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Music Therapy

Music therapy aims to help and support people to express themselves, explore their feelings and bring about positive change through music. A trained music therapist works with people with dementia to reduce their anxiety and restlessness (agitation) and to improve the confidence and wellbeing of themselves and/or their family carer.

Key points from the research:

  • a structured programme of music therapy, given by a trained therapist, can help to reduce agitation and depression
  • music therapy can provide an opportunity for people with dementia to meet and talk to others and express their personality
  • there is still relatively little research evidence about the effects of music therapy. Further research is needed to find out if music therapy offers value for money (is cost-effective), whether it works in the long-term and if it works for people with severed dementia.

Evidence Snapshot

Does it work for people with dementia?

Agitation
Cognition
Depression
Quality Of Life (self-rated)
Quality Of Life (proxy Rated)

Strength of evidence

Implemented in the UK?

What is Music Therapy?

In this summary we focus on music therapy as described by the British Association for Music Therapy (BAMT, 2012).

The therapy sessions are planned and structured and led by a trained music therapist. They include a variety of activities such as:

  • listening to well known popular songs
  • listening to music with the therapist
  • singing, clapping and feet tapping with other group members
  • playing musical instruments
  • dancing and moving to music

Music therapy can be in a group or a one-to one session depending on what is best for the individual. In the studies looked at for this summary the sessions usually took place two to three times a week and were between 30 – 90 minutes long. The length of the music therapy course varied but they all ran for less than a year. Some of the courses included family carers or care home staff but others were just for people with dementia.

Why is Music Therapy important?

People with dementia can experience depression, anxiety and agitation. This can be challenging and distressing for the person and stressful for the people caring for them.

Drug treatments can have side effects so it is important to explore other approaches for reducing these symptoms. (1) Music therapy provides an opportunity for people with dementia to see and talk to other people and to express their personality. (2)

Does Music Therapy work?

People with dementia

We looked at three reviews of research (we call these systematic reviews) on music therapy. (1,3,4) and three individual research studies. (2,5,6) The evidence on the impact of music therapy is growing.

People taking part in the research usually had mild or moderate dementia and lived in a care home although some lived in their own home with a family carer.

The findings of the research were mixed and this may reflect that most studies were very small and did not use robust methods. Most, but not all, of the studies found that music therapy was successful in reducing agitation(3,4,5) and symptoms of depression(2,5,4) in the short term. There has not been any research on the difference made in the longer term (more than four months).

Other studies looked at whether music therapy made a difference to the quality of life of the person with dementia and found that it made no difference(2,6). Of the studies that looked at whether it made a difference to memory and thinking (cognitive) skills(5,4), some found significant improvements and other studies no difference.

People with dementia and the people caring for them were enthusiastic about taking part in music therapy and attendance figures were good. (2)  

However, music therapy will not work for everyone. How well it works for an individual will depend on many different things including their personal preferences, other people involved and the setting and environment.

More research is needed to understand the effect of music therapy on people with more advanced dementia and the longer term impact of music therapy

Family carers?

Music therapy did not make a difference to the anxiety, depression, quality of life, carer burden or self-reported health of family carers. (4,2)

Is Music Therapy cost-effective?

There is little evidence on whether music therapy offers good value for money (is cost effective). However, one study did suggest that music therapy could be one of the most cost-effective ways to reduce agitation in people with dementia. (1)

The cost of music therapy for health and social care providers.

Music therapy is an inexpensive intervention, particularly when it is given to a group. We didn’t find any UK studies that reported the cost of an individual session however on the websites of various music therapists charges were between £40 – £45 per session in 2016.

What people say about Music Therapy?

Meet Kath and watch what music therapy means to her:

https://www.youtube.com/watch?v=SwT8J_fNUO4

Find out what Chris thinks about music therapy:

https://soundcloud.com/dementia-diaries/on-a-thursday-we-have-music-for-memory-which-is-my-favourite

One of the studies we looked at asked people with dementia for feedback after each session and also asked their family carers to keep a weekly diary (2)

Here are some of the comments from people with dementia who took part in the music therapy sessions:

‘I thought I probably can’t sing but when you do it with others it makes a tremendous difference’ (p.167)

‘I thought it was wonderful. . . we just enjoyed it and by the look of the faces on the others they did too’ (p.167)

‘I liked learning new songs best’ (p.167)

People with dementia commented on the changes that they noticed since taking part in the sessions

