Effect of music therapy on patients with rheumatic diseases

BACKGROUND

Music therapy seems to have a multitude of positive effects not only on mental health but also on organic pain. Some studies have showed its effectiveness on reducing pain for patients undergoing surgical procedures. However, data on its efficiency on patients' anxiety during rheumatology medical consultation for patients with chronic rheumatic diseases is lacking.

OBJECTIVES

The purpose of the present study was to describe the impact of music therapy on the mood of patients followed for chronic rheumatic diseases.

METHODS

We conducted a cross-sectional study including patients followed for chronic rheumatic diseases seen in the outpatient rheumatology department during a period of three weeks. Patients selected were randomly assigned into two groups. Patients seen while listening to music "The Mozart Sonata" formed theG1 (n = 40). Patients seen without listening to music formed the group G2 (n = 30). Participants' anxiety levels were assessedbefore and immediately after medical consultations by collecting vital signs (heart rate and respiratory rate) and by the Spielberger State Trait Anxiety inventory questionnaire (STAI).

RESULTS

The mean age of 70 patients included was 54.36 ± 14.62 years. Females outnumbered males (62.9 %).The STAI scores were 38.44 (range, 25-60) and 34.51 (range, 22-52)respectively pre- and post-consultation. The medical consultation lasted for a mean of 24 ± 1.1 min in G1 and 20.63 ± 1.3 in G2. Sharp after the consultation, the mean Heart Ratewas significantly lower in the group with music therapy (64±1.5 in G1 versus 66.3 ± 1.3 in G2, p = 0.02) and the mean STAI decreased also significantly in tne G1 (34.72±1 in G1 versus 40.7 ± 5.2 in G2, p = 0.018). However, the decline of the mean Respiratory Ratewas not significant between both groups(16.1 ± 1 in G1 versus 16.96 ± 1.7 in G2, p = 0.42).

CONCLUSION

Our study showed a significant lowering in anxiety level and heart rate in patients consulted while listening to music.This costless and available tool should be more used in our daily practice specially when treating patients with chronic painful diseases.

Utilising Emotion Monitoring for Developing Music Interventions for People with Dementia: A State-of-the-Art Review

The demand for smart solutions to support people with dementia (PwD) is increasing. These solutions are expected to assist PwD with their emotional, physical, and social well-being. At the moment, state-of-the-art works allow for the monitoring of physical well-being; however, not much attention is delineated for monitoring the emotional and social well-being of PwD. Research on emotion monitoring can be combined with research on the effects of music on PwD given its promising effects. More specifically, knowledge of the emotional state allows for music intervention to alleviate negative emotions by eliciting positive emotions in PwD. In this direction, the paper conducts a state-of-the-art review on two aspects: (i) the effect of music on PwD and (ii) both wearable and non-wearable sensing systems for emotional state monitoring. After outlining the application of musical interventions for PwD, including emotion monitoring sensors and algorithms, multiple challenges are identified. The main findings include a need for rigorous research approaches for the development of adaptable solutions that can tackle dynamic changes caused by the diminishing cognitive abilities of PwD with a focus on privacy and adoption aspects. By addressing these requirements, advancements can be made in harnessing music and emotion monitoring for PwD, thereby facilitating the creation of more resilient and scalable solutions to aid caregivers and PwD.

A participatory arts programme – Shared experience for family caregivers and care recipients

AIM

This study aimed to describe family caregivers of older people's experiences of participatory art interventions, including music, dance and visual arts.

DESIGN

A descriptive qualitative study.

METHODS

Thematic interviews were conducted with 12 family caregivers. Qualitative data were analysed with thematic analysis.

RESULTS

The results illustrated the meaning of art groups, which included a shared feeling of togetherness, empowering and activating peer support and a sense of communality. Art groups also represented a hobby, enhancing caregivers' social and mental well-being. The art groups could be described as an art-driven, participatory shared experience. Participatory arts are noteworthy contributors to the well-being of family caregivers and care recipients, especially from peer support and communality. Further research is needed to find out about participants' preferred art-based activities and their impact on their well-being. No patient or public contribution because of inflexibility in the timing of engagement.

