological treatments remain controversial. This study aimed to compare the efficacy of multiple non-pharmacological methods and identify the optimal therapy for BPSD. Potential randomised controlled trials (RCTs) were searched and selected from 15 databases and sources from the inception of the databases until 1 October 2022. Two independent authors implemented study screening, data extraction, and methodological quality assessment. Primary outcome was reduction of Neuropsychiatric Inventory (NPI). The secondary outcome were changes of Cornell Scale for Depression in Dementia (CSDD), the Cohen-Mansfield Agitation Inventory (CMAI), the Quality of Life in Alzheimer's Disease (QoL-AD), the Abilities of Daily Living scale, and the Apathy Evaluation Scale. Meta-analyses were performed using STATA v15.0 and ADDIS v1.16.8. The GRADE approaches were utilised to evaluate evidence quality. The present study included 43 RCTs with 4978 participants. The global methodological quality of the RCTs was moderate. Regarding NPI reduction, with moderate-certainty evidence, exercise plus treatment as usual (TAU) outperformed TAU (mean difference [MD]: -7.13; 95% confidence interval [CI]: -13.22, -0.76) and ranked as the optimal treatment. For reduction in CSDD, with low- to moderate-certainty evidence, massage plus TAU (MD: -15.26; 95% CI: -20.13, -10.52) and music plus TAU (MD: -2.40; 95% CI: -4.62, -0.12) were associated with greater reduction compared with TAU. For reduction in CMAI, with moderate-certainty evidence, aromatherapy plus massage (MD: -15.84; 95% CI: -29.76, -2.42) and massage plus music (MD: -13.12; 95% CI: -25.43, -0.76) were significantly more effective than TAU. For improvement in QoL-AD, with critically low- to low-certainty evidence, there were no statistical differences between any of non-pharmacological treatments and TAU. Due to the limited number of included studies, network meta-analysis was not performed for other outcomes. In conclusion, non-pharmacological treatments are effective for overall symptoms, depression, and agitation. Exercise plus treatment as usual may be an optimal non-pharmacological intervention for improving the overall BPSD. This may help to guide patients, doctors, and policymakers.
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Affiliation(s)
- Zihan Yin
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Yaqin Li
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qiongnan Bao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Xinyue Zhang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Manze Xia
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Wanqi Zhong
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Kexin Wu
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Jin Yao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Zhenghong Chen
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Mingsheng Sun
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Ling Zhao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
| | - Fanrong Liang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China
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Cassola EG, Santos LCD, Ferreira MSDC, Correa Barbosa G, Betini M, Domingos TDS. Systematic Review of Music Therapy and Musical Interventions for Patients with Moderate and Severe Mental Disorders. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024. [PMID: 38686522 DOI: 10.1089/jicm.2023.0419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Objective: This systematic review aims to assess the impact of music therapy and musical interventions on neuropsychiatric outcomes among patients with moderate and severe mental disorders, in comparison with conventional treatment in isolation. Methods: The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted on November 16, 2021, using the following databases and search interfaces: Cumulative Index to Nursing and Allied Health Literature, Embase, SCOPUS, Web of Science; PubMed, PsycINFO, Literatura Latino-Americana e do Caribe em Ciências da Saúde, and Scientific Electronic Library Online. Two authors independently assessed the studies for inclusion criteria, extracted the data, and evaluated the quality of the included studies using critical appraisal tools. Results: In total, 17 studies were included, 9 of which were randomized controlled trials. The experimental studies involved 5,082 adult and elderly patients. The most prevalent symptoms assessed in the studies were anxiety, depression, and positive and negative symptoms of psychotic disorders. Music interventions were predominantly conducted by music therapists and nurses, providing passive interventions with the selection of musical repertoire by therapists and patients. The frequency with which musical interventions occurred varied greatly in terms of session duration, number of times per week, and number of times during the day. The identified study designs included clinical and quasi-experimental studies. In terms of methodological quality, clinical studies showed weaknesses regarding deviations from intended interventions. Conclusion: The effectiveness of music therapy and musical interventions for neuropsychiatric symptoms in patients with moderate and severe mental disorders was evident in quasi-experimental and clinical studies with satisfactory methodological quality. Musical interventions, in various forms of application, represent an interdisciplinary therapeutic tool that complements and enhances conventional treatment. Unlike conventional treatments, the immersive and integrative nature of music interventions allows access to both intrapersonal and interpersonal dimensions during periods of psychic suffering. These findings highlight the importance of researchers addressing methodological limitations, such as deviations from intended interventions, and advocate for the expansion the use of music in community treatment settings.
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Affiliation(s)
- Eduardo Gabriel Cassola
- Faculdade de Medicina de Botucatu, Universidade Estadual "Júlio de Mesquita Filho," Botucatu, Brazil
| | | | | | - Guilherme Correa Barbosa
- Faculdade de Medicina de Botucatu, Universidade Estadual "Júlio de Mesquita Filho," Botucatu, Brazil
| | - Marluci Betini
- Faculdade de Medicina de Botucatu, Universidade Estadual "Júlio de Mesquita Filho," Botucatu, Brazil
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Uceda-Portillo C, Aranda-Valero S, Moruno-Miralles P. Occupational Therapy Interventions to Improve the Quality of Life of Older Adults with Dementia Living in Nursing Homes: A Systematic Review. Healthcare (Basel) 2024; 12:896. [PMID: 38727453 PMCID: PMC11083416 DOI: 10.3390/healthcare12090896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
The increase in older adults with dementia presents challenges in promoting research to improve the quality of life of this population. The objective of this study was to assess the scientific evidence on the effectiveness of occupational therapy interventions in improving the quality of life of older adults over 65 years old with dementia living in nursing homes. The databases used were PubMed, Web of Science, OTSeeker, clinicaltrials.gov, Dialnet, Scopus, Cochrane, and SciELO between 2013 and 2023. The studies were selected and evaluated according to the Cochrane guidelines. The review was carried out following the PRISMA 2020 Statement. Sixteen articles met the inclusion criteria and were categorized into four groups according to the focus of the intervention: "meaningful activities/occupations", "physical, cognitive and sensory functioning", "performance areas", and "physical and social environment and staff training". The strength of evidence was moderate, and the risk of bias was low. The findings revealed that occupational therapy interventions based on participation in recreational activities, reminiscence, performance-based activities and the physical and social environment, and specialized staff training, could improve the perceived quality of life of older adults with dementia living in nursing homes.
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Affiliation(s)
- Cristian Uceda-Portillo
- Department of Psychology, National University of Distance Education (UNED), Talavera de la Reina, 45600 Toledo, Spain
| | - Sandra Aranda-Valero
- Department of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain;
| | - Pedro Moruno-Miralles
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Talavera de la Reina, 45600 Toledo, Spain;
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Prick AEJC, Zuidema SU, van Domburg P, Verboon P, Vink AC, Schols JMGA, van Hooren S. Effects of a music therapy and music listening intervention for nursing home residents with dementia: a randomized controlled trial. Front Med (Lausanne) 2024; 11:1304349. [PMID: 38379562 PMCID: PMC10877716 DOI: 10.3389/fmed.2024.1304349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/09/2024] [Indexed: 02/22/2024] Open
Abstract
Introduction The aim of the present study was to evaluate the effects of an individual music therapy intervention and an individual music listening intervention on neuropsychiatric symptoms and quality of life in people with dementia living in a nursing home and on professional caregiver's burden to be able to make statements about their specific value of application in clinical practice. Methods A multicenter single blind randomized controlled trial with three groups was performed: an individual music therapy intervention (IMTI) group (n = 49), an individual music listening intervention (IMLI) group (n = 56) and a control group (n = 53) receiving usual care. The interventions were given during three weeks, three times a week on non-consecutive days during 30-45 minutes for in total nine sessions. The endpoint of the study is the difference from baseline to interim (1,5 week), post-intervention (3 weeks) and follow-up (6 weeks) in reported scores of problem behaviour (NPI-NH) and quality of life (Qualidem) in people with dementia and occupational disruptiveness (NPI-NH) in care professionals. Results In total 158 people with dementia were randomized to one of the two intervention groups or the control group. Multilevel analyses demonstrated that hyperactive behaviour assessed by the NPI-NH was significantly more reduced for the IMLI group at follow up and that restless behaviour assessed by the Qualidem was significantly more reduced for the IMTI group at post and follow-up measurement compared to the control group. No significant effects between groups were found in other NPI-NH clusters or Qualidem subscales. Conclusion In conclusion, because we found no convincing evidence that the IMTI or IMLI is more effective than the other both interventions should be considered in clinical practice. For the future, we advise further research into the sustainability of the effects with alternative designs, like a single case experimental design.
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Affiliation(s)
- Anna-Eva J. C. Prick
- Department of Creative Arts Therapies, Zuyd Hogeschool, Heerlen, Netherlands
- Department of Clinical Psychology, Open Universiteit, Heerlen, Netherlands
| | - Sytse U. Zuidema
- Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Alzheimer Centrum Groningen, Groningen, Netherlands
| | - Peter van Domburg
- Department of Neurology, Zuyderland Medical Center, Heerlen, Netherlands
| | - Peter Verboon
- Department of Methods and Statistics, Open Universiteit, Heerlen, Netherlands
| | - Annemieke C. Vink
- Department of Music Therapy, ArtEZ University of the Arts, Arnhem, Netherlands
| | - Jos M. G. A. Schols
- Department of HSR, Maastricht University, Maastricht, Netherlands
- Department of Family Medicine, Maastricht University, Maastricht, Netherlands
| | - Susan van Hooren
- Department of Clinical Psychology, Open Universiteit, Heerlen, Netherlands
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Lin TH, Liao YC, Tam KW, Chan L, Hsu TH. Effects of music therapy on cognition, quality of life, and neuropsychiatric symptoms of patients with dementia: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Res 2023; 329:115498. [PMID: 37783097 DOI: 10.1016/j.psychres.2023.115498] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/04/2023]
Abstract
Dementia is a major cause of disability and dependency. Pharmacological interventions are commonly provided to patients with dementia to delay the deterioration of cognitive functions but cannot alter the course of disease. Nonpharmacological interventions are now attracting increasing scholarly interest. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, we aim to assess the effectiveness of music-based therapies on the cognition, quality of life (QoL), and neuropsychiatric symptoms of patients with dementia through a systematic review and meta-analysis of randomized controlled trials (RCTs). The PubMed, Embase, and Cochrane databases were searched for reports of RCTs examining the effectiveness of music-based therapies for dementia published as of April 2023. A total of 674 articles were screened, and 22 trials from 21 studies (1780 patients) met the eligibility criteria. In 15 trials, music-based therapies significantly improved the cognition of patients with dementia compared with non-music therapies. In 11 trials, music-based therapies also significantly improved the QoL of patients with dementia compared with non-music therapies. In six trials, music-based therapies significantly improved patients' neuropsychiatric symptoms compared with non-music therapies. In conclusion, music-based therapy is recognized as a safe and effective alternative approach for patients with dementia.
