Singing versus conversation for wellbeing in dementia: A cross-over pilot study

Background: Music-based therapeutic interventions are a promising addition to conventional treatments for people with dementia, positively affecting mood and wellbeing. However, previous studies on music-based interventions show variability in design and results, hampering clear understanding of their beneficial effects. Particularly, the specific benefits of music compared to similar non-musical activities remain unclear. Objective: Here, we piloted the feasibility of a randomized cross-over design to isolate music-specific positive effects of an intervention from general, nonspecific effects of participating in a stimulating group activity, assessing outcomes both in people with dementia and caregivers. Methods: 15 nursing home residents diagnosed with dementia participated in both a music and a conversation activity, which only differed with respect to the presence of music. Before and after five weeks of intervention, we assessed behavioral symptoms and caregiver burden, using the Neuropsychiatric Inventory (NPI-NH), and wellbeing, using the Quality of Life in Late-Stage Dementia (QUALID) scale. During the activities we assessed engagement (Menorah Park Engagement Scale; MPES) and affect (Observed Emotion Rating Scale; OERS). Results: The singing activity reduced professional caregiver burden, while the conversation activity increased participant wellbeing. We found no difference between music and conversation in eliciting engagement and affect during the activities. Conclusions: Tentatively, both singing and conversation activities can positively affect people with dementia, with neither clearly outperforming the other. Given our sample size, these findings need to be confirmed in larger studies. We discuss the feasibility of the design and implications for future studies examining music-specific positive effects on people with dementia. © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).