Author (s), year & Country

Methodology

Research Findings

Rank

Garland K, Beer E, Eppingstall B, O’Connor DW

(2007)

Australia

[27]

30 nursing home residents had behavioral issues related to dementia. This was a randomized single blind exposure of 15 min audiotapes from a stimulated family member, music, and a placebo reading condition from horticultural text. Multiple behaviors were counted and absent at regular intervals. All 3 treatments were compared to usual care. 

Stimulated music and preferred music were effective in reducing agitated behavior. The response varied widely.

The simplest technology can improve lives of patients and their caregivers

II

Cohen-Mansfield J, Marx M, Dakheel-Ali M, Thein K.

(2015)

USA

[28]

There were 89 nursing home residents from 6 nursing home in Maryland. The mean age was 85.9 years. Research Assistants had tailored interventions according to the participants needs. The effects of the intervention were noted immediately by the research assistant.  

Each participant was observed for 3 days every half hour between 8 am to 9 pm. Each observation was 3 minutes.

The intervention with the highest impact on behavior was music, folding towels, hand massage, care and videos.

IV

Gerdner LA

(2000)

USA

[29]

There were 39 participants from 6 long term care facilities in Lowa. The sample consisted of 30 women and 9 men. The mean age was 82 years. Baseline data was collected in 3 weeks. A modified Hartsock music preference questionnaire guided the section of personal music.

Group A consisted of 16 participants who received an individualized music intervention for 6 weeks, following a 2-week washout period and 6 weeks of classical relaxation music. Group B consisted of 23 participants in the same protocol, but the order was reversed.

The intervention was for 30 mins, 2 times per week

The Bonferroni post hoc showed a significant reduction in agitation during individualized music, in comparison to classical.

IV

Park H, Specht P 

(2009)

USA

[30]

This study investigated the effects of music on patients with dementia at home. 15 individuals listened to their preferred music for 30 mins prior to when patients feel agitated 2 times per week for 2 weeks with no music intervention for the next 2 weeks. This was repeated once.

The mean agitation level was significantly reduced while patients were listening to music than before listening to music.

IV

McDermott O, Orrell M, Ridder MH

(2013)

London

[31]

There was a focus group and an interview was conducted with home care residents, hospital patients with dementia, home care staff, and music therapist.

6 key themes were identified and applied in these 4 areas. The findings of the analysis were investigated to develop a theoretical model on music. The aim of the focus group/interview was to engage the participants in a musical experience. The questions that were asked was “What does music mean to you? What do you think of your music therapy/music activities? If music is important to you, in what way? (People with dementia).”

“What changes and responses do you observe in your family members/clients following music therapy or music activities? How do you know when music is meaningful to the person? (Families, staff and music therapists)”.

The psychosocial model was developed.

Theme 1: The accessibility of music. All participants seemed interested in music by feet tapping, clapping or singing along. People with dementia had immediately responded to it. The residents and hospital patients explained singing and listening to music was emotionally meaningful.

Theme 2: Retained memory of song lyrics connected to personal history. Music brings back memories, it is a personal and cultural identity

Theme 3: Connected, a new experience of music making. Participants took interest in learning how to play music

Theme 4: Effects of music on mood. Music helped to improve mood and decrease agitation levels. Everyone had a brighter mood.

Theme 5: Effects of music on home care environment. Music had an effect on visiting family members.

Theme 6: Evaluation and communication of music therapy

The effects of music are beyond the reduction of behavioral and psychological symptoms. Music was seen to maintain and improve the quality of life. It was also evident that music was preserved in the minds of dementia patients. 

V

Poli LF, Bieleninik L, Brondino N, Chen X, Gold C

(2017)

London 

[32]

A systematic review was conducted, and a search was performed in Medline, PsycINFO, Embase, CINAHL and RILM. All RCTs that had a comparison between music therapy, standard care and non-musical interventions were included. The purpose was to evaluate cognitive outcomes. 