‘I play a lot now, I listen to more music’ (p.167)

and changes in their family carer

‘My husband now puts on the radio (he didn’t do that before)’ (p.167)

Family carers said:

‘It was very relaxing, no one was left out. We were all taking part, no matter if we could sing or not’ (p.168)

‘The other thing I liked about the group was that it was a group of people with dementia and carers but the dementia was not the focus. It enabled me to see people in a sort of natural setting that were clearly involved, engaged, coping and comfortable with each other’ (p.168)

Find out more about Music Therapy

Further research

There is not much evidence on the impact of music therapy on people with severe dementia or on family carers. A lot of the research uses questions that are different from those asked in studies of other interventions for people with dementia. This makes it difficult to compare how well music therapy works compared to other interventions.

There is also not enough evidence on if music therapy offers value for money (is cost-effective).

The following organisations have information on where music therapy is available in the UK:

British Association for music therapy (BAMT): Music therapy in the UK

http://www.bamt.org/music-therapy/music-therapy-in-the-uk.html

Harmony Music therapy Scotland

http://www.harmonymusictherapyscotland.co.uk/

Soundwell music therapy trust (a specialist mental health music therapy charity) http://www.soundwell.org/

Music therapy Lambeth

http://www.musictherapylambeth.org.uk/?gclid=CILKldnuq8wCFQae2wodZgIHMQ

Find out more about organisations that have information or offer support to people with dementia and their families.

Study

Livingston et al (2014a)

HTA report, Systematic review and economic analyses

Does it Work for People with Dementia?

Agitation

Does it Work for Carers?

Strength of Evidence

Study

Livingston et al (2014b)

Systematic review and meta-analysis, 47-306 participants

Does it Work for People with Dementia?

Agitation

Does it Work for Carers?

Cost Effectiveness

Strength of Evidence

Study

Chu et al (2014)

RCT, 104 participants, Taiwan

Does it Work for Carers?

Cost Effectiveness

Strength of Evidence

Study

Camic et al. (2013)

Before & after, pilot study, 20 participants (10 pairs), UK

Does it Work for Carers?

Cost Effectiveness

Strength of Evidence

Study

Ridder et al (2013)

RCT 42 participants Norway and Denmark

Does it Work for Carers?

Cost Effectiveness

Strength of Evidence

Study

McDermott et al (2012)

Systematic review

Cost Effectiveness

Strength of Evidence

References

1. Livingston, Gill; Kelly, Lynsey; Lewis-holmes, Elanor; Baio, Gianluca; Morris, Stephen; Patel, Nishma; 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, National Institute for Health Research; 2014,

2. Camic P. M., Williams C. M., Meeten F., Does a 'Singing Together Group' improve the quality of life of people with a dementia and their carers? A pilot evaluation study Dementia, SAGE Publications; 2011, 157-176

3. Livingston, G.; Kelly, L.; Lewis-holmes, E.; Baio, G.; Morris, S.; Patel, N.; et al. Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials The British Journal of Psychiatry, Royal College of Psychiatrists; 2014, 436-442

4. Mcdermott Orii, Crellin Nadia, Ridder Hanne Mette, Orrell Martin, Music therapy in dementia: a narrative synthesis systematic review Int J Geriatr Psychiatry, Wiley-Blackwell; 2012, 781-794

5. Chu, H.; Yang, C.-y.; Lin, Y.; Ou, K.-l.; Lee, T.-y.; O'brien, A. P.; et al. The Impact of Group Music Therapy on Depression and Cognition in Elderly Persons With Dementia: A Randomized Controlled Study Biological Research For Nursing, SAGE Publications; 2013, 209-217

6. Ridder Hanne Mette O., Stige Brynjulf, Qvale Liv Gunnhild, Gold Christian, Individual music therapy for agitation in dementia: an exploratory randomized controlled trial Aging & Mental Health, Informa UK Limited; 2013, 667-678

About this summary

Author: A-La Park

Edited by: Helen Hayes and Adelina Comas-Herrara

Thank you to Kath for sharing her experience of music therapy and to Chris from the Dementia Diaries project.

Summary First Published: Wednesday, August 3rd, 2016

Summary Last Updated: Wednesday, August 3rd, 2016

The support of the Economic and Social Research Council (ESRC) and National Institute for Health Research (NIHR) is gratefully acknowledged. The views expressed in this publication are those of the author(s) and not necessarily those of the ESRC, NIHR or Department of Health.