Journal List > Korean J Adult Nurs > v.27(1) > 1076307

Korean J Adult Nurs. 2015 Feb;27(1):106-116. Korean.
Published online February 28, 2015.  https://doi.org/10.7475/kjan.2015.27.1.106
© 2015 Korean Society of Adult Nursing
Effects of Music Therapy on Agitation in Dementia: Systematic Review and Meta-analysis
Eun-Hi Kong,1 and Myonghwa Park2
1College of Nursing, Gachon University, Incheon, Korea.
2College of Nursing, Chungnam National University, Daejeon, Korea.

Corresponding author: Park, Myonghwa. College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon 301-747, Korea. Tel: +82-42-580-8328, Fax: +82-42-580-8309, Email: mhpark@cnu.ac.kr
Received December 09, 2014; Revised February 03, 2015; Accepted February 07, 2015.

Abstract

Purpose

The purpose of this review was to assess the quality and to evaluate the effectiveness of music interventions in reducing agitation in older adults with dementia.

Methods

Randomized controlled studies and randomized crossover studies were identified by searching MEDLINE, EMBASE, CINAHL, PsycINFO, AGELINE, Cochrane Central Register of Controlled Trials, Korea Med, Kmbase, RISS, National Assembly Digital Library, KISS, and RICH. Two reviewers independently retrieved articles, extracted data, and assessed the quality of studies.

Results

In total, 10 studies were selected from 1095 unique citations. All included studies were conducted in long term care settings. Overall, risk of bias for included studies was low to moderate. The weighted average effect size across studies was -0.39 (95%CI [-0.69, -0.10], p=.009, I2=63%). Music therapy was effective to reduce agitation of the older adults with dementia.

Conclusion

Music intervention can be an effective non-pharmacological intervention for the reduction of agitation in dementia. Future studies need to use rigorous research method and to provide description of research methods in greater detail. In addition, future studies are required to explore the effects of music therapy according to severity of agitation and dementia.

Keywords: Music; Psychomotor agitation; Dementia; Systematic review; Meta-analysis

Figures


Figure 1
PRISMA flow diagram of screening and selection process of studies.
Click for larger image


Figure 2
Forest plot of effect size and 95% CI by music therapy on agitation.
Click for larger image


Figure 3
Funnel plot of effect sizes by standard error.
Click for larger image

Tables


Table 1
Descriptive Summary of Included Studies
Click for larger image

Notes

This study was supported by Gachon University Research Fund and Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Science, ICT and future Planning(NRF. 2013R1A2A2A01069090).