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Affiliation(s)
- Ting-Han Lin
- school of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Yin-Chun Liao
- Center for General Education, Chung Shan Medical University, Taichung City, Taiwan
| | - Ka-Wai Tam
- Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang-Ho Hospital, New Taipei City, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan; Cochrane Taiwan, Taipei Medical University, Taipei City, Taiwan; Center For Evidence-Based Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Lung Chan
- Department of Neurology, Taipei Medical University-Shuang-Ho Hospital, New Taipei City, Taiwan; Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Tzu-Herng Hsu
- Department of Physical Medicine and Rehabilitation, Taipei Medical University-Shuang-Ho Hospital, New Taipei City, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
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Wang M, Wu J, Yan H. Effect of music therapy on older adults with depression: A systematic review and meta-analysis. Complement Ther Clin Pract 2023; 53:101809. [PMID: 37952258 DOI: 10.1016/j.ctcp.2023.101809] [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: 12/31/2022] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND AND PURPOSE Depression is becoming more prevalent in older adults. Music therapy appears to have a positive effect on older adults with depression, but the effects of specific interventions (such as active music therapy and passive music therapy) are not fully known. This review aims to evaluate the therapeutic effects of music therapy and the effects of specific interventions on older adults with depression. METHODS A systematic search was conducted from inception to June 2022, and an updated search was conducted in July 2023 on PubMed, Web of Science, Cochrane Library, Embase, VIP, Wanfang Data, CNKI, and CBM. This review solely targeted randomized controlled trials. Two reviewers independently reviewed the retrieved studies. The risk of bias was evaluated using the Cochrane risk of bias assessment tool 2.0, and statistical analysis was made using the RevMan 5.4 software. RESULTS Twenty-one studies with a total of 1777 participants were included. Music therapy was beneficial in reducing depression, anxiety, and blood pressure and increasing cognitive ability (p < 0.05). Subgroup analysis showed that passive music therapy, single intervention for 60 min, individual intervention format, and total duration of 20 h had a more significant effect on depressive symptoms in older adults. CONCLUSION Music therapy reduces symptoms of depression and anxiety, improves blood pressure, and enhances cognitive ability in older adults with depression. Further rigorously designed studies are warranted to confirm the effects of music therapy on older adults with depression.
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Affiliation(s)
- Min Wang
- Chengdu University of Traditional Chinese Medicine, China
| | - Jingwen Wu
- Chengdu University of Traditional Chinese Medicine, China
| | - Hong Yan
- Chengdu University of Traditional Chinese Medicine, China.
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Ting B, Chen DTL, Hsu WT, Liang CS, Malau IA, Li WC, Lee SL, Jingling L, Su KP. Does Music Intervention Improve Anxiety in Dementia Patients? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med 2023; 12:5497. [PMID: 37685564 PMCID: PMC10488399 DOI: 10.3390/jcm12175497] [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: 06/07/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
Music interventions (MIs) have been widely used to relieve anxiety in dementia in clinical settings. However, limited meta-analysis with randomized controlled trials (RCTs) on this topic has been conducted so far. A systematic search was conducted in four major databases (PubMed, EMBASE, Web of Science, and Cochrane Library) for data provided by RCTs from the inception to February 2023. The search strategy employed the terms "anxiety AND music AND dementia OR Alzheimer's disease". Thirteen RCTs (827 participants) were included. The results showed MI reduced anxiety significantly (SMD = -0.67, p < 0.001), especially for Alzheimer's disease (p = 0.007) and Mixed (p < 0.001)-type dementia. Moreover, significant improvements in agitation (p = 0.021) and depression (p < 0.001) in dementia were observed. Additionally, several psychological mechanisms which may be associated with MI were reviewed comprehensively. In conclusion, our findings support the efficacy of MI in alleviating anxiety symptoms in dementia patients. PROSPERO Registration (ID: CRD42021276646).
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Affiliation(s)
- Berne Ting
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung 40402, Taiwan;
- Mind–Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 40402, Taiwan; (D.T.-L.C.); (I.A.M.); (W.-C.L.)
| | - Daniel Tzu-Li Chen
- Mind–Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 40402, Taiwan; (D.T.-L.C.); (I.A.M.); (W.-C.L.)
- M.D.-Ph.D. Program, College of Medicine, China Medical University, Taichung 40402, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 40402, Taiwan;
| | - Wei-Ti Hsu
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 40402, Taiwan;
- Department of Anesthesiology, China Medical University Hospital, Taichung 40402, Taiwan
| | - Chih-Sung Liang
- Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Ikbal Andrian Malau
- Mind–Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 40402, Taiwan; (D.T.-L.C.); (I.A.M.); (W.-C.L.)
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 40402, Taiwan;
| | - Wei-Chih Li
- Mind–Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 40402, Taiwan; (D.T.-L.C.); (I.A.M.); (W.-C.L.)
- School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Sheau-Ling Lee
- National Health Research Institutes, Miaoli 35053, Taiwan;
| | - Li Jingling
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 40402, Taiwan;
| | - Kuan-Pin Su
- Mind–Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 40402, Taiwan; (D.T.-L.C.); (I.A.M.); (W.-C.L.)
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 40402, Taiwan;
- An-Nan Hospital, China Medical University, Tainan 70965, Taiwan
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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: 0] [Impact Index Per Article: 0] [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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Russo FA, Mallik A, Thomson Z, de Raadt St. James A, Dupuis K, Cohen D. Developing a music-based digital therapeutic to help manage the neuropsychiatric symptoms of dementia. Front Digit Health 2023; 5:1064115. [PMID: 36744277 PMCID: PMC9895844 DOI: 10.3389/fdgth.2023.1064115] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023] Open
Abstract
The greying of the world is leading to a rapid acceleration in both the healthcare costs and caregiver burden that are associated with dementia. There is an urgent need to develop new, easily scalable modalities of support. This perspective paper presents the theoretical background, rationale, and development plans for a music-based digital therapeutic to manage the neuropsychiatric symptoms of dementia, particularly agitation and anxiety. We begin by presenting the findings of a survey we conducted with key opinion leaders. The findings highlight the value of a music-based digital therapeutic for treating neuropsychiatric symptoms, particularly agitation and anxiety. We then consider the neural substrates of these neuropsychiatric symptoms before going on to evaluate randomized control trials on the efficacy of music-based interventions in their treatment. Finally, we present our development plans for the adaptation of an existing music-based digital therapeutic that was previously shown to be efficacious in the treatment of adult anxiety symptoms.
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Affiliation(s)
- Frank A. Russo
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada,KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada,LUCID Inc., Toronto, ON, Canada,Correspondence: Frank A. Russo
| | | | | | | | - Kate Dupuis
- Center for Elder Research, Sheridan College, Oakville, ON, Canada
| | - Dan Cohen
- Right to Music, New York, NY, United States
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Prinz A, Schumacher A, Witte K. Changes in Selected Cognitive and Motor Skills as Well as the Quality of Life After a 24-Week Multidimensional Music-Based Exercise Program in People With Dementia. Am J Alzheimers Dis Other Demen 2023; 38:15333175231191022. [PMID: 37611012 PMCID: PMC10655793 DOI: 10.1177/15333175231191022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
The loss of independence is one of the greatest consequences of dementia. Multidimensional music-based exercise programs could counteract. The present study investigates the effects of such a program on people with dementia and bases on a 24-week intervention with three measurement time points. Sixty-nine people with dementia were randomly assigned to the intervention (n = 43) and control group (n = 26). The following outcome parameters were measured: leg strength, gait, grip strength, balance, reaction time, selected cognitive abilities, and quality of life. A mixed ANOVA with repeated measurement showed significant interaction effects between group and time. After 24-weeks in contrast to the control group the intervention group significantly improved in leg strength (P = .001), balance (P = .001), gait (P = .001), grip strength (right P = .002, left P = .011), reaction time (P = .003), global cognition (P = .039), verbal fluency (P = .002), attention (P = .013) and quality of life (P = .011). In conclusion, the program enhanced selected cognitive and motor skills and quality of life.
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The Effect of Music-Based Intervention on General Cognitive and Executive Functions, and Episodic Memory in People with Mild Cognitive Impairment and Dementia: A Systematic Review and Meta-Analysis of Recent Randomized Controlled Trials. Healthcare (Basel) 2022; 10:healthcare10081462. [PMID: 36011119 PMCID: PMC9408548 DOI: 10.3390/healthcare10081462] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Music-based intervention has been used as first-line non-pharmacological treatment to improve cognitive function for people with mild cognitive impairment (MCI) or dementia in clinical practice. However, evidence regarding the effect of music-based intervention on general cognitive function as well as subdomains of cognitive functions in these individuals is scarce. Objective: To evaluate the efficacy of music-based interventions on a wide range of cognitive functions in people with MCI or dementia. Method: We searched the effect of various music therapies using randomized controlled trials on cognitive function using several databases. Studies based on any type of dementia or MCI were combined. The effects of music-based intervention on each cognitive function were pooled by meta-analysis. Results: A total of 19 studies involving n = 1024 participants (mean age ranged from 60 to 87 years old) were included. We found statistically significant improvements in MMSE (general cognitive function), the Frontal Assessment Battery (executive function), and the Auditory Verbal Learning Test (episodic memory). Conclusions: This study provides positive evidence to support music-based interventions for improving a wide range of cognitive functions in older adults with MCI and dementia. Therefore, we recommend increased use of music in people’s homes, day care centers and nursing homes. This study was registered with PROSPERO, number 250383.
