The impact of music therapy on wellbeing of dementia patients

This systematic literature review explores the potential of music therapy as a non-pharmacological intervention for dementia patients. The review highlights the effectiveness of music therapy in improving cognitive and behavioral problems, emotional and social functioning, and reducing anxiety and depression in dementia patients.

Running head: HEALTH AND SOCIAL CARE
Research project in health and social care
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Abstract
Dementia is one of the most prominent health concerns among the aged population across the
globe. The neurodegenerative condition leads to severe cognitive impairments in individuals who
demonstrate dysfunctional behavior and depressive symptoms. While pharmacological treatment
options have been proved to be effective for dementia treatment, the limitations of the same have
been articulated. Non pharmacological treatment options like music therapy hold potential to
cater the varied care needs presented by dementia patients. The present systematic literature
review aimed at understanding the impact music therapy has on wellbeing of dementia patients.
The findings of this research have been presented in here along with recommendations for
practice.

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The impact of music therapy on wellbeing of dementia patients
Chapter 1 Introduction
Dementia is a progressive neurodegenerative illness affecting around 35 million people
across the globe. Researchers have pointed out the condition to be an organic mental health
issue. It has been estimated by through statistical data that the prevalence of the disease would
definitely continue to rise with a rapid rate in the coming years (Dewing and Dijk 2016;
Livingstone et al. 2017). According to Miller et al. (2016) dementia is the reason behind
significant cognitive impairments that hinder the quality of life of patients. Depression, agitation
and anxiety have been known to be the common symptoms experienced by these individuals. For
addressing the symptoms researchers have come up with drug therapies that act as the first-line
treatment options, with the aim of impairing the progression of the condition. Challenging
behaviors have been addressed in patients to some extent with the help of antipsychotic
medication. However, continual research is been carried out for understanding the effective of
non-pharmacological interventions in this regard (Brooke and Latham 2015). Music therapy has
been noted to be a potential non-pharmacological intervention for addressing varied symptoms of
dementia. Health and social care workers can deliver better care to dementia patients if there is
increased knowledge about the applicability of music therapy (Melhuish et al. 2017; Lee,
Weston, and Hillier 2018).
The present research had the aim to understand the influence music therapy can have on
wellbeing of dementia patients. The research question that was addressed through the research
was as follows-
“Does music therapy helps in improving the well being of patients suffering from dementia?”

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Chapter 2 Literature review
The prevalence of dementia has been on the rise in the past few years, increasing the
burden on health and social care workers. Dementia has been noted to be associated with
psychological and behavioral symptoms that have lead to decreased quality of life of individuals
(Hallberg et al. 2016). Further, the healthcare costs of delivering dementia care have been
significant in the contemporary era, leading professionals to come up with effective intervention
strategies. Since the condition is not completely curable, the symptoms are arrested and reduced
through different interventions (Surr et al. 2016). According to the researchers, pharmacological
medication is administered to patients with dementia for addressing challenging behaviors and
negative outcomes such as agitation and depression. However, the risk of suffering adverse
effects encompassing fatigue and dizziness are prominent, and patients often suffer injuries and
falls as a result of such complications.
Non-pharmacological treatment options for dementia have been constantly drawing the
attention of the scientific domain who strives to outline the key approaches for non-
pharmacological interventions (Johnell 2015). Music therapy, according to Hsu (2017) can be
considered for gaining improvements in the cognitive and behavioral problems of individuals in
addition to emotional and social functioning. Music therapy can be considered as a safe
treatment option for dementia care with no complications associated with it. The significance of
music due to its nonverbal therapeutic attribute can act as a communication medium between
individuals. It has been found that music can elicit movements that engage in stimulating
interactions between action systems and perception. The definition of music therapy put forward

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by the American Music Therapy Association has put forward points out music therapy as the
evidence based and clinical use of music as an intervention through an approved music therapy
program for accomplishing individualized care goals in the context of therapeutic services
provided by a skilled and credentialed professional. As dementia patients are found to be
demonstrating captivating sensitivity to music, the process has been denoted to have important
therapeutic purposes (Yinger 2017).
Chapter 3 Research Methodology
The present research was a systematic literature review carried out in alignment with the
research question. Systematic literature reviews gives a comprehensive overview of the research
topic through analysis of existing research related to it. The concept is to gather the best
evidences from reliable and trustworthy sources that can direct future practices. An extensive
literature search was done in electronic databases such as PubMed, CINAHL and Science Direct.
The keywords used for the optimizing the research was as dementia, dementia patients, music
therapy, music. Research articles published after the year 2014 were considered for the study.
Those published in English language and had full text access were included in the review. The
main findings of the research papers were considered for the data analysis section.
Chapter 4 Findings and analysis
Chang et al. (2015) aimed at understanding the efficacy of music therapy in relation to
treatment of people with dementia through a meta-analysis of randomized controlled trials. The
researchers gave the focus on the effect of the therapy on depressive moods, anxiety levels,
disruptive behaviours, and cognitive functioning in people with dementia. Studies included in the