References
1. Ayalon L, Bornfeld H, Gum AM, Areán PA. The use of problem-solving therapy and restraint-free environment for the management of depression and agitation in long-term care. Clinical Gerontologist 2009;32(1):77–90. [doi: 10.1080/07317110802468728]
2. Kong E. Agitation in dementia: concept clarification. Journal of Advanced Nursing 2005;52(5):526–536. [doi: 10.1111/j.1365-2648.2005.03613.x]
3. Cohen-Mansfield J, Billig N. Agitated behaviors in the elderly: I. a conceptual review. Journal of the American Geriatrics Society. 1986;34(10):711–721.
4. Cohen-Mansfield J, Libin A, Marx MS. Nonpharmacological treatment of agitation: a controlled trial of systematic individualized intervention. Journals of Gerontology Series A: Biological Sciences & Medical Science 2007;62(8):908–916. [doi: 10.1093/gerona/62.8.908]
5. Cohen-Mansfield J. Nonpharmacologic interventions for inappropriate behaviors in dementia: a review, summary, and critique. American Journal of Geriatric Psychiatry 2001;9(4):361–381. [doi: 10.1097/00019442-200111000-00005]
6. Kong E, Evans LK, Guevara JP. Non-pharmacological intervention for agitation in dementia: a systematic review and meta-analysis. Aging & Mental Health 2009;13(4):512–520. [doi: 10.1080/13607860902774394]
7. McGonigal-Kenny ML, Schutte DL. Nonpharmacologic management of agitated behaviors in persons with Alzheimer disease and other chronic dementing conditions. Journal of Gerontological Nursing 2006;32(2):9–14.
8. Kim BY. A study on the effects of the music therapy for dementia senile people. Journal of Korean Gerontological Nursing 2000;2(1):22–35.
9. Kim HK, Lee OR. A study on the effects of cognition, behavior and affection of the music therapy for dementia senile people. Journal of Korean Academy of Adult Nursing 2000;12(3):463–476.
10. Kim HJ, Jung JW. A study on the effect of Korean traditional music therapy with on depression and quality of life of the elderly with mid dementia. Journal of Arts Psychotherapy 2013;9(3):19–38.
11. Hong YK, Kang YS. Effects of a music program on cognitive function and disturbing behavior in elders with dementia. Journal of Korean Gerontological Nursing 2009;11(1):5–15.
12. Brotons M, Koger SM, Pickett-Cooper P. Music and Dementias: a review of literature. Journal of Music Therapy 1997;34(4):204–245. [doi: 10.1093/jmt/34.4.204]
13. Spiro N. Music and dementia: observing effects and searching for underlying theories. Aging & Mental Health 2010;14(8):891–899. [doi: 10.1080/13607863.2010.519328]
14. Goodall D, Etters L. The therapeutic use of music on agitated behavior in those with dementia. Holistic Nursing Practice 2005;19(6):258–262. [doi: 10.1097/00004650-200511000-00005]
15. Livingston G, Kelly L, Lewis-Holmes E, Baio G, Morris S, Patel N, et al. A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia. Health Technology Assessment 2014;18(39):1–226. [doi: 10.3310/hta18390]
16. Sung H, Chang AM. Use of preferred music to decrease agitated behaviours in older people with dementia: a review of the literature. Journal of Clinical Nursing 2005;14(9):1133–1140. [doi: 10.1111/j.1365-2702.2005.01218.x]
17. Choi AN, Ryu KK. The effect of group music therapy on cognition, depressive mood, quality of life and BPSD (behavioral and psychological symptoms of dementia) in patients with dementia. Journal of Special Education & Rehabilitation Science 2007;46(3):143–174.
18. Craig J. Music therapy to reduce agitation in dementia. Nursing Times 2014;110(32-33):12–15.
19. American Music Therapy Association. What is music therapy? [Internet]. Silver Spring: American Music Therapy Association; 2014 [cited 2014 December 7].
20. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. [Internet]. United Kingdom: The Cochrane Collaboration; 2011 [cited 2014 November 10].
21. Oh S. In: Meta-analysis: theory and practice. 1st ed. Seoul: Konkuk press; 2002.
22. Copas J, Shi JQ. Meta-analysis. funnel plots and sensitivity analysis. Biostatistics 2000;1(3):247–262. [doi: 10.1093/biostatistics/1.3.247]
23. Cochrane Information and Knowledge Department. RevMan 5.3 beta [Internet]. United Kingdom: The Cochrane Collaboration; 2011 [cited 2014 October 03].
24. Cooke ML, Moyle W, Shum DHK, Harrison SD, Murfield JE. A randomized controlled trial exploring the effect of music on agitated behaviours and anxiety in older people with dementia. Aging & Mental Health 2010;14(8):905–916. [doi: 10.1080/13607861003713190]
25. Lin Y, Chu H, Yang C, Chen C, Chen S, Chang H, et al. Effectiveness of group music intervention against agitated behavior in elderly persons with dementia. International Journal of Geriatric Psychiatry 2011;26(7):670–678. [doi: 10.1002/gps.2580]
26. Narme P, Clément S, Ehrlé N, Schiaratura L, Vachez S, Courtaigne B, et al. Efficacy of musical interventions in dementia: evidence from a randomized controlled trial. Journal of Alzheimer's Disease 2014;38:359–369. [doi: 10.3233/JAD-130893]
27. Raglio A, Bellelli G, Traficante D, Gianotti M, Ubezio MC, Gentile S, et al. Efficacy of music therapy treatment based on cycles of sessions: a randomised controlled trial. Aging & Mental Health 2010;14(8):900–904. [doi: 10.1080/13607861003713158]
28. Raglio A, Bellelli G, Traficante D, Gianotti M, Ubezio MC, Villani D, et al. Efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia. Alzheimer Disease & Associated Disorders 2008;22(2):158–162. [doi: 10.1097/WAD.0b013e3181630b6f]
29. Remington R. Calming music and hand massage with agitated elderly. Nursing Research 2002;51(5):317–323. [doi: 10.1097/00006199-200209000-00008]
30. Ridder HMO, Stige B, Qvale LG, Gold C. Individual music therapy for agitation in dementia: an exploratory randomized controlled trial. Aging & Mental Health 2013;17(6):667–678. [doi: 10.1080/13607863.2013.790926]
31. Sung H, Chang AM, Abbey J. The effects of preferred music on agitation of older people with dementia in Taiwan. International Journal of Geriatric Psychiatry 2006;21(10):999–1000. [doi: 10.1002/gps.1585]
32. Sung H, Chang S, Lee W, Lee M. The effects of group music with movement intervention on agitated behaviours of institutionalized elders with dementia in Taiwan. Complementary Therapies in Medicine 2006;14(2):113–119. [doi: 10.1016/j.ctim.2006.03.002]
33. Sung H, Lee W, Li T, Watson R. A group music intervention using percussion instruments with familiar music to reduce anxiety and agitation of institutionalized older adults with dementia. International Journal of Geriatric Psychiatry 2012;27(6):621–627. [doi: 10.1002/gps.2761]
34. Kim MR, Lee SJ, Shin AY, Kim SR. A review of the trends of nursing research on dementia in Korea. Journal of the Korean Gerontological Society 2013;33(4):895–910.
35. Ueda T, Suzukamo Y, Sato M, Izumi S. Effects of music therapy on behavioral and psychological symptoms of dementia: a systematic review and meta-analysis. Ageing Research Reviews 2013;12(2):628–641. [doi: 10.1016/j.arr.2013.02.003]
36. Vink AC, Bruinsma MS, Scholten RJPM. Music therapy for people with dementia. Cochrane Database of Systematic Reviews 2003;(4):1–48. [doi: 10.1002/14651858.CD003477.pub2]
37. McDermott O, Crellin N, Ridder HM, Orrell M. Music therapy in dementia: a narrative synthesis systematic review. International Journal of Geriatric Psychiatry 2013;28(8):781–794. [doi: 10.1002/gps.3895]
TOOLS
Similar articles

Effects of Aromatherapy on Agitation in Patients with Dementia: A Systematic Literature Review and Meta-analysis

Effects of Reminiscence Therapy on Depressive Symptoms in Older Adults with Dementia: A Systematic Review and Meta-Analysis

Stimulation-Oriented Interventions for Behavioral Problems among People with Dementia: A Systematic Review and Meta-Analysis

A Meta-Analysis of the Variables related to Agitation in Patients with Dementia

An Introduction of the Systematic Review and Meta-Analysis