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Music Therapy and Its Effect on Dementia

Ashely Murphy

James Madison University

NSG 464: Introduction to Nursing Research

April 11, 2021

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Abstract:

This paper reviews quantitative and qualitative evidenced based practice research on the

impact of music therapy has on agitation in older adults with dementia. Six research studies of

pilot studies, randomized controlled trials, were reviewed to answer the pico research question.

In people with dementia, what is the effect of nonpharmacological intervention such as music

therapy on agitation? The goal of this paper is to examine these evidenced-based research

studies to determine if music therapy has an effect on agitation in older patient with dementia

through a literacy review. The paper also looks at three main themes and implications for current

nursing practices in the six research studies.

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Dementia is a growing clinical condition marked by severe cognitive dysfunction and

related physical disability, affecting almost 50 million people worldwide. (Holden et al., 2019).

Dementia impairs a person's cognitive and psychological abilities, such as memory, judgment,

vocabulary, and social skills. People with dementia, which are often are older adults, may feel

agitated caused by numerous reasons such as changes in environment or schedule, heightened

external stimulation, or anxiety as a result of attempting to make sense of the world around them

(Thornley, 2016). However, studies have shown that when nurses use music therapy as an

intervention, it can help patients with dementia relieve feelings of agitation. The goal of this

paper is to examine these evidenced- based research studies to answer the question, in people

with dementia, what is the effect of nonpharmacological interventions such as music therapy on

agitation? This will be done by analyzing relevant research studies and their findings on this

topic.

So, what is music therapy? Music therapy is a well-known wellness profession where

music is used in a therapeutic environment to meet individuals' physical, mental, cognitive, and

social needs (Lyu, 2018). According to Holden et al. (2019), treatment for dementia patients

involves a combination of pharmacological intervention and nonpharmacological interventions.

Although pharmacological interventions can reduce dementia related symptoms,

nonpharmacological interventions such as music therapy can provided emotional comfort to

clients by allowing them to express and soothe their feelings.

It can be difficult to stay involved in enjoyable and interesting things for those who are

diagnosed with dementia. In a randomized control trial study Pongan (2017) interviewed 59

patients with dementia who participated in musical therapy and concluded that patients that were

involved with music therapy whether through listening, singing, or playing an instrument were
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shown to have less stress and anxiety post-intervention. Thus, reducing agitation in the

participants. Another study was a pilot randomized control in which only 16 participants were

screened after they went to a music therapy group for four weeks (Maseda, 2018). The screening

results showed similar outcome in which participants mood had improved when music therapy

was incorporated into their plan of care.

Three main themes were found within these studies. The first theme was improved mood

for the participants within these studies. Patients exposed to music therapy were happy and more

content compared to those who did not receive music therapy (Thornley, 2016). Another theme

was that the participants had mild to moderate dementia. None of the patients were in the late

stages of dementia. Had there been patients with late stages of dementia participating in these

studies, perhaps the outcome may have been different in terms of the effective music therapy had

on agitation. Lastly, all participants were in a long-term care facility such as a nursing home or

on a unit within a hospital. Being in a different environment than what the patient is used to

could cause more agitation in patients with dementia (Holden et al., 2019). However, the results

remained the same. Participants were less agitated after the intervention was initiated.

In conclusion, music therapy has a huge impact on agitation in dementia patients. This is

because it allows people to remember or evoke memories, experiences, and emotions. Music

therapy encourages constructive behavior and improved coping abilities in dementia patients.

This therapeutic intervention along with pharmacological interventions can reduce patients’

agitation levels. However, more clinical trials that will focus on designing standardized protocols

based on the type or stage of dementia a patient has are needed, so that they can be used in

conjunction with existing therapies. Such as the length of time patients were exposed to the

intervention, types of music used, and what type of involvement did the participants participated
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in. Future studies should develop a theoretical framework in order to avoid inconsistency in

applying the intervention.

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References:

Holden, S. K., Sheffler, J., Stewart, R., Thompson, S., Persson, J., Finseth, T., Sillau, S.,

& Kluger, B. M. (2019). Feasibility of Home-Based Neurologic Music Therapy for

Behavioral and Psychological Symptoms of Dementia: A Pilot Study. Journal of Music

Therapy, 56(3), 265–286. https://doi.org/10.1093/jmt/thz009

Lyu, J. (2018). The Effects of Music Therapy on Cognition, Psychiatric Symptoms, and

Activities of Daily Living in Patients with Alzheimer’s Disease. Journal of

Alzheimer’s Disease., 64(4), 1347–1358. https://doi.org/10.3233/JAD-180183

Maseda, A. (2018). Multisensory Stimulation and Individualized Music Sessions

on Older Adults with Severe Dementia: Effects on Mood, Behavior, and

Biomedical Parameters. Journal of Alzheimer’s Disease., 63(4), 1415–1425.

https://doi.org/10.3233/JAD-180109

Moir, A. R., Cassidy-Nolan, D., Gough, A. S., & Cassidy, K.-L. (2019). Music Therapy

in Long-Term Care: Impact on Behavioral and Psychological Symptoms of Dementia

and Facility Milieu. Canadian Journal of Music Therapy, 25, 50–59.

https://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=7&sid=d20438ad-9cb8-

469c-9f24-253aaa66d952%40sdc-v-sessmgr02

Pongan, E. (2017). Can Musical or Painting Interventions Improve Chronic Pain, Mood,

Quality of Life, and Cognition in Patients with Mild Alzheimer’s Disease? Evidence
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from a Randomized Controlled Trial. Journal of Alzheimer’s Disease., 60(2), 663–677.

https://doi.org/10.3233/JAD-170410

Thornley, J. (2016). Music therapy in patients with dementia and behavioral disturbance

on an inpatient psychiatry unit: results from a pilot randomized controlled study.

International Psychogeriatrics., 28(5), 869–871.

https://doi.org/10.1017/S1041610215001866