Feasibility of Home-Based Neurologic Music Therapy for Behavioral and Psychological Symptoms of Dementia: A Pilot Study

Abstract

Family caregivers often feel ill-equipped to handle bothersome behavioral and psychological symptoms of dementia, such as agitation, apathy, and sleep disturbances, leading to increased caregiver distress and nursing home placement for people with dementia. Therapies for such symptoms are currently limited and non-pharmacological options are preferred, given potential side effects of medications. Neurologic music therapy (NMT) could provide an additional treatment option for managing behavioral and psychological symptoms for community-dwelling people with dementia and their caregivers. This pilot study sought to evaluate the feasibility, acceptability, and effectiveness of home-based NMT for behavioral and psychological symptoms of dementia. Eighteen persons with dementia-caregiver dyads were enrolled to receive one-hour weekly sessions of home-based NMT for 6 weeks. Demographic, quality of life, neuropsychiatric symptom, and caregiver burden and self-efficacy information was collected at baseline, 6 weeks, and 12 weeks. Seven dyads (38.9%) withdrew from therapy before completing all sessions; these participants had higher Neuropsychiatric Inventory scores and were of older age at baseline. For those who completed therapy, neuropsychiatric symptom scores improved at 6 weeks, an effect that was sustained at 12 weeks. No other outcome measures changed significantly after therapy. Initiating NMT too late in the course of dementia, when behavioral symptoms are already present, may be impractical for people with dementia and increase caregiver stress, even when provided within the home. Introducing and incorporating the principles of NMT earlier in the course of dementia could allow for increased comfort and benefit for people with dementia and their caregivers.

Investigation of the effects of interventions made according to the Progressively Lowered Stress Threshold Model on the care outcomes of Alzheimer patients and their families: a randomized clinical trial

“…32 In a study where Holden et al administered neurological music therapy in home visits for six weeks to dementia patients, it was found that there was a decrease in the neuropsychiatric symptoms of the patients. 33 In a study where Parajuli et al applied individualized music therapy and cared for patients with dementia according to PLST, it was reported that although there was a decrease in the psychotropic, antipsychotic, and antidepressant drugs used by the patients for three months, the difference was not statistically significant. 34 In the study by Akpınar 12 In a study by Chrabaszcz, caregivers of dementia patients were trained according to the PLST model and it was found that there was a minimum decrease in the behavioural problems of the dementia patients.…”

A Focus on the Reminiscence Bump to Personalize Music Playlists for Dementia

“…In other studies, NMT has been used to aid the psychosocial symptoms of dementia. 44 Techniques such as Musical Sensory Orientation Therapy and Musical Attention Control Therapy use elements of musicality, such as rhythm and melody to both orient the participants in time and space and to improve attentive functions. Although not always successful, such studies have assessed the question as to how important knowing the music actually is and whether it is the elements of the music, and not just the emotional attachment that provides the response in participants.…”

“…Although not always successful, such studies have assessed the question as to how important knowing the music actually is and whether it is the elements of the music, and not just the emotional attachment that provides the response in participants. 44 …”

“…Although not always successful, such studies have assessed the question as to how important knowing the music actually is and whether it is the elements of the music, and not just the emotional attachment that provides the response in participants. 44 The study has a number of limitations. It is not possible from this study to generalize about musical interests and evoked emotions of individual participants.…”

Eficacia de la musicoterapia en el bienestar psicológico y la calidad de vida en personas con discapacidad física y orgánica severa

“…En el campo de la demencia, Fakhoury et al (2017) observan que las intervenciones musicoterapéuticas disminuyen fuertemente la ansiedad y tienen el potencial de mejorar la calidad de vida. Holden et al (2019) sostienen que, aplicada en el hogar, ayuda a reforzar un grado de independencia a estos pacientes y sus cuidadores, permitiendo una traducción directa de beneficios a su vida diaria. Lam et al (2020) encuentran que "podría mejorar la fluidez verbal y reducir la ansiedad, la depresión y la apatía en pacientes con demencia, aunque no parece haber beneficios comprobados en memoria, función diaria o calidad de vida en general.…”