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analysis were retrieved from databases such as PubMed, CINAHL, Medline, Cochrane Library
Database, SCOPUS and PsycINFO. The results were that music therapy was effective in
improving disruptive behavior [Hedge’s g=-0.66; 95% confidence interval (CI) = -0.44 to -0.88]
as well as anxiety levels [Hedge’s g= -0.51; 95% confidence interval (CI)= -0.02 to -1.00]. The
study was the first one to undertake an evaluation of effectiveness of randomised controlled trials
of music therapy for dementia patients over the past twenty years.
In the study conducted by Chu et al. (2014) an attempt was made to establish the benefits
of group music therapy for improvement of depression suffered by elderly dementia patients.
The research had a prospective, parallel-group design with permuted-block randomization design
wherein random allocation was done for 1044 older dementia patients to either control or
intervention group. 12 sessions of music therapy was delivered and data collection was done at
different intervals. The results highlighted group music therapy could reduce attributes of
depression in dementia patients. The improvements were evident immediately after the group
therapy. For assessing the impact of active music therapy and individualized listening to music,
Raglio et al. (2015) carried out a randomized controlled trial with 120 individuals from nine
Italian institutions who suffered from moderate to severe dementia. The Neuropsychiatric
Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Cornell-Brown Scale
for Quality of Life in Dementia (CBS-QoL) were considered for use before intervention. A
particular coding scheme (Music Therapy Check List-Dementia) helped in evaluation of the
music therapy process. The study indicated that no significant reduction to be achieved in
behavioural and psychological symptoms in dementia patients.
According to Ray and Mittleman (2015) agitation, wandering and depression are common
behaviours in dementia patients. The researchers aimed at examining the utilization of music

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therapy by care professionals for targeting treatment of similar clinical symptoms. Recruitment
of 132 individuals was done suffering from moderate to severe dementia. ANOVA test was
applied after assessment was done after two week of intervention. Multivariate analyses
indicated that there exists a relationship between changes in meuropsychiatric symptoms and
music therapy.
Zhaang et al. (2017) carried out an extensive literature search to analyze the efficacy and
value of music therapy for addressing elderly dementia patients’ concerns. The study considered
34 studies that encompassed 1757 subjects and 42 analyzes with which a meta-analysis was
carried out. While the primary outcome was cognitive function, the secondary outcomes were
anxiety, depression and quality of life. The main inference drawn from the study was that music
therapy proved to be effective in supporting the needs of addressing anxiety and disruptive
behavior in dementia patients. The therapy can therefore be used for enhancing quality of life of
dementia patients. A similar study had been carried out by Blackburn (2014) who considered
carrying out a critical and analytical review of existing literature to highlight and bring into
limelight the implications of music therapy for dementia service users. From this review carried
out it was can concluded that music therapy holds the potential to bring in promising results in
relation to dementia care. Nevertheless, most of the studies that were included in this review had
methodological limitations, as pointed out by the researchers.
The review gave a compressive overview of the impact music therapy has on the well
being of dementia patients. In this paper the studies discussed above indicate that music therapy
promises to address varied problems pertaining to dementia in individuals suffering from the
condition in mild or moderate form. The symptoms that can be influenced include anxiety,
depression and cognitive decline, which are the most prominent characteristics of dementia.

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While most of the studies bring into limelight the effectiveness of the intervention, a debate
might be emerging concerning the same given that a certain section of the existing studies bring
in different results. It is to be remembered that the methodological flaws of the research highlight
the need of conducting further studies that have address the gaps. In depth research is warranted
in this domain to clearly highlight the relation of music therapy with dementia care.
Chapter 5 Conclusion and recommendation
Dementia is one of the major public health concerns at the contemporary era, compelling
healthcare professionals to come up with novice strategies that can address the varied patient
needs. in spite of the favorable outcomes of the present literature review, it is to be mentioned
that there lies immense scope of carrying out research concerning the extent to which music
therapy can augment the wellbeing of dementia patients. For clarifying the emerging issues it
would be beneficial if more robust trials are carried out in future. Nevertheless, the potential of
music therapy cannot be underestimated at present. Healthcare professionals can consider this
intervention across settings for reducing the symptoms experienced by dementia patients. Since
distressed behaviors and cognitive functioning can be improved among patients, professionals
can foster the quality of life of patients through this uncomplicated and inexpensive strategy.
This would require involvement of trained and skilled professionals in order to optimize the
patient outcomes. Healthcare settings would need to allocate resources for this purpose and
support the professionals.

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Appendix
Ethical concern
Ethical concerns related to use of secondary research drawn in the attention of researchers to
issue of consent to use data available. For adhering to ethical principles for the present study the
original data have been acknowledged appropriately in each step. Further, data have been
evaluated for certain criteria such as the methodology of data collection and accuracy. The report
has been stored in a safe manner to avoid unauthorized access, accidental loss or destruction.
Data in the form of softcopies have been kept as encrypted files in computers.