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Dhippayom T, Saensook T, Promkhatja N, Teaktong T, Chaiyakunapruk N, Devine B. Comparative effects of music interventions on depression in older adults: A systematic review and network meta-analysis. EClinicalMedicine 2022; 50:101509. [PMID: 35812990 PMCID: PMC9257333 DOI: 10.1016/j.eclinm.2022.101509] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The effect of different music interventions on depression in older adults is varied. We aimed to explore the comparative effect of different music intervention features on depression in older adults. METHODS We searched PubMed, EMBASE, CENTRAL, CINAHL, and ProQuest Dissertations&Theses from inception to October 2021 for randomized controlled trials (RCTs) of music interventions in participants aged ≥60 years. Music interventions were classified based on the TIP (theme, intensity, and provider/platform) framework. The theme was divided into: 1) active music therapy (ACT); 2) receptive music therapy (Recep); and 3) music medicine (MM). The intensity was classified as high (>60 minutes/week), and low (≤60 minutes/week). The provider was classified as a music therapist (MT) or a non-music therapist (NonMT). Summary standardized mean differences (SMD) of level of depression with 95% confidence interval (CI) were estimated using a frequentist framework with a random-effects model. The certainty of evidence was evaluated using the Confidence in Network Meta-Analysis (CINeMA) approach. This study was registered with PROSPERO (CRD42021247165). FINDINGS Fifteen RCTs involving 1,144 older adults (mean age 67.9-86.6 years) were included. When compared with usual care, the most effective music intervention was active music therapy >60 minutes/week by music therapist (Act/High/MT) (SMD -3.00; 95%CI, -3.64,-2.35), followed by music medicine >60 minutes/week by non-music therapist (MM/High/NonMT) (SMD -2.06; 95%CI, -2.78,-1.35) with moderate and high certainty of evidence, respectively. Depression scores in older adults treated with ACT/High/MT was also significantly lower than all other interventions, except MM/High/NonMT. Low intensity music interventions other than Act/Low/MT had no impact on depression. INTERPRETATION Although active music therapy >60 minutes/week by music therapist is the most effective intervention to alleviate depression in older adults, music medicine by listening to music of older adult's own preference >60 minutes/week is an alternative approach in settings with limited resources. FUNDING None.
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Affiliation(s)
- Teerapon Dhippayom
- The Research Unit of Evidence Synthesis (TRUES), Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
- Corresponding author at: The Research Unit of Evidence Synthesis (TRUES), Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Thitinan Saensook
- Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | | | - Thanasak Teaktong
- Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, University of Utah College of Pharmacy
- IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
| | - Beth Devine
- The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute; School of Pharmacy; University of Washington
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13
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Yu AL, Lo SF, Chen PY, Lu SF. Effects of Group Music Intervention on Depression for Elderly People in Nursing Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159291. [PMID: 35954677 PMCID: PMC9368414 DOI: 10.3390/ijerph19159291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/17/2022] [Accepted: 07/26/2022] [Indexed: 02/01/2023]
Abstract
Depression is the most common mental problem among the elderly, especially in long-term care facilities. The purpose of the present study was to examine the effects of group music intervention on depression for elderly people in nursing homes. Methods: A randomized control trial consisting of sixty-three elderly participants randomly and blindly assigned to a music group or control group was utilized. The music group received 20 sessions of group music intervention (two 30-min sessions per week for 10 weeks), and the control group received usual care with no music intervention. The Geriatric Depression Scale—Short Form (GDS-SF) and salivary cortisol at baseline, 5 weeks, and 10 weeks were collected for analysis. Results of the GEEs (generalized estimating equations) analysis indicated that after 20 sessions for 10 weeks of group music intervention, the groups showed a statistically significant difference in depression at 5 weeks and 10 weeks. There was no significant difference in the salivary cortisol concentration between the two groups. The results show that the group music intervention may effectively reduce the depression scores for elderly people in nursing homes. Conclusion: The group music intervention has positive effects on depression.
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Affiliation(s)
- Ai-Ling Yu
- Department of Nursing, St. Mary’s Junior College of Medicine, Nursing and Management, Sanshing Township, Yilan 26647, Taiwan;
| | - Shu-Fen Lo
- Department of Nursing, Tzu Chi University, Hualien 97074, Taiwan;
| | - Pei-Yu Chen
- Center for Health and Welfare Data Science, Tzu Chi University, Hualien 97074, Taiwan;
| | - Shiou-Fang Lu
- Department of Nursing, Tzu Chi University, Hualien 97074, Taiwan;
- Correspondence: ; Tel.: +886-3-8565301 (ext. 2224)
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14
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Agüera-Ortiz L, Babulal GM, Bruneau MA, Creese B, D'Antonio F, Fischer CE, Gatchel JR, Ismail Z, Kumar S, McGeown WJ, Mortby ME, Nuñez NA, de Oliveira FF, Pereiro AX, Ravona-Springer R, Rouse HJ, Wang H, Lanctôt KL. Psychosis as a Treatment Target in Dementia: A Roadmap for Designing Interventions. J Alzheimers Dis 2022; 88:1203-1228. [PMID: 35786651 PMCID: PMC9484097 DOI: 10.3233/jad-215483] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Psychotic phenomena are among the most severe and disruptive symptoms of dementias and appear in 30% to 50% of patients. They are associated with a worse evolution and great suffering to patients and caregivers. Their current treatments obtain limited results and are not free of adverse effects, which are sometimes serious. It is therefore crucial to develop new treatments that can improve this situation. We review available data that could enlighten the future design of clinical trials with psychosis in dementia as main target. Along with an explanation of its prevalence in the common diseases that cause dementia, we present proposals aimed at improving the definition of symptoms and what should be included and excluded in clinical trials. A review of the available information regarding the neurobiological basis of symptoms, in terms of pathology, neuroimaging, and genomics, is provided as a guide towards new therapeutic targets. The correct evaluation of symptoms is transcendental in any therapeutic trial and these aspects are extensively addressed. Finally, a critical overview of existing pharmacological and non-pharmacological treatments is made, revealing the unmet needs, in terms of efficacy and safety. Our work emphasizes the need for better definition and measurement of psychotic symptoms in dementias in order to highlight their differences with symptoms that appear in non-dementing diseases such as schizophrenia. Advances in neurobiology should illuminate the development of new, more effective and safer molecules for which this review can serve as a roadmap in the design of future clinical trials.
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Affiliation(s)
- Luis Agüera-Ortiz
- Department of Psychiatry, Instituto de Investigación Sanitaria (imas12), Hospital Universitario 12 de Octubre, & Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Ganesh M Babulal
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Department of Psychology, Faculty of Humanities, University of Johannesburg, South Africa
| | - Marie-Andrée Bruneau
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Quebec, Canada.,Geriatric Institute of Montreal Research Center, Montreal, Quebec, Canada
| | - Byron Creese
- Medical School, College of Medicine and Health, University of Exeter, UK
| | | | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Ontario, Canada.,University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Jennifer R Gatchel
- Harvard Medical School; Massachusetts General Hospital, Boston MA, USA.,McLean Hospital, Belmont MA, USA
| | - Zahinoor Ismail
- Hotchkiss Brain Institute & O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Sanjeev Kumar
- Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - William J McGeown
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Moyra E Mortby
- School of Psychology, University of New South Wales, Sydney, Australia & Neuroscience Research Australia, Sydney, Australia
| | - Nicolas A Nuñez
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Fabricio F de Oliveira
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Arturo X Pereiro
- Facultade de Psicoloxía, Universidade de Santiago de Compostela, Spain
| | - Ramit Ravona-Springer
- Sheba Medical Center, Tel Hashomer, Israel & Sackler School of Medicine, Tel Aviv University, Israel
| | - Hillary J Rouse
- School of Aging Studies, University of South Florida, Tampa, FL, USA.,SiteRx, New York, NY, USA
| | - Huali Wang
- Dementia Care and Research Center, Peking University Institute of Mental Health; National & Clinical Research Center for Mental Disorders, Beijing, China
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute and Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, Ontario, Canada
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15
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Madsø KG, Molde H, Hynninen KM, Nordhus IH. Observing Music Therapy in Dementia: Repeated Single-case Studies Assessing Well-being and Sociable Interaction. Clin Gerontol 2022; 45:968-982. [PMID: 34585627 DOI: 10.1080/07317115.2021.1978121] [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
OBJECTIVES This study compared behavioral expressions of momentary well-being and sociable behavior toward significant others during music therapy and regular social interaction. METHODS A 10-week active music therapy intervention was provided for people living with dementia and family caregivers. A bi-phasic AB single-case design was replicated for three sessions per dyad and coded using the Observable Well-being in Living with Dementia-Scale (OWLS) and the Verbal and Nonverbal Sociable Interaction Scale-Care Receiver (VNVIS-CR). Effect sizes (Log Response Ratio) were calculated for each session and analyzed with robust cluster meta-analysis. RESULTS Eleven dyads were included, and 32 sessions analyzed (2102 observations). Within sessions we found a 48% increase in well-being, and a 32% increase in sociable interaction during music therapy. Heterogeneity was high. Dementia severity predicted an increase in nonverbal sociable interaction (93% for moderate dementia). Depression and time did not predict any change. CONCLUSION The potential of music therapy to increase well-being and sociable interactions toward significant others calls for further investigation of heterogeneity and covariates. Single-case designs are demonstrated to be feasible for these investigations. CLINICAL IMPLICATIONS Preference-based music therapy may alleviate some of the individual and relational consequences of living with dementia, facilitating positive emotions and connection to significant others.
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Affiliation(s)
- Kristine Gustavsen Madsø
- Department of Clinical Psychology, University of Bergen, Bergen, Norway.,NKS Olaviken Gerontopsychiatric Hospital, Bergen, Askøy, Norway
| | - Helge Molde
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | | | - Inger Hilde Nordhus
- Department of Clinical Psychology, University of Bergen, Bergen, Norway.,Department of Behavioral Medicine, University of Oslo, Oslo, Norway
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16
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Burley CV, Burns K, Lam BCP, Brodaty H. Nonpharmacological approaches reduce symptoms of depression in dementia: A systematic review and meta-analysis. Ageing Res Rev 2022; 79:101669. [PMID: 35714853 DOI: 10.1016/j.arr.2022.101669] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 06/09/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Depression is a common psychological symptom associated with dementia. Pharmacological approaches are often used despite two large negative trials of efficacy. This meta-analysis examines nonpharmacological (i.e., psychosocial) approaches for symptoms of depression in people living with dementia and reports statistical and clinical significance. METHODS Relevant studies published between 2012 and 2020 were sourced by searching electronic databases: MEDLINE, EMBASE, PsychINFO, Social Work Abstracts and the Cochrane Central Register of Controlled Trials. Studies were assessed for methodological quality. Random-effects meta-analysis was performed to calculate a pooled effect size (ES) and 95% confidence intervals (CI). RESULTS Overall, 37 nonpharmacological studies were identified including 2,636 participants. The mean quality rating was high (12/14, SD=1.4). Meta-analysis revealed that nonpharmacological approaches were significantly associated with reduced symptoms of depression with a medium effect size (ES=-0.53, 95%CI [-0.72, -0.33], p < 0.0001). There was considerable heterogeneity between studies. Meta-regression revealed this was not driven by intervention type or setting (residential versus community). CONCLUSIONS Nonpharmacological approaches such as reminiscence, cognitive stimulation/ rehabilitation, therapeutic, music-based approaches and education/ training, have the potential to reduce symptoms of depression in dementia.
