Music based interventions to reduce agitation in nursing home residents diagnosed with dementia- a systematic review

Background:
Agitation is a distressing symptom of dementia. Some research suggests that engaging in music can reduce this symptom. This review synthesises recent evidence on this.

Methods:
A search was conducted of Pubmed articles in the last 10 years. A two-stage screening of the titles and abstracts was conducted. A narrative synthesis was performed due to heterogeneity of methods.

Results:

The search yielded 24 papers of which 15 were excluded. These studies were either randomised controlled trials or before-after studies. They all had an objective scale used to assess agitation as an outcome measure. They varied in intervention length (2 weeks-6 months) and format of therapy.

In most cases a statistically significant reduction in agitation- related behaviours was demonstrated. In all the studies, an individualised playlist was created. Agitation related behaviour was assessed with a scale by an observer or staff.

2 studies assessed the behaviours of residents while music was playing and found that they were less agitated during the intervention. 8 studies looked at the long-term effects of music exposure. 3 studies had a more unstructured approach to exposing the resident to music which led to variation in exposure. Most studies showed a significant reduction in agitation, dependent on how much exposure the residents had.

3 studies chose to compare different forms of music interventions eg. individual vs group. These were small studies but found no intergroup difference in the outcome measures.

Conclusion:
Music-based interventions, particularly when regularly implemented, can reduce agitation and behavioural symptoms in people with dementia. The study designs and results vary greatly, showing that there is need for structured trials. However, given that this is a low risk and low-cost intervention, implementation should be considered where possible.