RCT Music Therapy in Care Homes

Effects of Music Therapy in elderly care: 
cognition, biomarkers, mood and social behaviour

(ongoing 2019)

(Mangiacotti, Biasutti & Franco in partnership with MHA)

Music therapy (MT) can provide significant benefits for people with cognitive decline living in care homes, helping them to enhance social-cognitive function & reducing behavioral symptoms (Zhang, 2017). Nevertheless, RCT studies that demonstrate the effectiveness of this intervention have often methodological flaws, with consequent significant limitations in the generalizability of this approach (see the reviews by Fusar-Poli, 2018; McDermott, 2013). In order to develop further studies aligned with the empirical approach, it appears crucial to present both clinical and scientific evidence, based on standardized tests, supported by biomarkers and implicit measures (psychophysiology, brain activity, saliva hormones), and developing protocols that could be replicable.

In order to fill this gap we are conducting a 4 months RCT study. We have recruited 54 elderly participants with mild to moderate cognitive impairment (MMSE between 18-23) living in 5 different MHA (Methodist Home Association) care homes in the UK.

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In order to test the effectiveness of MT, we compare 2 groups: [1] the first group will attend one-to-one, 40 min once a week Music Improvisational Therapy activities, [2] the second group will attend one to one, 40 min once a week, Story Telling activities.

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The story telling protocol was developed so as to match the use of improvisational techniques and the mood-matching approach (Franco et al., 2014) used in the MT activities.

Before and after the 4 months intervention we collect neuropsychological tests in order to assess the general cognitive level of the participants, complemented by a new neuropsychological test that we developed (currently under validation with a large sample)  in order to assess the cognitive functions directly stimulated by musical interactions (Music Cognitive Test). Behavioural and wellbeing measurements were also used to assess psychiatry behavioural symptoms, mood, locus of control, motivation, life satisfaction and quality of fife.

Furthermore, in order to increase the empirical understanding of the impact of music therapy, we are also collecting measures of physiological regulation (Respiratory Sinus Arrhythmia, RSA), salivar Cortisol/DHEA ratio and EEG (Di Liberto, 2015), the latter within a feasibility study.

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In conclusion, we expect that result to provide robust evidence confirming the effectiveness of Music Therapy interventions for ageing adults with cognitive decline leaving in care homes.

 

References:

Di Liberto, G. M., O’Sullivan, J. A., & Lalor, E. C. (2015). Low-frequency cortical entrainment to speech reflects phoneme-level processing. Current Biology25(19), 2457-2465.

Franco, F., Swaine, J. S., Israni, S., Zaborowska, K. A., Kaloko, F., Kesavarajan, I., & Majek, J. A. (2014). Affect-matching music improves cognitive performance in adults and young children for both positive and negative emotions. Psychology of Music42(6), 869-887.

Fusar-Poli, L., Bieleninik, Ł., Brondino, N., Chen, X. J., & Gold, C. (2018). The effect of music therapy on cognitive functions in patients with dementia: a systematic review and meta-analysis. Aging & mental health22(9), 1103-1112.

Hsu, M. H., Flowerdew, R., Parker, M., Fachner, J., & Odell-Miller, H. (2015). Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: a cluster randomised controlled feasibility study. BMC geriatrics15(1), 84.

McDermott, O., Crellin, N., Ridder, H. M., & Orrell, M. (2013). Music therapy in dementia: a narrative synthesis systematic review. International journal of geriatric psychiatry28(8), 781-794.

Zhang, Y., Cai, J., An, L., Hui, F., Ren, T., Ma, H., & Zhao, Q. (2017). Does music therapy enhance behavioral and cognitive function in elderly dementia patients? A systematic review and meta-analysis. Ageing research reviews35, 1-11.

 

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