Exploring the Clinical Utility of the Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC) with People with End-Stage Dementia

Dementia is a major health concern globally and cross-culturally with progressive decline in cognition, mobility and communication. There are few interventions for end-stage dementia (ESD) although music interventions have been observed to be accessible for people with mid to late-stage dementia. The lack of protocols and measures suited to ESD has limited research into the effects of music therapy. Measure sensitivity to minimal responsiveness is one limitation to the use of existing music intervention measures with ESD. This exploratory study examined the clinical utility of the Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC) for use with people with end-stage dementia, including preliminary reliability and validity. The MATADOC is a standardized assessment for minimally responsive patients with disorders of consciousness and may be useful for ESD. Using repeated measures with blinded MATADOC-trained raters, MATADOC data were collected with a small convenience sample of people with ESD in a residential care setting. Clinical utility data were collected from the raters and evaluated using a multidimensional model. To explore its functionality, MATADOC outcomes were compared to another measure for music interventions in dementia. The MATADOC may be useful for assessing functioning and responsiveness to music interventions for people with ESD without the risk of floor effects. Modifying the MATADOC protocol and assessment documentation prior to testing with a larger sample will enhance its sensitivity specific to ESD and age-related needs, providing a new music-based ESD assessment.

Tailored music listening intervention to reduce sleep disturbances in older adults with dementia: Research protocol

Sleep disruption in older adults living with Alzheimer's disease and related dementias (ADRD) is debilitating and contributes to increased institutionalization, reduced cognitive function, and accelerated disease progression. Furthermore, sleep disruption is linked to poor health outcomes in caregivers, such as decreased quality of life and increased caregiver burden. Given the potentially harmful side effects of pharmacologic treatment, nonpharmacologic approaches, such as music, may provide a safer alternative to reducing sleep disruption in this vulnerable population. A growing body of literature suggests that calming tailored music may improve sleep quality in older adults with memory loss, but its efficacy has not been demonstrated in older adults with ADRD in the community, where most older adults with ADRD live. If shown to be feasible and acceptable, tailored music interventions can then be tested for efficacy in reducing sleep disruption. This protocol details a wait-list randomized controlled trial (NCT04157244), the purpose of which is to test the feasibility, acceptability, and examine the preliminary efficacy of a tailored music listening intervention in older adults with ADRD who report sleep disruption. Music selections will be tailored to the music genre preferences of older adults with ADRD and account for known sleep-inducing properties. The feasibility of processes that is key to the success of the subsequent study will be examined. Preliminary efficacy of the intervention will be assessed using objective (actigraphy) and subjective (proxy-reported) sleep quality measures. In addition, qualitative data will be solicited, examining the acceptability and satisfaction with the intervention by individuals with ADRD.

Unmittelbare Reaktionen von Menschen mit Demenz auf individualisierte Musik - Analyse von Verhaltensbeobachtungen im Pflegeheim

Immediate reactions of people with dementia to individualized music - Analysis of behavioral observations in a nursing home Abstract. Background: Due to the increasing prevalence of dementia, there is an urgent need for effective non-pharmacological interventions to improve the quality of life of people with dementia (PwD) and to relieve their carers. Studies show evidence for the benefits of individualized music. However, the immediate reactions to individualized music have not yet been adequately investigated.

AIM

The research objective of the study was the investigation of the immediate effects of an individualized music intervention in a nursing home using a newly developed systematic behavioral observation rating scale.

METHODS

In 153 behavioral observations of 20 PwD, 32 different experiences and behaviors pertaining to 11 categories such as emotional and motor changes which indicate immediate reactions to listening to music were rated.

