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Effects of Music Therapy on Cognitive function and Agitation, Anxiety and Depression in Dementia Elderly: a Systematic Review and Meta-analysis of Randomized Controlled Trials

음악요법이 치매노인의 인지기능, 초조행동, 불안 및 우울에 미치는 효과: 체계적 고찰 및 메타분석

  • Chai, Gong Ju (Department of Nursing, Hallym Polytechnic University) ;
  • Lee, Mi-Kyung (College of Nursing, Kangwon National University) ;
  • Nam, Eun Sook (College of Nursing, Kangwon National University) ;
  • Lee, Ho Yeon (Department of Nursing, Seoul Medical Center)
  • Received : 2020.11.30
  • Accepted : 2021.01.08
  • Published : 2021.01.31

Abstract

Objectives: This study aimed to identify the effects of music therapy on cognitive function, agitation, anxiety and depression in the elderly with dementia. Method: A comprehensive literature search was performed on PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, Google scholar and PsycINFO, for the period 2010 to 2019. In the meta-analysis, the standardized mean difference (Hedges' g) and 95% confidence interval were calculated as summary measure, and the random effect model and inverse variance method were applied using the RevMan 5.4 program. A total of 13 studies were included; all were determined to be acceptable, based on the Cochrane collaboration's tool for assessing risk of bias. Results: The effect size (Hedges' g) was 0.31 (95% CI: -0.02, 0.65) for cognition and -0.03 (95% CI: -0.17, 0.11) for agitation behavior as the primary outcomes, and 0.61 (95% CI: -1.17, -0.05) for anxiety and -0.44(95% CI: -0.88, 0.00) for depression as the secondary outcomes. Subgroup analysis by type of music intervention revealed that combined music therapy has a significantly increasing beneficial effect on cognition of dementia patients (g=0.45[95% CI: 0.03, 0.87]). Conclusion: Music therapy was determined to exert beneficial effects in reducing anxiety and depression, and combined music therapy demonstrated improved cognitive functions in elderly patients with dementia.

목표: 본 연구는 음악요법이 치매 노인의 인지기능, 초조행동, 불안, 우울에 미치는 영향을 규명하는 것을 목적으로 한다. 방법: 2010년부터 2019년까지 PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, Google scholar, PsycINFO에서 종합적인 문헌검색을 하였고 메타분석에서는 RevMan 5.4 프로그램을 사용하여 표준화된 평균 차이(Hedge's g)와 95% 신뢰 구간은 요약 측정으로 산출하고 랜덤 효과 모델과 역분산 방법을 적용하였다. 총 13개의 연구가 포함되었으며, 모두 오류 위험 평가를 위한 코크란 평가도구를 근거로 질 평가를 하였다. 결과: 효과 크기(Hedge's g)는 1차 결과 변수인 인지기능 0.31[95% CI:-0.02, 0.65], 초조행동 -0.03[95% CI: -0.17, 0.11], 2차 결과 변수인 불안 -0.61[95% CI: -1.17, -0.05], 우울 -0.44[95% CI: -0.88, 0.00]이었다. 음악중재 유형별 하위그룹 분석 결과 복합음악요법이 치매 환자의 인지기능(g=0.45[95% CI: 0.03, 0.87])에 유의한 증가 효과가 있는 것으로 나타났다. 결론: 음악요법은 불안과 우울을 감소시키는 데 유의한 효과를 보였으며, 복합음악치료는 치매 환자의 인지기능 개선 효과를 보였다.

