tailored music therapy for dementia

Conditions: Alzheimer Dementia; Dementia, Vascular; Dementia, Lewy Body; Dementia Parkinson's Disease

Summary: this study evaluates the effect and process of individualized music therapy for home-dwelling persons with mild to moderate dementia. the music therapy is administered individually and includes a close caregiver. memory of familiar music is found to be retained in persons with dementia. it is assumed to facilitate autobiographical memories and stimulate interaction with significant others. based on time series analyses we will use statistical process control to evaluate when and how change occur.

dementia is often followed by complicating symptoms such as anxiety, depression, agitation, hallucination and sleep disorders. the progression of dementia can threaten the relationship between the person with dementia (pwd) and their relatives. one reason is the possible loss of reciprocity and a mutual supportive relationship. this may influence the quality of life in both the pwd and their relatives and increase the caregiver-burden. the music therapy in this intervention is focusing on increasing positive emotions, increasing reciprocity and stimulating communication. the 1st, 5th and 10th music therapy-session is video-recorded. the first 5 recorded minutes before the sessions will provide a baseline of the observed primary outcomes throughout the session. videos are analyzed to examine changes in social communication behavior and emotional well-being. time-series analysis of the observations will be conducted, enabling us to evaluate potential effects of the therapeutic interventions and to find out when, why and to what extent changes unfold in real time. the pre-post measures are secondary. the project is a merging and further development of two recent music therapy designs. (articles cited in the references.)

Eligibility criteria:
inclusion criteria: * the patient is diagnosed with dementia of the alzheimer's type, vascular dementia, dementia with lewy bodies, parkinsons's disease dementia (icd-10 criteria) * the severity of the cognitive impairment is within the range of 0,5 - 2 when assessed with the clinical dementia rating scale (cdr) * a caregiver chosen by the patient commits to involvement in the treatment as a collateral (i.e. spouse, child, grandchild, sibling, close friend) * use of psychotropic medication has been stable during the past 2 weeks * the pwd is able to answer simple self-report questionnaires on their own or when interviewed by a trained professional * informed consent is obtained from patients and caregiver * the pwd's are living in their home, in assisted living facilities or only periodical living in care homes. exclusion criteria: * severe dementia(a score of 3\> on cdr). * severe aphasia * frontotemporal dementia * comorbid diagnosis of bipolar disorder, diagnosis of schizophrenia and related disorders * changes in psychotropic medications in the past 2 weeks. if so, the medication needs to be stable before pre-assessment is undertaken * severe psychotic symptoms or serious risk of suicide * permanent living arrangement in nursing home, or planned temporary stay during the treatment period