Effect of Active Music Therapy and Individualized Listening to Music on Dementia: A Multicenter Randomized Controlled Trial

ObjectivesTo assess the effects of active music therapy (MT) and individualized listening to music (LtM) on behavioral and psychological symptoms of dementia (BPSDs) in persons with dementia (PWDs). DesignRandomized controlled trial. SettingNine Italian institutions. ParticipantsPersons with moderate to severe dementia and BPSDs (N=120) were randomized to one of three treatments. InterventionsAll groups received standard care (SC), and two groups attended 20 individualized MT or LtM sessions, twice a week, in addition to SC. MeasurementsThe Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Cornell-Brown Scale for Quality of Life in Dementia (CBS-QoL) were administered before treatment, after treatment, and at follow-up to evaluate behavioral and psychological outcomes. A specific coding scheme (Music Therapy Check ListDementia) was used to evaluate the MT process. ResultsBehavioral assessment did not show significant differences between groups. All groups showed a reduction over time in NPI global score (P.001), CSDD (P=.001), and CBS-QoL (P=.01). The NPI global score fell 28% in the MT group, 12% in the LtM group, and 21% in the SC group at the end of treatment. An exploratory post hoc analysis showed similar within-group improvements for theNPI Delusion, Anxiety, and Disinhibition subscales. In the MT group, communication and relationships between the music therapists and PWDs showed a positive albeit nonsignificant trend during treatment. ConclusionThe addition of MT or LtM to standard care did not have a significant effect on BPSDs in PWDs. Further studies on the effects of the integration of standard care with different types of music interventions on BPSD in PWD are warranted.