RESULTS

Participants showed significantly more positive reactions (e. g. joy or relaxation) and less negative reactions immediately after listening to the music compared to before. Moreover, in the course of listening to music, participants showed significantly more positive reactions, most often smiles, movements to music, attentive listening, relaxation and general vigilance / interest / social contact.

CONCLUSIONS

The systematic behavioral observation rating scale proved to be a suitable method for rating the experiences and behaviors of people with dementia. Listening to individualized music seems to be a helpful intervention for PwD in institutional care settings.

Art intervention among Finnish older people and their caregivers: Experiences of art pedagogies

The benefits of art therapies on older people's health have been well documented. However, studies into the perspectives of pedagogues on conducting arts interventions are scarce and no empirical evidence of the views of professional pedagogues views have been published to date. In this study, seven professional art pedagogues were interviewed using a thematic interview approach focusing on the pedagogues' experiences of conducting arts interventions with a family caregiver and care recipient dyads. The interviews were analysed inductively using thematic content analysis. According to the analysis, three intersecting themes were found that both steered the pedagogical process and emerged from the process: holistic pedagogy, professional development and witnessing. The themes revealed a further understanding of approaches to the interviewees' teaching and the value of participatory community arts in practice. The pedagogues' experiences encourage art pedagogy to be acknowledged in a wider context within communities and healthcare environments. Further studies on interdisciplinary projects in collaboration with art pedagogues and healthcare professionals are encouraged.

Dementia: When music is the only way in – An emergency intervention: Innovative Practice

Music cannot only provide comfort and reduce agitation associated with dementia, but can also generate connections between all who are present. This article describes an ‘emergency’ music intervention conducted by the author during doctoral fieldwork, which illustrates how music was used as a medium for connection and comfort with a highly agitated person with advanced dementia. This experience provides strong support for increasing the training of musicians towards providing music for people living with dementia – particularly when other nonpharmaceutical methods are not proving effective.

Study protocol: individualized music for people with dementia - improvement of quality of life and social participation for people with dementia in institutional care

BACKGROUND

People with dementia (PwD) experience a range of negative behavioral and psychological symptoms which can lower their quality of life. Because of the increasing prevalence of dementia, interventions that maintain and enhance the quality of life for PwD are needed. Listening to individualized music constitutes a promising non-pharmacological intervention for PwD. However, despite some preliminary results, evidence regarding the effectiveness of such interventions has been mixed and previous studies have shown a number of methodological limitations. In a randomized controlled trial, we address the limitations of previous research and assess the feasibility, efficacy, and acceptability of an individualized music intervention for PwD living in a nursing home.

METHODS

Residents with dementia from four to five nursing homes in Germany will be randomly assigned to either an intervention or control group. The intervention group will listen to personally-relevant music for 20 min every other day for six weeks. Nursing staff will assess participants' quality of life and problem behavior at the six-week baseline, pretest, posttest, and at the six-week follow-up. Additionally, the participants' behavior will be observed during the intervention period by project staff. The implementation, acceptance, and applicability of the intervention will also be evaluated.

DISCUSSION

The study results will show whether an individualized music intervention can improve the quality of life for PwD living in a nursing home. Additionally, it will provide valuable insight into the acceptability and implementation of an individualized music intervention in the institutional care setting. If the individualized music intervention proves to be effective and widely applicable, it could be implemented on a large scale in institutional care as an easy-to-administer intervention.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00013793 ; ISRCTN registry, ISRCTN59052178 , date applied 27 February 2018, date assigned 4 April 2018, retrospectively registered.

Results from a person-centered music intervention for individuals living with dementia

AIM

Dementia is a chronic, costly disease affecting millions of people worldwide. Effective, affordable person-centered interventions are required to improve the lived experiences of individuals with dementia and their caregivers in various care settings. The present study examined the effects of a person-centered music listening intervention on mood, agitation and social engagement for individuals living with dementia.

