New Articles on MT for Agitation in Persons with Dementia

Agitation is a major issue for older adults with dementia. Older adults who have dementia with agitation often need more support services in order to ensure their safety. Two recent studies indicated that music therapy services may reduce the amount of agitation in older adults with dementia.

Zare et al. (2010) tested four music conditions (n=16) agains a no-music control (n=10), with the intervention lasting one month. Conditions included individual preferred music listening,  group preferred music listening, group non-preferred music listening, and group singing of preferred music.  The Cohen-Mansfield agitation inventory was scored by the patient’s caregivers. They found statistical significance in all music conditions, with greater significance in preferred individual listening and group singing.

There are a few issues with this study. There aren’t enough details about the interventions to replicate. They don’t say how often and for how long (i.e., 20 minutes) the intervention lasted. Also, they don’t provide the data for the control group, they only say that there was significance between experimental and control. Thats not enough information since we don’t know if thats for all four experimental groups, one group, etc…  Lastly, all of the experimental groups had 4 persons in them, not enough participants to infer anything to the general population.   There is no mention of a music therapist in the study.

Raglio et al. (2010) completed a RCT that compared music therapy session cycles (n=30) to no music therapy treatment (n=30) in older adults with Alzheimer type dementia. The three music therapy cycles included 30-minute improvisational music therapy (called sound-music improvisation), three times a week for four weeks. There was then a no-treatment phase that lasted for a month. Although both groups improved in overall measures, only the experimental group had a reduction of agitation and delusions.

Issues with this study include non-standarzided means of randomization, non-equivelent groups at baseline, and poor description of the intervention (no able to replicate).

What does this mean for the clinician? Well, despite the flaws of these studies, they both indicate that music therapy can reduce agitation in older adults with dementia. This is some nice evidence that could be used to show efficacy for individuals seeking jobs or retaining jobs with older adults. Furthermore, the evidence indicates that preferred individual music, small groups, and active engagement are most beneficial.

References:

Raglio, A., Bellelli, G., Traficante, D., Gianotti, M., Ubezio, M.C., et al. (2010). Efficacy of music therapy treatment based on cycles of sessions: A randomised controlled trial. Aging Ment Health, 14(8), 900-4. PMID: 21069596

Zare, M., Ebrahimi, A.A., & Birashk, B. (2010). The effects of music therapy on reducing agitation in patients with Alzheimer’s disease, a pre-post study. Int J Geriatr Psychiatry, 25(12), 1309-10. PMID: 21086543