Keywords

References

  1. Central Dementia Research Center, Dementia Guidebook 'That gives me strength', Ministry of Health and Welfare Center, Korea, p 6-11, 2020.
  2. M. Wortmann, "Dementia: a global health priority - highlights from an ADI and World Health Organization report", Alzheimers Resarch & Therapy. Vol.4, No. 5, p. 40, Published online 2012 Sep 21. DOI: https://doi.org/10.1186/alzrt143
  3. J. S. Lee, M. J. Kang, H. J. Nam, Y. J. Kim, O. J. Lee et al, Korean Dementia observatory 2019, Central Dementia Research Center, Korea, pp 3-140, 2019
  4. Alzheimer's Association,. "2017 Alzheimer's disease facts and figures", Alzheimer's & Dementia, Vol.13, No.4, pp. 325-373, 2017. DOI: https://doi.org/10.1016/j.jalz.2017.02.001
  5. S. Y. Ho, H, L. Lai, S. Y, Jeng, C.W. Tang, H. C. Sung, P. W. Chen, "The effects of researcher- composed music at mealtime on agitation in nursing home residents with dementia", Archives of Psychiatric Nursing, Vol.25, No.6, pp. 49-55, 2011. doi: https://doi.org/10.1016/j.apnu.2011.08.006
  6. M. Takeda, T. Tanaka, M. Okochi, H. Kazui, "Non‐ pharmacological intervention for dementia patients", Psychiatry and Clinical Neurosciences, Vol.66, No.1, pp. 1-7, 2012. DOI: https://doi.org/10.1111/j.1440-1819.2011.02304.x
  7. Y. Zhang, J. Cai, L. An, F. Hui, T. Ren, H. Ma, Q. Zhao, "Does music therapy enhance behavioral and cognitive function in elderlydementia patients? A systematic review and meta-analysis", Ageing research reviews, Vol.35, pp. 1-11, 2017. DOI: http://dx.doi.org/10.1016/j.arr.2016.12.003
  8. G. M. Gomez, G. J. Gomez, "Music therapy and Alzheimer's disease: cognitive, psychological and behavioural effects", Neurologia, Vol.32, No.5, pp. 300-308, 2017. http://dx.doi.org/10.1016/j.nrl.2015.12.003
  9. C. Meyer, F. O'Keefe, "Non-pharmacological interventions for people with dementia: a review of reviews", Dementia. Vol.19, No.6, pp. 1927-1954. 2018. DOI: https://doi.org/10.1177/1471301218813234
  10. H. Chu, C.Yang, Y. Lin, .,K. Ou, T.Lee, 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, Vol.16, No.2, pp. 209-217, 2014. DOI:https://doi.org/10.1177/1099800413485410
  11. I. S. Hong, M. J. Choi, "Songwriting oriented activities improve the cognitive functions of the aged with dementia", Arts in Psychotherapy, Vol.38, No.4, pp. 221-228, 2011. DOI: https://doi.org/10.1016/j.aip.2011.07.002
  12. M. Satoh, T. Yuba, K. Tabei, Y. Okubo, H. Kida et al, "Music therapy using singing training improves psychomotor speed in patients .with alzheimer's disease: A neuropsychological and fMRI study", Dementia and Geriatric Cognitive Disorders Extra, Vol.5, No3, pp. 296-308, 2015. https://www.karger.com/Article/FullText/436960 https://doi.org/10.1159/000436960
  13. A. Raglio, D. Bellandi, P. Baiardi, M. Gianotti, M. C. Ubezio et al, "Effect of active music therapy and individualized listening to music on dementia: A multicenter randomized controlled trial", Journal of the American Geriatrics Society, Vol.63, No.8, pp. 1534-1539, 2015. DOI:https://doi.org/10.1111/jgs.13558
  14. H. M. Ridder, B. Stige, L. G. Qvale, C. Gold, "Individual music therapy for agitation in dementia: An exploratory randomized controlled trial', Aging & Mental Health, Vol.17, No.6, pp. 667-678, 2013. DOI:https://doi.org/10.1080/13607863.2013.790926
  15. A. R. Giovagnoli, V. Manfredi, L. Schifano, C. Paterlini, A. Parente et al, "Combining drug and music therapy in patients with moderate alzheimer's disease: A randomized study", Neurological Sciences, Vol. 39, No. 6, pp. 1021-1028, 2018. DOI:https://doi.org/10.1007/s10072-018-3316-3
  16. M. Sakamoto, H. Ando, A. Tsutou, "Comparing the effects of different individualized music interventions for elderly individuals with severe dementia", International Psychogeriatrics, Vol. 25, No. 5, pp. 775-784, 2013. DOI:https://doi.org/10.1017/S1041610212002256
