Dementia Care Research and Psychosocial Factors

Area of Science:

• Neuroscience
• Psychology
• Music Therapy

Background:

• Alzheimer's disease (AD) is frequently accompanied by anxiety (AD-A), impacting patient quality of life and caregiver well-being.
• Pharmacological anxiety treatments for AD can cause adverse effects, necessitating exploration of non-pharmacological alternatives.
• Clinically Designed Improvisatory Music (CDIM) has demonstrated efficacy in reducing anxiety in healthy individuals and is being investigated for AD-A.

Purpose of the Study:

• To assess the feasibility and preliminary effects of CDIM in reducing anxiety in individuals with AD-A.
• To evaluate the impact of CDIM on caregiver burden.
• To explore the neural network changes associated with CDIM intervention in AD-A patients and their caregivers.

Main Methods:

• A study involving individuals with AD-A and their caregivers, employing a delayed enrollment design with pre- and post-intervention evaluations.
• CDIM intervention consisted of 8 thirty-minute sessions featuring slow, melodic music.
• Measurements included anxiety (RAID), caregiver burden (ZBI), physiological indicators (BP, HR, RR), and resting-state functional magnetic resonance imaging (fMRI) to analyze connectivity in the Default Mode (DMN), Salience (SN), Reward (RN), and Auditory Limbic (ALN) networks.

Main Results:

• Preliminary findings indicate a significant reduction in anxiety (RAID) and caregiver burden (ZBI) scores post-CDIM.
• Caregivers experienced significant reductions in systolic and diastolic blood pressure (BP) and respiratory rate (RR).
• fMRI data revealed altered connectivity in key brain networks for both AD-A participants and caregivers, with specific changes correlating with symptom reduction.

Conclusions:

• CDIM appears to be a feasible intervention that effectively reduces anxiety in AD-A patients and lessens caregiver burden.
• The intervention demonstrated symptomatic, physiological, and neural effects, suggesting a transition to a calmer autonomic and emotional state.
• CDIM may modulate abnormal brain network connectivity, offering a promising non-pharmacological approach for managing anxiety in Alzheimer's disease.