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Digital music intervention and music therapy across the dementia care continuum: Randomized controlled trial
Lotta M Kaila1,2, Ilja Salakka1,2, Anni Pitkäniemi1,2
1Centre of Excellence in Music, Mind, Body and Brain Research University of Helsinki & University of Jyväskylä Helsinki Finland.
Introduction:
Music interventions show promise in dementia care and digital approaches may increase availability and accessibility. We investigated the efficacy of a digital music intervention (DMI) and conventional music therapy (CMT) compared to standard care (SC) across the dementia care continuum.
Methods:
In an exploratory parallel-group randomized controlled trial, community-dwelling (HOME, n = 91) and care home-dwelling (CARE, n = 75) persons living with dementia (n = 166) were randomized to DMI, CMT, or SC. Group-based music interventions spanned 10 weeks (2 × 60-minute sessions/week) and included receptive (listening, reminiscing) and expressive (singing, movement) activity. DMI comprised pre-recorded video sessions followed on screen with a non-therapist facilitator; CMT was delivered live by professional music therapists. Outcomes were assessed at baseline (T1), 3 months (T2), and 6 months (T3), measuring cognition, mood, quality of life, and caregiver well-being. Primary outcomes were changes in general cognition (Montreal Cognitive Assessment, Consortium to Establish a Registry for Alzheimer's Disease Chandler total; T1-T2). Primary and sensitivity analyses used linear mixed-effects models in whole, HOME, and CARE samples.
Results:
No significant effects of CMT or DMI were found for primary general cognition outcomes in primary or sensitivity analyses. Across exploratory secondary outcomes, compared to SC, CMT improved naming (T1-T2) and verbal learning (T1-T3) in the whole sample and executive function in HOME (T1-T2). Compared to a decline in SC, prompted autobiographical memory was maintained by DMI and CMT in the whole sample (T1-T2) and by DMI in CARE (T1-T2). Sensitivity analyses largely supported these findings. No significant differences were observed between DMI and CMT.
Discussion:
CMT and DMI did not yield effects on primary general cognition outcomes. CMT showed modest but coherent effects on exploratory secondary cognitive outcomes across the dementia care continuum. The only exploratory secondary finding for DMI was maintenance of autobiographical memory against a decline in SC. These findings support existing evidence yet call for further research to optimize interventions.