There were 1089 records, 110 were assessed for eligibility and 7 met the inclusion criteria. Music therapy patients were involved in the production of music. Music enhanced the frontal cortex part of the brain. It is related to improvement in memory. 

I

Guétin S, Portet F, Picot MC, Pommié C, Messaoudi M, Djabelkir L, Touchon J

(2009)

[33]

This was a single centered randomized control trial which was comparative in nature. It was a blinded assessment. The follow up time period was 24 weeks. The treatment group had 15 participants who had a weekly session of receptive music therapy. The musical style was chosen by patients.

The control group which also consisted of 15 participants were in the same reading sessions. The principle endpoint was measured at 1,4,8,16 and 24 weeks. Anxiety was measured and depression was analyzed as the secondary end point.

There was significant improvement in anxiety and depression from the music therapy group from week 4 until 16. The effect was sustained for 8 weeks after the session had ended between week 16 and 24.

These results state that music is an effective therapy on depression and anxiety patients.

II

Van de Winckel, A, Fey H, De Weerdt W, Dom R

(2004)

Belgium

[34]

This is a randomized control trial which took place in a Belgium hospital. There were 25 patients with dementia. 15 patients had attended an exercise training for 3 months supported by music for 30 mins per session. The participants were compared with 10 control patients who received equal attention by a daily conversation.

Cognition was measured using Mini Mental Sate Examination and behavior was evaluated through Stockton Geriatric Rating Scale.

The exercise group with the music had shown improvement in cognition. Music based exercise program was effective for patients with moderate to severe dementia.

IV

Ying Y, Yanzhen W, Yulei S, Yamei B

(2019)

China

[35]

A randomized control trial was conducted on the effects of music therapy on dementia patients. The English and Chinese databases were searched, and a Meta-Analysis was performed with a RevMan 5.3.

13 articles were included with 580 patients. The meta-analysis had indicated a significant improvement in anxiety and depressive symptoms in the intervention group than the control group after the intervention.

Music therapy improves anxiety and depressive symptoms of patients with dementia.

I

Leva V, Guy M

(2013)

Sweden

[36]

This is a meta-analysis on the effects of music on dementia patients. All original studies found with the key words “music and dementia”. 

There were 19 studies with 478 patients. All patients had indicated a significant positive effect on behavioral, physiological and cognitive outcome. Music intervention are effective and have a potential to increase the quality of life.

I

Watanabe K, Torikawa S, Shiota K, Matsui H, Shigenobu K. & Ikeda M

(2003)

Japan

[37]

The effects of music were investigated on dementia patients with Alzheimer’s and vascular disease. Participants Ss had 6 males and 27 females with Alzheimer’s disease; 7 males and 10 females had vascular disease. The mean age was 79.9. Ss had weekly sessions for music therapy for 2 months. The sessions were evaluated using the Ehime Music Therapy scale.

The results indicated that speech and social activities had increased as participants became familiar with the therapeutic activities and staff members. Singing was easy for the Ss group and comprehension improved by utilizing some musical devices. Music therapy induced physical movements and was more effective than other activities. 

IV

Lyu J, Zhang J, Mu H, Li W, Champ M, Xiong Q, Li M

(2018)

China

[38]

There was a total of 298 patients diagnosed with Alzheimer’s. The participants were divided based on the severity of dementia.

Participants were divided into 3 groups which was a singing group, lyric group and control group. These groups had received an intervention for 3 months. Participants underwent a series of tests related to cognitive functions, daily living activities and neuropsychological symptoms.

Music therapy is more effective for improving psychiatric symptoms and verbal fluency. An analysis shows that music therapy is great for enhancing memory and language. Overall music therapy is a good tool to enhance cognitive function and mental well-being. This is a good first line of treatment for Alzheimer’s and dementia patients.  