METHODS

This quasi-experimental study was carried out with participants at five community-based adult day health centers (n = 51). Standardized instruments were used to measure mood and agitation, and in-person and video-recorded observations of participant behavior were used to analyze changes before, during and after the intervention across four domains: mood, agitation, connecting to music and engaging socially. Within-person differences were examined using the Wilcoxon signed rank test, and between-group differences were examined using the Mann-Whitney U-test.

RESULTS

Although standardized instruments did not yield statistically significant results, the behavioral observations showed a positive change in mood and a decrease in agitation. From pre- to post-intervention, there were statistically significant increases in joy, eye contact, eye movement, being engaged and talkativeness, and a decrease in sleeping and moving or dancing.

CONCLUSIONS

Behavioral observations show the positive impact a person-centered music listening intervention might have on individuals living with dementia and attending adult day health centers. This affordable intervention provides a useful tool for caregivers that might improve the day-to-day experience of individuals living with dementia. Geriatr Gerontol Int 2019; 19: 30-34.

The effect of music therapy on cognitive functions in patients with dementia: a systematic review and meta-analysis

OBJECTIVES

The aim of the present study was to meta-analyze the effect of music therapy (MT) on cognitive functions in patients with dementia.

METHOD

A systematic literature search was performed in Medline, PsycINFO, Embase, CINAHL and RILM up to 8 September 2016. We included all randomized controlled trials that compared MT with standard care, or other non-musical types of intervention, evaluating cognitive outcomes in patients with dementia. Outcomes included global cognition, complex attention, executive function, learning and memory, language, and perceptual-motor skills.

RESULTS

From 1089 potentially relevant records, 110 studies were assessed for eligibility, and 7 met the inclusion criteria, of which 6 contained appropriate data for meta-analysis (330 participants, mean age range 78.8-86.3). Overall, random-effects meta-analyses suggested no significant effects of MT on all outcomes. Subgroup analysis found evidence of a beneficial effect of active MT on global cognition (SMD = 0.29, 95% CI 0.02 to 0.57, p = 0.04).

CONCLUSION

Despite the limited evidence of the present review, it is important to continue supporting MT as a complementary treatment for older adults with dementia. RCTs with larger sample sizes are needed to better elucidate the impact of MT on cognitive functions.

The Unforgettables: a chorus for people with dementia with their family members and friends

Our experience evaluating a museum program for people with dementia together with their family members demonstrated benefits for all participants. We hypothesized that participation in a chorus would also have positive effects, giving them an opportunity to share a stimulating and social activity that could improve their quality of life. We inaugurated a chorus for people with dementia and their family caregivers in 2011, which rehearses and performs regularly. Each person with dementia must be accompanied by a friend or family member and must commit to attending all rehearsals and the concert that ensues. A pilot study included a structured assessment, take home questionnaires and focus groups. Analyses of pre-post scores were conducted; effect size was quantified using Cohen's d. Results showed that quality of life and communication with the other member of the dyad improved (Effect size: Cohen's d between 0.32 and 0.72) for people with dementia; quality of life, social support, communication and self-esteem improved (d between 0.29 and 0.68) for caregivers. Most participants stated that benefits included belonging to a group, having a normal activity together and learning new skills. Participants attended rehearsals in spite of harsh weather conditions. The chorus has been rehearsing and performing together for more than 6 years and contributing to its costs. Results of this pilot study suggest that people in the early to middle stage of dementia and their family members and friends can enjoy and learn from rehearsing and performing in concerts that also engage the wider community. It is essential to conduct additional larger studies of the benefits of participating in a chorus, which may include improved quality of life and social support for all, and reduced cognitive decline among people with dementia.

The Use of Music Playlists for People with Dementia: A Critical Synthesis

The use of pre-recorded music to ease behavioral and psychological symptoms associated with dementia is popular in health-care contexts in both formal music therapy settings and in non-therapist led interventions. However, further understanding of how non-therapist led interventions compare to therapist led interventions is needed. This paper reviews 28 studies that used pre-recorded music with people with dementia using a critical interpretive synthesis model. Results revealed that pre-recorded music can be effective in reducing a variety of affective and behavioral symptoms, in particular agitation, even where a trained music therapist is not present. However, the results are not universally positive, suggesting the need for further clarification of protocols for music use and closer investigation of variables that influence individual responseto music.

