Alfredo Raglio1,2, Daniele Bellandi3, Paola Baiardi4, Marta Gianotti3, Maria Chiara Ubezio3, Elisa Zanacchi3, Enrico Granieri2, Marcello Imbriani1,5, Marco Stramba-Badiale6. 1. Department of Public Health and Experimental and Forensic Medicine, University of Pavia, Pavia, Italy. 2. Neurology Clinic, Department of Biomedical and Surgical Sciences, University of Ferrara, Ferrara, Italy. 3. Sospiro Foundation, Cremona, Italy. 4. Scientific Direction, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico, Pavia, Italy. 5. Department of Occupational Medicine, Ergonomics and Disability, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico, Pavia, Italy. 6. Department of Geriatrics and Cardiovascular Medicine, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
Abstract
OBJECTIVES: To assess the effects of active music therapy (MT) and individualized listening to music (LtM) on behavioral and psychological symptoms of dementia (BPSDs) in persons with dementia (PWDs). DESIGN: Randomized controlled trial. SETTING: Nine Italian institutions. PARTICIPANTS: Persons with moderate to severe dementia and BPSDs (N = 120) were randomized to one of three treatments. INTERVENTIONS: All groups received standard care (SC), and two groups attended 20 individualized MT or LtM sessions, twice a week, in addition to SC. MEASUREMENTS: The Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Cornell-Brown Scale for Quality of Life in Dementia (CBS-QoL) were administered before treatment, after treatment, and at follow-up to evaluate behavioral and psychological outcomes. A specific coding scheme (Music Therapy Check List-Dementia) was used to evaluate the MT process. RESULTS:Behavioral assessment did not show significant differences between groups. All groups showed a reduction over time in NPI global score (P ≤ .001), CSDD (P = .001), and CBS-QoL (P = .01). The NPI global score fell 28% in the MT group, 12% in the LtM group, and 21% in the SC group at the end of treatment. An exploratory post hoc analysis showed similar within-group improvements for the NPI Delusion, Anxiety, and Disinhibition subscales. In the MT group, communication and relationships between the music therapists and PWDs showed a positive albeit nonsignificant trend during treatment. CONCLUSION: The addition of MT or LtM to standard care did not have a significant effect on BPSDs in PWDs. Further studies on the effects of the integration of standard care with different types of music interventions on BPSD in PWD are warranted.
RCT Entities:
OBJECTIVES: To assess the effects of active music therapy (MT) and individualized listening to music (LtM) on behavioral and psychological symptoms of dementia (BPSDs) in persons with dementia (PWDs). DESIGN: Randomized controlled trial. SETTING: Nine Italian institutions. PARTICIPANTS: Persons with moderate to severe dementia and BPSDs (N = 120) were randomized to one of three treatments. INTERVENTIONS: All groups received standard care (SC), and two groups attended 20 individualized MT or LtM sessions, twice a week, in addition to SC. MEASUREMENTS: The Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Cornell-Brown Scale for Quality of Life in Dementia (CBS-QoL) were administered before treatment, after treatment, and at follow-up to evaluate behavioral and psychological outcomes. A specific coding scheme (Music Therapy Check List-Dementia) was used to evaluate the MT process. RESULTS: Behavioral assessment did not show significant differences between groups. All groups showed a reduction over time in NPI global score (P ≤ .001), CSDD (P = .001), and CBS-QoL (P = .01). The NPI global score fell 28% in the MT group, 12% in the LtM group, and 21% in the SC group at the end of treatment. An exploratory post hoc analysis showed similar within-group improvements for the NPI Delusion, Anxiety, and Disinhibition subscales. In the MT group, communication and relationships between the music therapists and PWDs showed a positive albeit nonsignificant trend during treatment. CONCLUSION: The addition of MT or LtM to standard care did not have a significant effect on BPSDs in PWDs. Further studies on the effects of the integration of standard care with different types of music interventions on BPSD in PWD are warranted.
Authors: Sonja Aalbers; Laura Fusar-Poli; Ruth E Freeman; Marinus Spreen; Johannes Cf Ket; Annemiek C Vink; Anna Maratos; Mike Crawford; Xi-Jing Chen; Christian Gold Journal: Cochrane Database Syst Rev Date: 2017-11-16
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