II

Tuet R W K, Lam L C W

(2006)

Hong Kong

[7]

There were 14 patients with dementia who had at least one type of agitated behavior. Participants were put into 2 groups. 1 group received music therapy, and the other group did not receive music therapy with usual care for 3 weeks. The groups were crossed over after 3 weeks for the active and control intervention for another 3 weeks. Behavioral disturbances were measured by Cohen-Mansfield Agitation and neuropsychiatric inventory.

There was a reduction in the Cohen-Mansfield Agitation and neuropsychiatric inventory scores. The reduction was not found in usual care. There was no lasting effect in both groups. The results show that music has a positive effect on behavioral disturbances.

IV

Svansdottir H B, Snaedal J

(2006)

Iceland

[39]

This was a case control study carried out by music therapist in 2 nursing homes and psychogeriatric wards. There were 38 patients diagnosed with Alzheimer’s who were assigned to a random music therapy group and control group.

There was a reduction in activity disturbances during the 6 weeks’ time period such as aggressiveness and anxiety. This was rated through the Behavior Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD).

Music therapy was found to be a safe and effective method for treating anxiety and agitation.

IV

Lin Y, Chu H, Yang C, Chen C, Chen S, Chang H, Chou K

(2011)

Taiwan

[40]

This was an experimental design for participants suffering from dementia who reside in nursing facilities.

49 people were in the experimental group and 51 in the control group. The experimental group participated in a music intervention for 12 sessions that were 30 minutes long. This was conducted twice a week for 6 weeks. The control group carried out normal daily activities.

The music intervention experimental group showed an improved performance at the 6^th and 12^th session. 1 month after the therapy, there was a reduction in agitation, non-aggressive verbal and physical behavior. It is essential for nursing facilities to incorporate music interventions in order to reduce agitation and emotionally relax patients with dementia.  

II

Palisson J, Roussel-Baclet C, Maillet D, Belin C, Ankri J, & Narme P 

(2015)

[41]

12 patients had mild Alzheimer’s and 15 healthy controls learned texts which was either musical which is sung, or non-musical association, which is a silent movie sequence, or without association which is spoken alone.

Results showed that music which was sung was more helpful to retain in memory than spoken texts. The musical experience was robust and had a good impact on Alzheimer’s patients. The non-musical experience was helpful but to a lesser extent. A musical association facilitates learning and retention for patients with Alzheimer’s.

IV

Lou M

(2001)

[42]

This paper describes the use of music to decrease agitated behavior. 7 articles were assessed through online databases. The databases searched were CINAHL and Medline. The key words were music therapy, demented elderly and agitated behavior.

Music interventions was seen to decrease agitated behaviors. 4 of the studies used background music, 3 studies used preferred music. Amongst all of these studies, 6 studies had a positive impact on reducing agitated behavior, and 1 study shows no significant difference. The findings were consistent and suggested that music is a great way to decrease BPSD.

I

Choi A, Lee M, Cheong J, Lee J

(2009)

South Korea

[43]

20 patients were allocated to a music intervention group or a usual care group. The music intervention group received music therapy 50 minutes a day, 3 times per week for 5 weeks.

After 15 sessions, the music intervention group improved in agitation, behavioral and psychological symptoms.

II

Sakamoto M, Ando H, Tsutou A

(2013)

Cambridge

[44]

39 participants who were diagnosed with severe Alzheimer’s were randomly assigned to 2 passive music intervention groups. The third group is a non-music control group (non-intervention control group). All 3 interventions were performed for 30 minutes, once a week consecutively for 10 weeks. The effects after the intervention was evaluated using an emotional and stress response which was measured by autonomic nerve index and face scale. BPSD changes were evaluated using BEHAVE-AD rating scale.

The 2 passive music intervention groups caused a short-term parasympathetic dominance. The interactive intervention in the music groups had the greatest improvement in emotions. There was a reduction in BPSD. Interactive music sessions can store cognitive and emotional function, reduce stress and improve the quality of life.

IV