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Affiliation(s)
- Claire V Burley
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.
| | - Kim Burns
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Ben C P Lam
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.
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17
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Lineweaver TT, Bergeson TR, Ward MJ, Hagen NA, Ladd K, Johnson H, Braid D, Ott M, Hay DP, Plewes J, Hinds M, LaPradd ML, Bolander H, Vitelli S, Lain M, Brimmer T. Nursing Home Residents' Positive Behavioral Responses to Individualized Music Predict Improvements in Sundowning Symptoms After Music Listening. J Aging Health 2022; 34:1037-1047. [PMID: 35465759 DOI: 10.1177/08982643221087569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The goal of this exploratory study was to predict which long-term care residents with dementia would experience improvements in their sundowning symptoms after listening to personalized music playlists. Methods: We studied 101 residents with moderate to severe dementia from 15 long-term care facilities across 8 months. We observed residents' behavioral responses to individualized music while they listened and recorded sundowning symptoms both before and after each listening session. Results: As hypothesized, residents who exhibited a greater number of positive reactive behaviors while listening to music also evidenced more improvements in their confusion, disengagement, unresponsiveness, and restlessness after their music-listening session. Discussion: Our results reveal that observing behavioral responses during music listening is an effective way to determine when nursing home residents are benefiting from personalized music playlists. These findings inform music programs in long-term care settings by identifying residents whose sundowning symptoms are most amenable to music intervention.
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Affiliation(s)
- Tara T Lineweaver
- Department of Psychology, 4065Butler University, Indianapolis, IN, USA
| | - Tonya R Bergeson
- Department of Communication Sciences and Disorders, 4065Butler University, Indianapolis, IN, USA
| | - Marissa J Ward
- Department of Psychology, 4065Butler University, Indianapolis, IN, USA
| | - Nicole A Hagen
- Department of Psychology, 4065Butler University, Indianapolis, IN, USA
| | - Kendall Ladd
- Department of Psychology, 4065Butler University, Indianapolis, IN, USA
| | - Heather Johnson
- Department of Music, 4065Butler University, Indianapolis, IN, USA
| | - Donald Braid
- Center for Citizenship and Community, 4065Butler University, Indianapolis, IN, USA
| | - Monica Ott
- Department of Internal Medicine and Geriatrics, 10668Indiana University, Indianapolis, IN, USA
| | | | | | - Mary Hinds
- Center for Academic Technology, 4065Butler University, Indianapolis, IN, USA
| | - Michelle L LaPradd
- Department of Biostatistics, 10668Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Hannah Bolander
- Department of Psychology, 4065Butler University, Indianapolis, IN, USA
| | - Sarah Vitelli
- Department of Psychology, 4065Butler University, Indianapolis, IN, USA
| | - Mikala Lain
- Department of Psychology, 4065Butler University, Indianapolis, IN, USA
| | - Tim Brimmer
- Department of Music, 4065Butler University, Indianapolis, IN, USA
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18
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Veal BM, Dobbs D, Lee S, Bugos JA, Pyfrom MP, Boddupalli S, Lengacher CA, Meng H. Feasibility and Acceptability of a Group Music Intervention in Memory Care Communities. J Appl Gerontol 2022; 41:1528-1538. [PMID: 35341380 DOI: 10.1177/07334648221079118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Music-based interventions have been shown to reduce behavioral expressions among persons with dementia. The goal of this study was to examine the feasibility and acceptability of a group music intervention to reduce agitation. Two memory care communities were recruited to participate in this single-arm mixed-methods study. The group music intervention program included a total of 12 sessions delivered over 4 weeks. Agitation was assessed quantitatively at weeks 0, 2, and 4. Qualitative interviews of memory care staff were conducted post-intervention. Data were analyzed using linear mixed-effects models and qualitative content analysis. The study sample (N = 19) had a mean age of 82.74, and 73.7% were female. The great majority of participants completed the intervention and 63.2% experienced a reduction in agitation, suggesting that the intervention is feasible and acceptable in memory care and may be efficacious. Future research should evaluate the efficacy of the intervention in a randomized controlled trial.
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Affiliation(s)
- Britney M Veal
- School of Aging Studies, College of Behavioral and Community Sciences, 7831University of South Florida, Tampa, FL, USA
| | - Debra Dobbs
- School of Aging Studies, College of Behavioral and Community Sciences, 7831University of South Florida, Tampa, FL, USA
| | - Soomi Lee
- School of Aging Studies, College of Behavioral and Community Sciences, 7831University of South Florida, Tampa, FL, USA
| | - Jennifer A Bugos
- School of Music, College of the Arts, 7831University of South Florida, Tampa, FL, USA
| | - Mary P Pyfrom
- Department of Communication Sciences and Disorders, College of Behavioral and Community Sciences, 7831University of South Florida, Tampa, FL, USA
| | | | | | - Hongdao Meng
- School of Aging Studies, College of Behavioral and Community Sciences, 7831University of South Florida, Tampa, FL, USA
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19
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Hayden L, Passarelli C, Shepley SE, Tigno W. A scoping review: Sensory interventions for older adults living with dementia. DEMENTIA 2022; 21:1416-1448. [PMID: 35230906 DOI: 10.1177/14713012211067027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This scoping review focused on the existing scholarly literature exploring sensory interventions and immersive environments developed for, and used by, older adults living with dementia. The purpose of the scoping review is 1) to understand the various sensory interventions that have been developed, used, and have provided data to show how such interventions are expected to impact the lives of individuals living with dementia; and 2) to understand how the field is moving forward. We chose to map the literature to understand the types of interventions, the types of outcomes measured, and the contexts of their implementation. Our search was constrained to references from 1990 to 1 June 2019 in the following databases: Academic Search Complete, CINAHL Complete, MEDLINE, PsycINFO databases, and Summon Search discovery layer. We screened 2305 articles based on their titles and abstracts, and 465 were sent to full text review, of which 170 were included in our full text extraction. Once the data were extracted, we created emic categories, which emerged from the data, for data that were amenable to categorization (e.g., study setting, intervention type, and outcome type). We developed ten different categories of interventions: art, aromatics, light, multi-component interventions, multisensory rooms, multisensory, music, nature, touch, and taste. Sensory interventions are a standard psychosocial approach to managing the personal expressions commonly experienced by people living with dementia. Our findings can help providers, caregivers, and researchers better design interventions for those living with dementia, to help them selectively choose interventions for particular outcomes and settings. Two areas emerging in the field are nature interventions (replacing traditional "multisensory rooms" with natural environments that are inherently multisensory and engaging) and multi-component interventions (where cognitive training programs are enhanced by adding sensory components).
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20
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Zimmerman S, Resnick B, Ouslander J, Levy C, Gaugler JE, Sloane PD, Mor V. Pragmatic Trials and Improving Long-Term Care: Recommendations From a National Institutes of Health Conference. J Am Med Dir Assoc 2022; 23:323-327. [DOI: 10.1016/j.jamda.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/06/2022] [Indexed: 12/27/2022]
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21
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Zimmerman S, Resnick B, Ouslander J, Levy C, Gaugler JE, Sloane PD, Mor V. Pragmatic Trials and Improving Long-Term Care: Recommendations From a National Institutes of Health Conference. J Am Geriatr Soc 2022; 70:688-694. [PMID: 35195278 PMCID: PMC8915540 DOI: 10.1111/jgs.17697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Address correspondence to Sheryl Zimmerman, PhD, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr Blvd, Campus Box 7590, Chapel Hill, NC 27599-7590, USA. (S. Zimmerman)
| | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Joseph Ouslander
- Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Cari Levy
- Department of Veterans Affairs, Rocky Mountain Regional VA Medical Center, and University of Colorado, Aurora, CO, USA
| | - Joseph E. Gaugler
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Philip D. Sloane
- Cecil G. Sheps Center for Health Services Research and Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Vincent Mor
- Center of Innovation in Long-term Services and Supports, Providence VA Medical Center; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA
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22
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Aleixo MAR, Borges MBD, Gherman BR, Teixeira IA, Simões Neto JP, Santos RL, Dourado MCN, Marinho V. Active music therapy in dementia: results from an open-label trial. JORNAL BRASILEIRO DE PSIQUIATRIA 2022. [DOI: 10.1590/0047-2085000000363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective: Cognitive, neuropsychiatric and functional deficits are core symptoms of dementia. Non-pharmacological interventions, such as music therapy, when used in conjunction with pharmacological treatment, have the potential to alleviate these symptoms. The purpose of this preliminary study is to examine the active music therapy on cognition and neuropsychiatric symptoms in the elderly with mild and moderate dementia. Methods: The initial sample consisted of outpatients with dementia (N = 15) and their family members or caregivers (N = 15). Two dyads did not complete the assessments before intervention and were excluded from the analysis. Thirteen females (N = 13) comprised the final sampled and were diagnosed with Alzheimer’s disease (N = 10), vascular dementia (N = 2) and mixed dementia (N = 1), at mild (N = 11) and moderate (N = 2) dementia stage. Participants were enrolled in an open-label trial of active music therapy group, set to take place once weekly for 60 minutes over a period of 12 weeks. Results: Participants experienced a slight improvement on cognition measured with Mini-Mental State Examination (p = 0.41), although without statistical significance and a statistically significant decrease in anxiety (p = 0.042) in post-intervention. There were no significant effects on quality of life and caregiver burden. Conclusions: Active music therapy is a promising intervention with good acceptance among participants. More studies with larger sample sizes are needed to confirm its effects and efficacy in cognitive and neuropsychiatric symptoms in dementia.
