Efficacy of musical interventions in dementia: methodological requirements of nonpharmacological trials

Abstract

The management of patients with Alzheimer's disease is a significant public health problem given the limited effectiveness of pharmacological therapies combined with iatrogenic effects of drug treatments in dementia. Consequently, the development of nondrug care, such as musical interventions, has become a necessity. The experimental rigor of studies in this area, however, is often lacking. It is therefore difficult to determine the impact of musical interventions on patients with dementia. As part of a series of studies, we carried out randomized controlled trials to compare the effectiveness of musical activities to other pleasant activities on various functions in patients with severe Alzheimer's disease. The data obtained in these trials are discussed in light of the methodological constraints and requirements specific to these clinical studies. Although the results demonstrate the power of music on the emotional and behavioral status of patients, they also suggest that other pleasant activities (e.g., cooking) are also effective, leaving open the question about the specific benefits of music in patients with dementia. All these findings highlight the promising potential for nonpharmacological treatments to improve the well-being of patients living in residential care and to reduce caregiver burden.

Are Musical Autobiographical Memories Special? It Ain’t Necessarily So

“…Just having a musical aspect to the memory seemed initially to be associated with enhancements in many of the characteristics associated with vivid autobiographical memories. This finding would have added in a circular way to the general beliefs about the specialness of music, which in turn could affect the outcomes of other studies, as described in the Samson et al (2015) example.…”

Complementary and alternative treatment methods used for patient care bycaregivers to alzheimer's disease at home

“…Alzheimer hastasına bakım verenlerin hasta ile yakınlık derecesine bakıldığında; %37,9'u Alzheimer hastasının gelini, %33,9'u çocuğu, %10,7'si eşi, %10,2'si kardeşi, %7,3'ü ise bakıcı ve damatı olduğunu belirtmiştir. Bakım verenlerin bakım verme süresi ortalama 4,7±3,3 yıl (en çok-en az=0, [10][11][12][13][14][15]…”

“…Bundan dolayı Alzheimerlı bireylerin ve bakım verenlerin TAT yöntemlerine ulaşmaları ilaç uygulamalarına ulaşmalarından daha kolay olmaktadır. TAT yöntemleri bilinçli ve düzenli kullanıldığında Alzheimerlı bireylerin ve bakım verenlerin yaşam koşullarına olumlu katkı sağlamaktadır (13).…”

“…Alzheimer hastalığı semptomları üzerine etkili olan ve sıklıkla kullanılan TAT yöntemlerinden biri müzik terapisidir. Müzik terapisinin, Alzheimer, demans hastaları üzerinde olumlu etki yaptığı, yaşam kalitesini yükselttiği belirlenmiş ve bakım vericilerin üzerindeki yükün azalmasında etkili olduğu belirtilmiştir (13). Demanslı bireylerde tercih edilen TAT yöntemlerinden bir diğeri olan aromaterapi, farmakolojik tedaviye göre hem maliyetinin daha az olduğu hem de hiç yan etkisi olmayan bir uygulama olduğu tespit edilmiştir (14).…”

Alzheimer’s Disease: Dawn of a New Era?

“…The non-pharmacological approaches to prevent AD include relaxing activities, such as listening to music or cooking that are speculated to improve the neural efficacy of cognitive processing and emotional and behavioral functioning (42). On the other hand, the therapeutic agents currently in the market do not impact the progression of AD and are only expected to alter the cognitive symptoms, which appear in later stages of AD.…”