A recent study in the journal Aging & Mental Health examines the impact of music therapy on levels of agitation among nursing home residents with dementia. In a randomized trial, 42 study participants with dementia were assigned either standard care or six weeks of individual music therapy. The music therapy employed in this study took a person-centered approach rooted in the goal of facilitating initiative, engagement, self-expression, and mutual understanding. With this aim in mind, the music therapy was tailored to the individual resident’s needs and preferences, and so could include improvising, singing, dancing/moving, or other activities. For patients with dementia specifically, there are at least three ways of applying musical therapy, and the musical therapists for this study had been trained in all three. The first is catching the individual’s attention and creating a safe setting; second is regulating arousal levels to a point where self-regulation is possible; and third is using music to help engage in social communication.
To measure the effects of music therapy, the researchers examined the residents’ agitation frequency and agitation disruptiveness, in addition to prescription of psychotropic medications. Agitation behavior can take many forms, ranging from pacing to hiding things to hitting, and some of these behaviors are much more disruptive to a community than others. To account for this, the disruptiveness of each recorded agitated behavior was rated from 1 (not at all disruptive) to 5 (extremely disruptive).
While the impact of music therapy did not reach statistical significance for the measures of agitation frequency and quality of life, there were significant impacts on agitation disruptiveness for the individuals in this study: over the course of the study, the agitation disruptiveness of individuals in music therapy decreased, while it increased for individuals who were only receiving standard care.
Of the participants in the study, 71 percent were prescribed psychotropic medication at the time the study began. For 48 percent of these participants, medication usage did not change over the course of the study. However, when receiving standard care without music therapy, 17 percent of participants in the study required an increase in psychotropic drugs. When in music therapy, no participants required an increase in psychotropic medication and two participants had their psychotropic medication reduced.
Agitation behaviors have a negative and disruptive influence on both residents and caregivers in a nursing home, increasing agitation for other residents and leading to greater burnout among caregivers. This research suggests that music therapy can help address the problem of agitation behaviors in dementia care. Although the study showed statistical significance only in a decrease in agitation disruptiveness, the researchers suggest that with a larger number of participants, an observed decrease in agitation frequency could also be statistically significant. They also note that a larger study may be able to identify characteristics of individuals who might most benefit from music therapy, as well as determine which approaches to music therapy have the greatest clinical impact.
Ridder HMO, Stige B, Qvale LG, et al. Individual music therapy for agitation in dementia: an exploratory randomized controlled trial. Aging & Mental Health. (2013). DOI: 10.1080/13607863.2013.790926