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23
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Campbell EA, Wosch T. Music moves – Ettlingen dementia study: Protocol of a pragmatic randomised controlled trial. NORDIC JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1080/08098131.2022.2028885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Elsa A. Campbell
- Residential care home, Caritas Ettlingen, Germany
- Vibrac Centre for Vibroacoustic Therapy and Research, Eino Roiha Foundation, Finland
- Institute for Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | - Thomas Wosch
- Institute for Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
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24
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Yangöz ŞT, Özer Z. Effects of music intervention on physical and psychological problems in adults receiving haemodialysis treatment: A systematic review and meta-analysis. J Clin Nurs 2022; 31:3305-3326. [PMID: 35118718 DOI: 10.1111/jocn.16199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/26/2021] [Accepted: 12/20/2021] [Indexed: 01/21/2023]
Abstract
AIMS AND OBJECTIVES To synthesise the effects of music intervention on the physical and psychological problems of adults receiving haemodialysis. BACKGROUND Adults receiving haemodialysis experience many physical and psychological problems. Music interventions may have beneficial effect on the management of these problems. DESIGN A systematic review and meta-analysis based on PRISMA 2020. METHODS This study followed the Cochrane 2021 guideline. Eleven electronic databases were searched from inception to July 2021. Randomised controlled trials that assessed music intervention on haemodialysis-related physical and psychological problems were included. Two authors independently assessed risk of bias with the Cochrane Collaboration tool. The Comprehensive Meta-Analysis software version 3 was used for meta-analysis. RESULTS Sixteen randomised controlled trials were included. This meta-analysis demonstrated that music intervention had significant and large effect on physical outcomes such as breath rate, oxygen saturation, arteriovenous fistula puncture-related pain, itching, sleep quality as well as psychological outcomes such as state anxiety and stress. The study also found that music intervention had significant and medium effect on physical outcomes such as systolic and diastolic blood pressure, heart rate and pain, and psychological outcomes such as anxiety. Music intervention had no effect on physical outcomes such as body temperature and cramps, and psychological outcomes such as trait anxiety and depression. Subgroup analyses indicated that sessions of 4-6 are more effective for improving the systolic and diastolic blood pressure and heart rate than three sessions or less. It also found that music duration of 20 min or less is more effective in reducing anxiety compared to music duration of 30 min or more. CONCLUSIONS This study demonstrated that music intervention may partially improve haemodialysis-related physical and psychological problems. RELEVANCE TO CLINICAL PRACTICE This study will contribute to perform of music intervention for haemodialysis-related physical and psychological problems for health professionals, particularly nurses. STUDY REGISTRATION This study has been registered at PROSPERO (Registration No. CRD42021267463).
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Affiliation(s)
- Şefika Tuğba Yangöz
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Pamukkale University, Denizli, Turkey
| | - Zeynep Özer
- Department of Internal Medicine Nursing, Faculty of Nursing, University of Akdeniz, Antalya, Turkey
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Zimmerman S, Resnick B, Ouslander J, Levy C, Gaugler JE, Sloane PD, Mor V. Pragmatic trials and improving long-term care: Recommendations from a national institutes of health conference. Geriatr Nurs 2022; 44:288-292. [DOI: 10.1016/j.gerinurse.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bufalini J, Eslinger P, Lehman E, George DR. Effects of a Personalized Music Intervention for Persons with Dementia and their Caregivers. J Alzheimers Dis Rep 2022; 6:43-48. [PMID: 35360273 PMCID: PMC8925117 DOI: 10.3233/adr-210043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/12/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Given the challenges of developing disease-modifying treatments for Alzheimer’s disease and related disorders, non-pharmacological interventions represent an increasingly promising approach in long-term care settings. Music-based interventions have been effective in improving the quality of life by influencing biopsychosocial factors that play a role in the progression of illnesses such as depression and anxiety. However, approaches have tended to focus exclusively on the person with dementia rather than integrating caregivers. Objective: This study aimed to determine the impact of a music-based intervention on the quality of life of persons with dementia and their caregivers. Methods: A mixed-methods study was conducted with seven dyads consisting of residents (aged 76–92) with diagnoses of dementia and their caregivers (aged 53–84) at a skilled nursing facility in Pennsylvania. Eight music intervention sessions were completed in the presence of the resident and caregiver using personalized playlists created for the dyad. Pre- and post-intervention questionnaires were administered during each session, and observational data for both residents and caregivers were collected. Results: Caregivers reported feeling less overwhelmed after the intervention with a mean difference of –0.24±0.14, p = 0.016. Mean difference in the other 5 responses showed that listening to music had a beneficial impact for resident/caregiver dyads. Observations of interpersonal behavior supported the benefit of the intervention for these dyads. Conclusion: Quantitative analysis of a personalized music intervention for residents/caregivers showed positive trends in increasing personal connection, and qualitative data identified greater appreciation of the relationship and increased bonding.
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Affiliation(s)
| | - Paul Eslinger
- Departments of Neurology, Neural & Behavioral Sciences, and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Erik Lehman
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Daniel R. George
- Department of Humanities, Penn State College of Medicine, Hershey, PA, USA
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Yang B, Tao B, Yin Q, Chai Z, Xu L, Zhao Q, Wang J. Associations Between Oral Health Status, Perceived Stress, and Neuropsychiatric Symptoms Among Community Individuals With Alzheimer's Disease: A Mediation Analysis. Front Aging Neurosci 2022; 13:801209. [PMID: 35082659 PMCID: PMC8786079 DOI: 10.3389/fnagi.2021.801209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/14/2021] [Indexed: 11/13/2022] Open
Abstract
Community individuals with Alzheimer's disease (AD) experience oral disease alongside neuropsychiatric symptoms (NPS) with disease progression. Despite growing evidence for the link between oral health and cognitive status, few studies have investigated the associations between oral health and NPS, especially based on individuals' experience of AD. The primary aim of this study was to examine (a) the difference in oral health-related stressors among individuals with AD, mild cognitive impairment (MCI), and subjective cognitive decline (SCD); and (b) the associations of these stressors with NPS under the framework of the stress process model (SPM). A cross-sectional study was conducted among individuals diagnosed with AD (n = 35), MCI (n = 36) or SCD (n = 35), matched for age, sex education, and body mass index (BMI). Multiple regression and mediation model analyses were performed to explore predictors and their relationships with NPS based on the SPM. Data collection comprised four sections: (a) individual context; (b) oral health-related stressors, including dental caries, periodontal status, oral hygiene, the geriatric oral health assessment index (GOHAI), oral salivary microbiota, pro-inflammatory cytokines, and oral health behavior; (c) subjective stressors (i.e., perceived stress [PS]); and (d) NPS. Decayed, missing, and filled teeth (DMFT), missing teeth (MT), loss of attachment (LoA), plaque index (PLI), PS, oral health behavior, GOHAI, pro-inflammatory cytokines, and salivary bacterial composition were significantly different among the three groups; these parameters were poorer in the AD group than SCD and/or MCI group. LoA, PLI, PS, and pain or discomfort in the GOHAI were directly associated with NPS. PLI, LoA, and psychosocial function in the GOHAI indirectly affected NPS, and this relationship was mediated by PS. Individuals with AD reported greater oral health-related stressors. This study identifies direct and indirect associations linking oral health-related stressors and PS with NPS in individuals with AD. Our findings suggest that targeted dental care and oral-related stressor control may be valuable for managing NPS.
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Affiliation(s)
- Bing Yang
- Department of Nursing, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Binbin Tao
- Department of Nursing, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Qianyu Yin
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhaowu Chai
- Department of Nursing, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Ling Xu
- Community Health Center of Daxigou, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Wang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Exploring Factors Associated With Successful Nonpharmacological Interventions for People With Dementia. Dement Neurocogn Disord 2022; 21:1-16. [PMID: 35154336 PMCID: PMC8811205 DOI: 10.12779/dnd.2022.21.1.1] [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: 11/02/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/27/2022] Open
Abstract
Background and purpose Methods Results Conclusions
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Sousa L, Neves MJ, Moura B, Schneider J, Fernandes L. Music-based interventions for people living with dementia, targeting behavioral and psychological symptoms: A scoping review. Int J Geriatr Psychiatry 2021; 36:1664-1690. [PMID: 34097789 DOI: 10.1002/gps.5568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 05/06/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Dementia care is a major public health issue worldwide. The management of behavioral and psychological symptoms (BPSD) is one of the hardest challenges in this context. Non-pharmacological strategies, like music-based interventions (Mbi), seem promising options, being considered low-risk, widely available and inclusive. This scoping review aimed at mapping all Mbi used in dementia care, targeting BPSD, and debriefing its components, structure and rationale. Music therapy and other therapeutic music activities were included. METHODS The Arksey and O'Malley framework, Cochrane recommendations and PRISMA checklist were followed. Embase, PubMed, PsycINFO, ASSIA and Humanities Index were searched from first records until the 31st of March 2020. Snowballing process and screening of relevant journals were also undertaken. A panel of experts critically guided the evidence synthesis. RESULTS Overall, 103 studies (34 RCT; 12 NRT; 40 Before/After studies and 17 Case Studies) met inclusion criteria. Basic elements of the Mbi, the rationale supporting its development and hypothesis tested were mostly underreported, thus hampering cross-study comparisons and generalizations. Despite this, available evidence indicates that: it is feasible to deliver Mbi to PwD at very different stages and in different settings - from community to the acute setting - even for non-music therapists; positive or neutral effects in BPSD are often reported but not without exception; individualization seems a critical factor mediating Mbi effects. CONCLUSIONS Detailed intervention and research reporting are essential to interpretation, replication and translation into practice. Ten years after the publication of specific reporting guidelines, this goal is not yet fully achieved in music in dementia care.
