Melbourne Conservatorium of Music - Research Publications

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Author: Baker, Felicity × Author: Tamplin, Jeanette × End date: 2021 × Type: Preprint ×

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    Clinical Effectiveness of Music Interventions for Dementia and Depression in ELderly Care (MIDDEL) in Australia: Pragmatic Cluster-Randomised Controlled Trial
    Baker, F ; Lee, Y-E ; Sousa, TV ; Stretton-Smith, P ; Tamplin, J ; Sveinsdottir, V ; Geretsegger, M ; Wake, JD ; Assmus, J ; Gold, C ( 2021)
    Background: Dementia and depression are highly prevalent and comorbid conditions among older adults living in care homes, and are associated with individual distress and rising societal costs. Effective, scalable, and feasible interventions are needed. Different music interventions have shown promising effects, but the current evidence-base is inconclusive.

    Methods: We implemented a 2x2 factorial cluster-randomised controlled trial to determine whether 1) group music therapy (GMT) is more effective than standard care (SC) or 2) recreational choir singing (RCS) is more effective than SC, for reducing depressive symptoms and other secondary outcomes in people with dementia with mild to severe depressive symptoms living in residential aged care. Care home units with at least 10 residents were allocated to GMT, RCS, both GMT and RCS, or SC, using a computer-generated list with block randomisation (block size four). The protocolised interventions were delivered by music therapists (GMT) and community musicians (RCS). The primary outcome was Montgomery-Åsberg Depression Rating Scale score at 6 months, assessed by a masked assessor and analysed on an intention-to-treat basis using linear mixed-effects models, which examined the effects of GMT vs no-GMT and RCS vs no-RCS, as well as interaction effects of GMT and RCS. Trial registration: NCT03496675; ACTRN12618000156280.

    Findings: Between July 18, 2018, and November 26, 2019, 20 care home units were randomised (318 residents). Recruitment ceased in March 2020 due to COVID-19. The primary endpoint, available from 20 care home units (214 residents), suggested beneficial effects of RCS (mean difference: -4·25; 95% CI -7·89 to -0·62) but not GMT (mean difference -0·44; 95% CI -4·32 to 3·43). No related serious adverse events occurred.

    Interpretation: Our study supports implementing group singing as a clinically relevant therapeutic intervention in reducing depressive symptoms for people with dementia in the Australian care home context.

    Trial Registration: Trial registration: NCT03496675; ACTRN12618000156280.

    Funding: National Health and Medical Research Council, Australia.

    Declaration of Interest: We declare no competing interests

    Ethical Approval: Ethical approval was obtained from the Medicine and Dentistry Human Ethics Sub-Committee at the University of Melbourne, Australia (January 12, 2018, Ethics ID 1750400).