  17. R. T. Ho, T. C. Fong, C. Y. Sing, P. H. Lee, A. B. Leung et al, "Managing behavioral and psychological symptoms in chinese elderly with dementia via group-based music intervention: A cluster randomized controlled trial", Dementia(London, England), Vol.18, No.8, pp. 2785-2798, 2018. DOI:https://doi.org/10.1177/1471301218760023
  18. C. Moreno-Morales, R. Calero, P. Moreno-Morales, C. Pintado, "Music therapy in the treatment of dementia: A systematic review and meta-analysis", Frontiers in Medicine, Vol. 7, pp. 1-11, 2020. DOI:https://doi.org/10.3389/fmed.2020.00160
  19. H. Li, H. Wang, C. Lu, T. Chen, Y. Lin et al, "The effect of music therapy on reducing depression in people with dementia: A systematic review and meta-analysis", Geriatric Nursing(New York, N.Y.), Vol. 40, No. 5, pp. 510-516, 2019. DOI: https://doi.org/10.1016/j.gerinurse.2019.03.017
  20. K. K. F. Tsoi, J. Y. C. Chan, Y. M. Ng, M. M. Y. Lee, T. C. Y. Kwok et all, Receptive music therapy is more effective than interactive music therapy to relieve behavioral and psychological symptoms of dementia: A systematic review and meta-analysis. Journal of the American Medical Directors Association, Vol. 19, No.7, pp. 568-576.e3, 2018 DOI:https://doi.org/10.1016/j.jamda.2017.12.009
  21. J. Higgins, S. Green, Cochrane Handbook for Systematic Reviews Interventions Version 5.1.0 [Updated March 2011]. The Cochran collaboration retrieved from http://www.cochrane handbook.org. DOI: https://doi.org/10.1002/jrsm.38
  22. M. Borenstein, L. V. Hedges, J. P. Higginests, H. R. Rothstein, Introduction to Meta-analysis. Chichester, UK: Willey .& Sons, 2009. DOI:http://dx.doi.org/10.1002/9780470743386
  23. S. D. Hwang, Meta-analysis Using R. seoul-Korea. Hakgisa Corp, 2015
  24. Y. Lin, H. Chu, C. Y. Yang, C.H. Chen, S. G. Chen et al, "Effectiveness of group music intervention against agitated behavior in elderly persons with dementia", International Journal of Geriatric Psychiatry, Vol. 26, No. 7, pp. 670-678, 2011. DOI:https://doi.org/10.1002/gps.2580
  25. Q. Tang, Y. Zhou, S. Yang, W. K. S. Thomas, G. D. Smith et al, "Effect of music intervention on apathy in nursing home residents with dementia", Geriatric Nursing, Vol.39, No.4, pp. 471-476, 2018. DOI:https://doi.org/10.1016/j.gerinurse.2018.02.003
  26. K. Thomas, R. Baier, C. Kosar, J. Ogarek, A. Trepman etc, "Individualized music program is associated with improved outcomes for US nursing home residents with dementia", American Journal of Geriatric Psychiatry, Vol.25, No.9, pp. 931-938, 2017. DOI:https://doi.org/10.1016/j.jagp.2017.04.008
  27. J. Thornley, H. Hirjee, A. Vasudev, "Music therapy in patients with dementia and behavioral disturbance on an inpatient psychiatry unit: Results from a pilot randomized controlled study", International Psychogeriatrics, Vol.28, No.5, pp. 869-871, 2016. DOI:https://doi.org/10.1016/j.jagp.2017.04.008
  28. Z. Wang, Z. Li, J. Xie, T. Wang, C. Yu, et al, "Music therapy improves cognitive function and behavior in patients with moderate alzheimer's disease", International Journal of Clinical and Experimental Medicine, Vol.11, No.5, pp. 4808-4814, 2018. 2018. http://www.ijcem.com/files/ijcem0048744.pdf
  29. J. Cohen, Statistical Power Analysis the Behavioral Sciences(2nd ed.), Hildale, New Jersey, United States. Lowence Erlbaum Associates: 1988.
  30. T. Ueda, Y. Suzukamo, M. Sato, S. Izumi, "Effects of music therapy on behavioral and psychological symptoms of dementia: A systematic review and meta-analysis", Ageing Research Reviews, Vol. 12, No. 2, pp. 628-641, 2013. DOI:https://doi.org/10.1016/j.arr.2013.02.003
  31. Y. S. Chang, H. Chu, C. Y. Yang, J. C. Tsai, M. H. Chung et al, "The efficacy of music therapy for people with dementia: A meta-analysis of randomised controlled trials", Journal of Clinical Nursing, Vol. 24, No.23-24, pp.3425-3440, 2015. DOI: https://doi.org/10.1111/jocn.12976