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Affiliation(s)
- Lídia Sousa
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of Porto University, Porto, Portugal.,Geriatrics & Mental Health Group, CINTESIS - Center for Health Technologies and Services Research, Porto, Portugal
| | - Maria J Neves
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of Porto University, Porto, Portugal.,Unidade de Saúde Familiar Espinho, ACeS Grande Porto VIII, Portugal
| | - Bárbara Moura
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of Porto University, Porto, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Justine Schneider
- School of Sociology & Social Policy, University of Nottingham, Nottingham, UK
| | - Lia Fernandes
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of Porto University, Porto, Portugal.,Geriatrics & Mental Health Group, CINTESIS - Center for Health Technologies and Services Research, Porto, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar Universitário de S. João, Porto, Portugal
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30
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Jang S, Kunde L. A systematic review of music therapy interventions used to address emotional needs of older adults. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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31
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Li W, Xu X, Wu F, Ni Y, Lan J, Hu X. Comparative efficacy of non-pharmacological interventions on behavioural and psychological symptoms in elders with dementia: A network meta-analysis. Nurs Open 2021; 8:2922-2931. [PMID: 34472717 PMCID: PMC8510770 DOI: 10.1002/nop2.1049] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 07/22/2021] [Accepted: 08/04/2021] [Indexed: 02/05/2023] Open
Abstract
Aim To explore the best non‐pharmaceutical interventions for improving the behavioural and psychological symptoms in elders with dementia. Design Bayesian network meta‐analysis. Methods A comprehensive electronic literature search was performed in five English databases and four Chinese databases to identify relevant randomized controlled trials (RCTs) that were published up to 31 October 2019. Results A total of 41 RCTs were included in this network meta‐analysis involving 5 different non‐pharmacological interventions: therapeutic recreation (TC), reminiscence therapy (RT), behaviour therapy (BT), massage therapy (MT) and individualized nursing (IN).The results of network meta‐analysis showed that individualized nursing was the best in improving depression, cognitive function, and activities of daily living of behavioural and psychological symptoms of dementia. Behaviour therapy was the best in improving anxiety symptoms. Reminiscence therapy was the best in improving neuropsychiatric symptoms.
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Affiliation(s)
- Wenjie Li
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaofeng Xu
- Trauma Center Ward 2 of West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Fen Wu
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Yuanyuan Ni
- School of Nursing, Changzhi Medical College, Shanxi, China
| | - Jun Lan
- Department of Orthopedics Surgery, Chongqing General Hospital, University of Chinese Academy of Sciences (UCAS), Beijing, China
| | - Xiuying Hu
- Innovation Center of Nursing Research, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China.,Nursing Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China
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Hui EK, Tischler V, Wong GHY, Lau WYT, Spector A. Systematic review of the current psychosocial interventions for people with moderate to severe dementia. Int J Geriatr Psychiatry 2021; 36:1313-1329. [PMID: 34350626 DOI: 10.1002/gps.5554] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/15/2021] [Accepted: 03/30/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Dementia, a global epidemic, currently affects 50 million individuals worldwide. There are currently limited effective treatments for moderate to severe dementia, and most treatments focus on reducing symptoms rather than improving positive factors. It is unclear if improvements are not possible due to disease severity. This review examines the efficacy of the current psychosocial interventions for people with moderate to severe dementia, focusing on improving cognition and quality of life (QoL) to evaluate what treatments are working and whether improvements are possible. METHODS A systematic search was conducted using six key databases to identify psychosocial interventions for people with moderate to severe dementia, measuring cognition or QoL in randomized controlled trials (RCTs), published between 2000 and 2020. RESULTS The search identified 4193 studies, and 74 articles were assessed for full-text review. Fourteen RCTs were included and appraised with the Physiotherapy Evidence Database Scale. The included RCTs were moderate in quality. CONCLUSIONS Aromatherapy and reminiscence therapy showed the strongest evidence in improving QoL. There was some evidence that aerobic exercise enhanced cognition, and a multicomponent study improved QoL. However, a quality assessment, using pre-specified criteria, indicated many methodological weaknesses. While we found improvements in cognition and QoL for moderate to severe dementia, results must be interpreted with caution. Future interventions with rigorous study designs are a pressing need and required before we can recommend specific interventions.
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Affiliation(s)
- Esther K Hui
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Victoria Tischler
- European Center for Environment and Human Health, The University of Exeter, Truro, UK
| | - Gloria H Y Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - W Y Tiffany Lau
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Dahms R, Eicher C, Haesner M, Mueller-Werdan U. Influence of Music Therapy and Music-Based Interventions on Dementia: A Pilot Study. J Music Ther 2021; 58:e12-e36. [PMID: 33948656 DOI: 10.1093/jmt/thab005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
According to national dementia plan in many countries, the music implementation into the daily routine as an adjunctive therapy to medication treatment is common. However, the ability of long-term care facilities to implement individualized music therapy (MT) and music-based interventions is not sufficiently taken into account. This pilot study examined the frequency of use and acceptance of MT and technology-based music interventions (TBMI) as well as the influence of high and low usage of both interventions of dementia on behavioral and psychological symptoms (BPSD) at two timepoints. Furthermore, the influence on the combination of MT and TBMI of dementia within the nursing home setting on BPSD with a focus on agitation, apathy, depression, and quality of life at all timepoints was considered. In the present study, data from 30 people with dementia (PwD) aged on average 81 years were analyzed within an eight-week noncontrolled intervention study, including four-week follow-up. Initial outcome data indicated significant decreases at times T2 and T3 in agitation and apathy among PwD with a high usage of MT and TBMI than among those with a low usage. In general, reductions were obtained from all observed BPSD at all timepoints. Significant results were found only for agitation over time. Considering the demonstrated results, a long-term implementation of music within daily routines in nursing homes for PwD should be strived for.
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Affiliation(s)
- Rebecca Dahms
- Charité - Universitätsmedizin Berlin, Berlin, Germany
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Lineweaver TT, Bergeson TR, Ladd K, Johnson H, Braid D, Ott M, Hay DP, Plewes J, Hinds M, LaPradd ML, Bolander H, Vitelli S, Lain M, Brimmer T. The Effects of Individualized Music Listening on Affective, Behavioral, Cognitive, and Sundowning Symptoms of Dementia in Long-Term Care Residents. J Aging Health 2021; 34:130-143. [PMID: 34346261 DOI: 10.1177/08982643211033407] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study aimed to replicate music's positive effects on dementia-related symptoms, determine whether a 6-month intervention would lead to greater positive outcomes than typical 3- to 4-month interventions, and examine changes in sundowning symptoms after music listening. METHODS 282 nursing home residents with dementia listened to personalized music playlists 1-3 times weekly for 30 minutes across 6 months. Standardized assessments of affect, behavior, and cognition and direct observations of sundowning symptoms comprised the outcomes. RESULTS Results documented significant improvements in residents' general neuropsychiatric symptoms, agitation, and depression across the first 3 months, but no additional improvements across the subsequent 3 months. Seven sundowning symptoms significantly improved following music listening, with some (e.g., disengagement) being more amenable to music than others (e.g., aggression). DISCUSSION Results support short-term individualized music listening as an effective non-pharmacological approach for improving dementia-related symptoms in nursing home residents and suggest new applications of music-related interventions.
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Affiliation(s)
| | | | | | | | | | - Monica Ott
- Indiana University, Indianapolis, IN, USA
| | | | | | - Mary Hinds
- 4065Butler University, Indianapolis, IN, USA
| | - Michelle L LaPradd
- 10668Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | | | | | - Mikala Lain
- 4065Butler University, Indianapolis, IN, USA
| | - Tim Brimmer
- 4065Butler University, Indianapolis, IN, USA
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Gómez-Gallego M, Gómez-Gallego JC, Gallego-Mellado M, García-García J. Comparative Efficacy of Active Group Music Intervention versus Group Music Listening in Alzheimer's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8067. [PMID: 34360360 PMCID: PMC8345612 DOI: 10.3390/ijerph18158067] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Music interventions are promising therapies for the management of symptoms in Alzheimer's disease (AD). Globally, music interventions can be classified as active or receptive depending on the participation of the subjects. Active and receptive music tasks engage different brain areas that might result in distinctive clinical effects. This study aims to compare the clinical effects of two types of music interventions and a control activity. METHODS Ninety AD patients from six nursing homes participated in the study. Nursing homes were randomly and blindly assigned to receive either active music intervention, receptive music intervention, or the usual care. Effects on cognition, behaviour, daily living activities, and motor function were assessed. RESULTS Active music intervention improved cognition, behaviour, and functional state in a higher extent than both receptive music intervention and usual care. The effect size of active music intervention for cognitive deficits and behavioural symptoms was large (η2 = 0.62 and 0.61, respectively), while for functional state, it was small-to-medium sized (η2 = 0.18). Receptive music intervention had a stabilizing effect on behavioural symptoms compared to control intervention (mean change from baseline ± standard deviation = -0.76 ± 3.66 and 3.35 ± 3.29, respectively). In the active music intervention, the percentage of patients who showed improvement in cognitive deficits (85.7), behavioural symptoms (92.9), and functional state (46.4) was higher than in both receptive listening (11.8, 42.9, and 14.3, respectively) and control group (6.3, 12.2, and 17.1, respectively). CONCLUSIONS Active music intervention is useful to improve symptoms of AD and should be prescribed as a complement to the usual treatment.
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Affiliation(s)
- María Gómez-Gallego
- Clinical Neuroscience Research Group, Faculty of Health Sciences, Catholic University of Saint Anthony, 30100 Murcia, Spain
| | | | | | - Javier García-García
- Clinical Neuroscience Research Group, Faculty of Economics, Catholic University of Murcia, 30107 Murcia, Spain;
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36
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Lin PC, Lay YL, Chiu HL, Chen IH, Peters K. Effectiveness of a musical fitness programme for older adults with cognitive impairment in long-term care facilities: A quasi-experimental study. J Clin Nurs 2021; 31:995-1004. [PMID: 34227165 DOI: 10.1111/jocn.15956] [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: 03/28/2021] [Revised: 05/12/2021] [Accepted: 06/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the effectiveness of a musical fitness programme (MFP) intervention in improving neuropsychiatric symptoms, depression, upper-limb muscle strength and cognition of older adults with cognitive impairment in long-term care (LTC) facilities. BACKGROUND Because of population ageing, the number of older adults with cognitive impairment has been increasing. The effectiveness of medications in treating cognitive impairment is limited; therefore, the global trend has been for non-pharmacological treatments. However, intervention studies of MFPs on older LTC residents with cognitive impairment are scant. DESIGN This study adopted a quasi-experimental design in accordance with the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) checklist. In total, 84 older adults with cognitive impairment were recruited from seven LTC facilities. The MFP was implemented from July-November 2019. METHODS The intervention group received the MFP, which was 50 min per session, twice a week for 12 weeks, whereas the comparison group received usual care. Neuropsychiatric inventory nursing home version, the Cornell scale for depression in dementia Chinese version, 30-s arm curl test and Mini-Mental State Examination were the outcome measures. Data were analysed using Chi-square test, t test and repeated measure analysis of variance. RESULTS After the intervention, the scores of neuropsychiatric inventory and the Cornell depression exhibited significant differences over time between two groups (F = 3.6, p = .029; F = 5.96, p = .003, respectively). Nevertheless, 30-s arm curl test and Mini-Mental State Examination demonstrated non-significant between-group differences. CONCLUSION The MFP can effectively reduce neuropsychiatric symptoms and depression in older adults with cognitive impairment in LTC facilities. To ensure a more robust evidence base, more research is warranted. RELEVANCE TO CLINICAL PRACTICE The MFP is a non-pharmacological treatment that can be implemented to promote psychological well-being among older adults with cognitive impairment in LTC facilities, and to indirectly reduce nursing staff burden. To assist nursing staff in providing this intervention, on-the-job training is needed.
