The effects of singing interventions on quality of life, mood and levels of agitation in community-dwelling people living with dementia: A quantitative systematic review

Background and Aims: Music-based interventions have been found to benefit people living with dementia and have positive impacts on cognition and well-being. Most people with dementia live in the community and compared to people with dementia in residential care often have less access to music-based interventions. There are many forms of music interventions and singing has shown particular promise; in the realm of music interventions. It is important to determine what aspects of music interventions yield the most benefits for people with dementia. This review aimed to synthesise evidence on the impacts of singing interventions on quality of life, mood and neuropsychiatric symptoms for community-dwelling people with dementia. Methods: We systematically searched three electronic databases (PsycINFO, MEDLINE and Web of Science) for studies reporting on singing interventions with community-dwelling people with dementia. Studies were eligible for inclusion if they reported on a singing intervention with people living with dementia that included an outcome measure of quality of life, mood or agitation. Fourteen publications were identified and included in this review, with a total of n = 361 people with dementia. Results: Despite some inconsistencies across the literature, evidence suggests that singing interventions led to an improvement in mood and a reduction in agitation levels in people living with dementia. There was no strong evidence to suggest that singing interventions led to significant improvements in quality of life. Conclusions: This review highlights the potential of singing interventions as an effective psychosocial intervention for community-dwelling people with dementia. For key developments in this area, we urge that future studies include a control group where possible which will allow for more robust examinations of singing interventions and allow intervention effects to be distinguished from general deterioration in dementia symptoms over time.

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.

[Stimulation-Oriented Interventions for Behavioral Problems among People with Dementia: A Systematic Review and Meta-Analysis]

PURPOSE

This study was a systematic review and meta-analysis designed to investigate the effects of stimulation-oriented interventions for behavioral problems among people with dementia.

METHODS

Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a literature search was conducted using seven electronic databases, gray literature, and other sources. Methodological quality was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) for randomized controlled trials (RCTs). Data were analyzed using R with the 'meta' package and the Comprehensive Meta-Analysis (CMA 2.0) program.

RESULTS

Sixteen studies were included for meta-analysis to investigate the effect of stimulation-oriented interventions. The quality of individual studies was rated as '++' for eight studies and '+' for the rest. The effect sizes were analyzed according to three subgroups of interventions (light, music, and others); Hedges' g=0.04 (95% CI: -0.38~0.46), -0.23 (95% CI: -0.56~0.10), -0.34 (95% CI: -0.34~0.00), respectively. To explore the possible causes of heterogeneity (I²=62.8%), meta-regression was conducted with covariates of sample size, number of sessions, and length of session (time). No moderating effects were found for sample size or number of sessions, but session time showed a significant effect (Z=1.96, 95% CI: 0.00~0.01). Finally, a funnel plot along with Egger's regression test was performed to check for publication bias, but no significant bias was detected.

CONCLUSION

Based on these findings, stimulation-oriented interventions seem to have a small effect for behavioral problems among people with dementia. Further research is needed to identify optimum time of the interventions for behavioral problems among dementia pateints.