Non-pharmacological management in dementia: Music therapy

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Date
2016
Authors
Nason, Amelia R.
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Background: Behavioural and psychiatric symptoms of dementia (BPSD) represent a significant problem in the aging population. Management is challenging and involves pharmacologic and non-pharmacologic modalities. With the accumulating evidence of the adverse effects associated with the use of psychotropic medication in the elderly population, non-pharmacological interventions have become first-line therapy. This paper will provide an outline of current management of dementia, and review the current literature on music therapy as a non-pharmacological intervention for BPSD. Method: A literature search was conducted using the online databases Embase, Scopus, and PsycInfo. Articles were chosen using specific inclusion and exclusion criteria. 10 relevant randomized controlled trials were identified and reviewed. Results: The methods for delivery of music therapy varied between studies. All studies reviewed show a positive effect in one or more psychiatric and behavioural symptoms with individualized or group music therapy. Significant reductions BPSD after music therapy intervention were observed in all but one study. Conclusion: Due to the methodological limitations and heterogeneity of the studies reviewed in terms of outcome measures and delivery of music therapy, it is not possible to confidently draw conclusions on the effectiveness of music therapy in reducing BPSD. However, the findings are encouraging, and support further evaluation of this noninvasive and inexpensive tool using improved study designs. The overwhelming evidence of adverse effects associated with pharmacological therapy in dementia makes scientific development of innovative and sustainable approaches to manage BPSD imperative.
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