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Affiliation(s)
- Pi-Chu Lin
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Yu-Ling Lay
- Taipei Veterans General Hospital-Yuanshan Branch, Yilan, Taiwan
| | - Huei-Ling Chiu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - I-Hui Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Kath Peters
- School of Nursing and Midwifery, Western Sydney University, Penrith South, NSW, Australia
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Music and Nursing Home Residents with Dementia: A Literature Review. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ibnidris A, Piumatti G, Carlevaro F, Fadda M, Magno F, Magistro D, Albanese E. Italian version of the short 10/66 dementia diagnostic schedule: a validation study. BMJ Open 2021; 11:e045867. [PMID: 34193490 PMCID: PMC8246379 DOI: 10.1136/bmjopen-2020-045867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To determine the criterion and concurrent validity of the Italian version of the short 10/66 Dementia Diagnostic Schedule and algorithm in a sample of Italian native speakers, older adults. DESIGN A cross-sectional, validation study. SETTING The study was conducted with older adults living in the community and in nursing homes in the Canton of Ticino, Switzerland, and the Piedmont region in Italy between March and August 2019. PARTICIPANTS A convenience sample of 229 participants (69% females) were recruited. The eligibility criteria were being ≥60 years old and having an informant. The final sample included 74 participants (32%) with a previous clinical diagnosis of dementia and 155 (68%) cognitively healthy older adults. PRIMARY AND SECONDARY OUTCOME MEASURES The short version of 10/66 Dementia Diagnostic Schedule consists of the Community Screening Instrument for Dementia, the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) 10-word list learning task with delayed recall and the depression scale, Euro-Depression (EURO-D) scale. Disability was measured using the WHO Disability Assessment Schedule (WHO-DAS II). RESULTS The Italian version of the short 10/66 Dementia Diagnostic Schedule showed fair sensitivity (87%), specificity (61%) and agreement with the clinical diagnosis of dementia (kappa=0.40, area under the receiver operating characteristics curve=0.74). Older adults with dementia living in nursing homes had higher disability scores (WHO-DAS II mean=23.14, SE=1.29) than those living in the community (WHO-DAS II mean=7.08, SE=0.66). WHO-DAS II was positively correlated with the short version of the 10/66 dementia diagnosis (β=5.23, 95% CI 2.05 to 8.41). CONCLUSIONS In settings where lengthy diagnostic procedures are not feasible, the short 10/66 is a practical tool to identify dementia in older adults. Our findings extend evidence on the validity of the 10/66 dementia diagnostic algorithm to high-income countries, where epidemiological evidence on dementia and its impact is outdated.
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Affiliation(s)
- Aliaa Ibnidris
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Giovanni Piumatti
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
- Division of Primary Care, Geneva University Hospitals, Geneve, Switzerland
| | - Fabio Carlevaro
- Polo Universitario Asti Studi Superiori (Uni-Astiss), University of Turin, Torino, Italy
| | - Marta Fadda
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Francesca Magno
- Polo Universitario Asti Studi Superiori (Uni-Astiss), University of Turin, Torino, Italy
| | - Daniele Magistro
- Department of Sport Science, Nottingham Trent University, Nottingham, UK
| | - Emiliano Albanese
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
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Daniel Lai LL, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [PMID: 34368465 PMCID: PMC8311801 DOI: 10.12688/wellcomeopenres.16189.3] [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] [Accepted: 06/16/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
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Affiliation(s)
- L L Daniel Lai
- Clinical Psychology, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong
| | - Sebastian J Crutch
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, Royal Academy of Music, London, UK
| | - Emma Harding
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Emilie V Brotherhood
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Rohan Takhar
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Nicholas Firth
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Paul M Camic
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
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Daniel Lai L, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [PMID: 34368465 PMCID: PMC8311801 DOI: 10.12688/wellcomeopenres.16189.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 08/08/2023] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
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Affiliation(s)
- L.L. Daniel Lai
- Clinical Psychology, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong
| | - Sebastian J. Crutch
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, Royal Academy of Music, London, UK
| | - Emma Harding
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Rohan Takhar
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Nicholas Firth
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
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D’Aniello GE, Cammisuli DM, Cattaneo A, Manzoni GM, Molinari E, Castelnuovo G. Effect of a Music Therapy Intervention Using Gerdner and Colleagues' Protocol for Caregivers and Elderly Patients with Dementia: A Single-Blind Randomized Controlled Study. J Pers Med 2021; 11:jpm11060455. [PMID: 34071112 PMCID: PMC8224547 DOI: 10.3390/jpm11060455] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 11/25/2022] Open
Abstract
Music therapy (MT) is considered one of the complementary strategies to pharmacological treatment for behavioral and psychological symptoms (BPSD) of dementia. However, studies adopting MT protocols tailored for institutionalized people with dementia are limited and their usefulness for supporting caregivers is under investigated to date. Our study aimed at evaluating the effects of an MT intervention according to Gerdner and colleagues’ protocol in a sample of 60 elderly people with moderate-to-severe dementia of the Auxologico Institute (Milan, Italy) and associated caregivers, randomly assigned to an Experimental Group (EG) (n = 30) undergoing 30 min of MT two times a week for 8 weeks and to a Control Group (n = 30) (CG) receiving standard care. Before and after the intervention, residents-associated caregivers were administered the Caregiver Burden Inventory (CBI) and the Neuropsychiatric Inventory (NPI). Depression and worry were also assessed in caregivers prior to the intervention, by the Beck Depression Inventory-II and the Penn State Worry Questionnaire, respectively. A mixed model ANCOVA revealed a Time*Group effect (p = 0.006) with regard to CBI decreasing after the intervention for the EG and Time*Group effects (p = 0.001) with regard to NPI_frequencyXseverity and NPI_distress, with a greater effect for the EG than the CG. Implications for MT protocols implementations are discussed.
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Affiliation(s)
- Guido Edoardo D’Aniello
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20122 Milan, Italy; (A.C.); (G.M.M.); (E.M.); (G.C.)
- Correspondence: ; Tel.: +39-328-0326424
| | | | - Alice Cattaneo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20122 Milan, Italy; (A.C.); (G.M.M.); (E.M.); (G.C.)
| | - Gian Mauro Manzoni
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20122 Milan, Italy; (A.C.); (G.M.M.); (E.M.); (G.C.)
- Faculty of Psychology, eCampus University, 20060 Novedrate, Italy
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20122 Milan, Italy; (A.C.); (G.M.M.); (E.M.); (G.C.)
- Department of Psychology, Catholic University of the Sacred Heart, 20123 Milan, Italy;
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20122 Milan, Italy; (A.C.); (G.M.M.); (E.M.); (G.C.)
- Department of Psychology, Catholic University of the Sacred Heart, 20123 Milan, Italy;
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Daniel Lai L, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [DOI: 10.12688/wellcomeopenres.16189.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
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Raglio A, Bellandi D, Manzoni L, Grossi E. Communication improvement reduces BPSD: a music therapy study based on artificial neural networks. Neurol Sci 2021; 42:2103-2106. [PMID: 33428051 DOI: 10.1007/s10072-020-04986-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 12/10/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Literature showed the effects of music therapy on behavioral disturbances, cognitive functions, and on quality of life in people with dementia. Especially, relational active music therapy approach is oriented to reduce behavioral disturbances increasing communication, especially non-verbal communication. OBJECTIVE This study aimed at exploring the connection between the baseline characteristics of responders and the positive outcome of the intervention, but also the close relationship between the behavioral disturbances and the core of the therapeutic intervention (the relationship/communication improvement). METHOD Linear correlation index between input variables and the presence of a critical improvement of behavioral symptoms according Neuropsychiatric Inventory and a semantic connectivity map were used to determine, respectively, variables predictive of the response and complex connections between clinical variables and the relational nature of active music therapy intervention. The dataset was composed of 27 variables and 70 patients with a moderate-severe stage of dementia and behavioral disturbances. RESULTS The main predictive factor is the Barthel Index, followed by NPI and some of its sub-items (mainly, Disinhibition, Depression, Hallucinations, Irritability, Aberrant Motor Activity, and Agitation). Moreover, the semantic map underlines how the improvement in communication/relationship is directly linked to "responder" variable. "Responder" variable is also connected to "age," "Mini Mental State Examination," and sex ("female"). CONCLUSIONS The study confirms the appropriateness of active music therapy in the reduction of behavioral disturbances and also highlights how unsupervised artificial neural networks models can support clinical practice in defining predictive factors and exploring the correlation between characteristics of therapeutic-rehabilitative interventions and related outcomes.
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Affiliation(s)
- Alfredo Raglio
- Music Therapy Research Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri, 27100, Pavia, Italy.
| | - Daniele Bellandi
- Geriatric Department, Fondazione Istituto Ospedaliero di Sospiro, Sospiro, CR, Italy
| | - Luca Manzoni
- Department of Mathematics and Geosciences, University of Trieste, Trieste, Italy
| | - Enzo Grossi
- Villa Santa Maria Foundation, Tavernerio, CO, Italy
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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: 1.0] [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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Martínez-Castilla P, Gutiérrez-Blasco IM, Spitz DH, Granot R. The Efficacy of Music for Emotional Wellbeing During the COVID-19 Lockdown in Spain: An Analysis of Personal and Context-Related Variables. Front Psychol 2021; 12:647837. [PMID: 33897554 PMCID: PMC8062927 DOI: 10.3389/fpsyg.2021.647837] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/17/2021] [Indexed: 12/13/2022] Open
Abstract
The strict lockdown experienced in Spain during March-June 2020 as a consequence of the COVID-19 crisis has led to strong negative emotions. Music can contribute to enhancing wellbeing, but the extent of this effect may be modulated by both personal and context-related variables. This study aimed to analyze the impact of the two types of variables on the perceived efficacy of musical behaviors to fulfill adults' emotional wellbeing-related goals during the lockdown established in Spain. Personal variables included age, gender, musical training, personality, resilience, and perception of music's importance. Contextual variables referred to living in a region with a high COVID-19 impact, perception of belonging to a risk group, being alone, having caring responsibilities during confinement, and amount of time of music listening as compared to prior to the crisis. The study was conducted retrospectively during August-December 2020, when the strict lockdown was over in Spain. An online survey was disseminated among the general population and groups of musicians, and the answers of 507 adults (from 18 years on, 73.9% females, 51.3% musically trained adults) were analyzed. Only personal, but not COVID-19 context-related variables, showed an impact on music's efficacy. The youngest age group of adults and those with musical training reported the highest efficacy of music for wellbeing enhancement, and music's importance was found to be the main significant predictor of music's perceived efficacy. Our findings suggest that the people who have been reported to be emotionally more vulnerable during the lockdown, due to either a strong impact on their daily lives or their lower resilience, perceive a higher benefit from musical behaviors. Being musically trained, even for a small number of years, also leads to a perception of higher efficacy of music for the achievement of emotional wellbeing goals. However, this effect is explained by the musically trained individuals' higher perception of music's importance. Although musical behaviors can be generally considered as important for wellbeing enhancement, our study highlights who are the potential individuals who could benefit the most from music-related activities for obtaining better levels of wellbeing, at least within the current context of the COVID-19 crisis.