Combining drug and music therapy in patients with moderate Alzheimer's disease: a randomized study

Alzheimer's disease (AD) can impair language, but active music therapy (AMT) and memantine (M) can improve communication. This study aimed to clarify whether adding AMT to M may improve language in comparison with drugs alone in patients with moderate AD on stable therapy with acetylcholinesterase inhibitors (AchEI). Forty-five AD patients treated with stable dose of AchEI were randomized to receive AMT plus M 20 mg/day or M 20 mg/day for 24 weeks. The Severe Impairment Battery-Language (SIB-l), SIB, Mini Mental State Examination, Neuropsychiatric Inventory (NPI), Lubben Social Network Scale, Activities of Daily Living, and Instrumental Activities of Daily Living scores at baseline and 12 and 24 weeks assessed language (primary variable) and overall cognitive, psycho-behavior, social, and functional aspects (secondary variables). The SIB-l showed a stabilization of the baseline condition in both groups, in the absence of between-group differences. The NPI depression and appetite scores significantly improved in the M-AMT group. Moreover, significantly less patients in the M-AMT group than those in the M group showed worsening of the NPI total score. Daily activities, social relationships, and overall cognitive performance did not deteriorate. In patients with moderate AD, AMT added to pharmacotherapy has no further benefits for language in comparison with pharmacotherapy alone. However, this integrated treatment can improve the psycho-behavioral profile.

Musical neurofeedback for treating depression in elderly people

We introduce a new neurofeedback approach, which allows users to manipulate expressive parameters in music performances using their emotional state, and we present the results of a pilot clinical experiment applying the approach to alleviate depression in elderly people. Ten adults (9 female and 1 male, mean = 84, SD = 5.8) with normal hearing participated in the neurofeedback study consisting of 10 sessions (2 sessions per week) of 15 min each. EEG data was acquired using the Emotiv EPOC EEG device. In all sessions, subjects were asked to sit in a comfortable chair facing two loudspeakers, to close their eyes, and to avoid moving during the experiment. Participants listened to music pieces preselected according to their music preferences, and were encouraged to increase the loudness and tempo of the pieces, based on their arousal and valence levels. The neurofeedback system was tuned so that increased arousal, computed as beta to alpha activity ratio in the frontal cortex corresponded to increased loudness, and increased valence, computed as relative frontal alpha activity in the right lobe compared to the left lobe, corresponded to increased tempo. Pre and post evaluation of six participants was performed using the BDI depression test, showing an average improvement of 17.2% (1.3) in their BDI scores at the end of the study. In addition, an analysis of the collected EEG data of the participants showed a significant decrease of relative alpha activity in their left frontal lobe (p = 0.00008), which may be interpreted as an improvement of their depression condition.

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

OBJECTIVES

Agitation in nursing home residents with dementia leads to increase in psychotropic medication, decrease in quality of life, and to patient distress and caregiver burden. Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been methodologically insufficient. The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes, and to explore its effect on psychotropic medication and quality of life.

METHOD

In a crossover trial, 42 participants with dementia were randomized to a sequence of six weeks of individual music therapy and six weeks of standard care. Outcome measures included agitation, quality of life and medication.

RESULTS

Agitation disruptiveness increased during standard care and decreased during music therapy. The difference at -6.77 (95% CI (confidence interval): -12.71, -0.83) was significant (p = 0.027), with a medium effect size (0.50). The prescription of psychotropic medication increased significantly more often during standard care than during music therapy (p = 0.02).

CONCLUSION

This study shows that six weeks of music therapy reduces agitation disruptiveness and prevents medication increases in people with dementia. The positive trends in relation to agitation frequency and quality of life call for further research with a larger sample.