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Affiliation(s)
- Pastora Martínez-Castilla
- Department of Developmental and Educational Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | | | - Daniel H. Spitz
- Department of Psychology and The Jerusalem School of Business Administration, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Roni Granot
- Department of Musicology, The Hebrew University of Jerusalem, Jerusalem, Israel
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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: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [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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Isaac V, Kuot A, Hamiduzzaman M, Strivens E, Greenhill J. The outcomes of a person-centered, non-pharmacological intervention in reducing agitation in residents with dementia in Australian rural nursing homes. BMC Geriatr 2021; 21:193. [PMID: 33743597 PMCID: PMC7980426 DOI: 10.1186/s12877-021-02151-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 03/11/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND There is limited best- practice evidence to address behavioral and psychiatric symptoms for those with dementia in Australian rural nursing homes. This study aims to evaluate the outcomes of a person-centered, non-pharmacological dementia care model, 'Harmony in the Bush', based on the Progressively Lowered Stress Threshold principles and person-centered music in rural Australia. METHODS A quasi-experimental (nonrandomized, pre-post) intervention study was conducted in five rural nursing homes in Queensland and South Australia. Seventy-four residents with dementia participated in this intervention study, which yielded a sample power of 80%. Eighty-seven staff completed the Caregiver Stress Inventory at pre-post four-weeks of intervention. Staff training workshops focused on the theory of the Progressively Lowered Stress Threshold principles and delivery of person-centered care plan with integrated music intervention. We used reported changes in agitation of the residents, measured using Cohen- Mansfield Agitation Inventory, and staff's caregiving stress, using Caregivers Stress Inventory. This study adheres to the CONSORT guidelines. RESULTS Mean age of residents with dementia was 82.4 (7.7) years and 69% were females. The mean age of admission was 80.1(8.4) years. Baseline measures indicated that 32.7% had mild- severe pain and 30.5% reported mild-severe sadness. The results showed statistically significant decline in aggressive behaviors, physically non-aggressive behaviors, verbally agitated behavior and hiding and hoarding. There was similar reduction in staff stress in the domains of aggressive behaviors, inappropriate behaviors, resident safety, and resource deficiency. CONCLUSIONS The Harmony in the Bush model is effective in reducing agitation among dementia residents with significant reduction in staff stress levels in nursing homes in rural Australia. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry (ANZCTR) on 20/2/2018 (Registration No: ACTRN12618000263291p). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374458.
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Affiliation(s)
- Vivian Isaac
- Rural and Remote Health South Australia, College of Medicine and Public Health, Flinders University, Po Box 852, Ral Ral Avenue, Renmark, SA, 5341, Australia.
| | - Abraham Kuot
- Rural and Remote Health South Australia, College of Medicine and Public Health, Flinders University, Po Box 852, Ral Ral Avenue, Renmark, SA, 5341, Australia
| | - Mohammad Hamiduzzaman
- Rural and Remote Health South Australia, College of Medicine and Public Health, Flinders University, Po Box 852, Ral Ral Avenue, Renmark, SA, 5341, Australia
| | - Edward Strivens
- James Cook University & Clinical Director, Older Persons Health Services, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, 4870, Australia
| | - Jennene Greenhill
- Rural and Remote Health South Australia, College of Medicine and Public Health, Flinders University, Po Box 852, Ral Ral Avenue, Renmark, SA, 5341, Australia
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Kuot A, Barton E, Tiri G, McKinlay T, Greenhill J, Isaac V. Personalised music for residents with dementia in an Australian rural aged-care setting. Aust J Rural Health 2021; 29:71-77. [PMID: 33591614 DOI: 10.1111/ajr.12691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/22/2020] [Accepted: 11/04/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Personalised music reportedly has a positive effect on behaviour and mood in people living with dementia. This intervention has not been conducted in low-resourced or rural aged-care settings. We evaluated the effect of a non-therapist-led personalised music listening intervention on residents with dementia and workplace culture in a rural aged-care facility in South Australia. DESIGN Qualitative pilot study. SETTING Rural aged-care home in South Australia. PARTICIPANTS Ten residents with dementia and 15 aged-care staff participated in this study. INTERVENTIONS Ten residents participated in an 8-week music program. Four focus groups were conducted with aged-care staff post-intervention. A thematic analysis was used to identify emerging themes. MAIN OUTCOME MEASURE Personalised music positively influenced resident's behaviour and well-being, social interaction and the workplace environment and culture, and served as a useful tool for personalised care. RESULTS Three themes emerged: quality of life, personalised care and better aged-care environment. Personalised music positively influenced resident's behaviour and well-being, social interaction and the workplace environment and culture, and served as a useful tool for personalised care. CONCLUSION Personalised music program is an effective, low-cost intervention to improve quality of life and personalised care of residents living with dementia, staff well-being, and a workplace and culture in low-resourced or rural aged-care settings.
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Affiliation(s)
- Abraham Kuot
- Flinders University Rural Health South Australia, Flinders University, Renmark, SA, Australia
| | - Elsa Barton
- Flinders University Rural Health South Australia, Flinders University, Renmark, SA, Australia
| | - Grace Tiri
- Flinders University Rural Health South Australia, Flinders University, Renmark, SA, Australia
| | | | - Jennene Greenhill
- Flinders University Rural Health South Australia, Flinders University, Renmark, SA, Australia
| | - Vivian Isaac
- Flinders University Rural Health South Australia, Flinders University, Renmark, SA, Australia
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Lee KH, Lee JY, Kim B. Person-Centered Care in Persons Living with Dementia: A Systematic Review and Meta-Analysis. THE GERONTOLOGIST 2020; 62:e253-e264. [PMID: 33326573 PMCID: PMC9019632 DOI: 10.1093/geront/gnaa207] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives The concept of person-centered care has been utilized/adapted to various interventions to enhance health-related outcomes and ensure the quality of care delivered to persons living with dementia. A few systematic reviews have been conducted on the use of person-centered interventions in the context of dementia care, but to date, none have analyzed intervention effect by intervention type and target outcome. This study aimed to review person-centered interventions used in the context of dementia care and examine their effectiveness. Research Design and Methods A systematic review and meta-analysis were conducted. We searched through 5 databases for randomized controlled trials that utilized person-centered interventions in persons living with dementia from 1998 to 2019. Study quality was assessed using the National Institute for Health and Clinical Excellence checklist. The outcomes of interest for the meta-analysis were behavioral and psychological symptoms in dementia (BPSD) and cognitive function assessed immediately after the baseline measurement. Results In total, 36 studies were systematically reviewed. Intervention types were reminiscence, music, and cognitive therapies, and multisensory stimulation. Thirty studies were included in the meta-analysis. Results showed a moderate effect size for overall intervention, a small one for music therapy, and a moderate one for reminiscence therapy on BPSD and cognitive function. Discussion and Implications Generally speaking, person-centered interventions showed immediate intervention effects on reducing BPSD and improving cognitive function, although the effect size and significance of each outcome differed by intervention type. Thus, health care providers should consider person-centered interventions as a vital element in dementia care.
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Affiliation(s)
- Kyung Hee Lee
- Yonsei University College of Nursing, Seoul, South Korea.,Mo-Im Kim Nursing Research Institute, Seoul, South Korea
| | - Ji Yeon Lee
- Yonsei University College of Nursing, Seoul, South Korea
| | - Bora Kim
- Yonsei University College of Nursing, Seoul, South Korea
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Reschke-Hernández AE, Belfi AM, Guzmán-Vélez E, Tranel D. Hooked on a Feeling: Influence of Brief Exposure to Familiar Music on Feelings of Emotion in Individuals with Alzheimer’s Disease. J Alzheimers Dis 2020; 78:1019-1031. [DOI: 10.3233/jad-200889] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Research has indicated that individuals with Alzheimer’s-type dementia (AD) can experience prolonged emotions, even when they cannot recall the eliciting event. Less is known about whether music can modify the emotional state of individuals with AD and whether emotions evoked by music linger in the absence of a declarative memory for the eliciting event. Objective: We examined the effects of participant-selected recorded music on self-reported feelings of emotion in individuals with AD, and whether these feelings persisted irrespective of declarative memory for the emotion-inducing stimuli. Methods: Twenty participants with AD and 19 healthy comparisons (HCs) listened to two 4.5-minute blocks of self-selected music that aimed to induce either sadness or happiness. Participants reported their feelings at baseline and three times post-induction and completed recall and recognition tests for the music selections after each induction. Results: Participants with AD had impaired memory for music selections compared to HCs. Both groups reported elevated sadness and negative affect after listening to sad music and increased happiness and positive affect after listening to happy music, relative to baseline. Sad/negative and happy/positive emotions endured up to 20 minutes post-induction. Conclusion: Brief exposure to music can induce strong and lingering emotions in individuals with AD. These findings extend the intriguing phenomenon whereby lasting emotions can be prompted by stimuli that are not remembered declaratively. Our results underscore the utility of familiar music for inducing emotions in individuals with AD and may ultimately inform strategies for using music listening as a therapeutic tool with this population.
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Affiliation(s)
| | - Amy M. Belfi
- Department of Psychological Science, Missouri University of Science and Technology, Rolla, MO, USA
| | - Edmarie Guzmán-Vélez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel Tranel
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
- Department of Neurology, Division of Neuropsychology and Cognitive Neuroscience, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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