Non-pharmacological Care of Alzheimer's Disease: Benefice of Musical Interventions
Condition: Alzheimer's Disease (AD) and Related Disorders
MeSH terms: Alzheimer Disease
Study type: Interventional

Summary: 
      Cares of Alzheimer's disease (AD) and related disorders are presenting a real public health
      challenge. Because of the limited effectiveness of pharmacological treatments, there is a
      growing interest in care approach based on nonpharmacological treatments, such as musical
      interventions. Several lines of evidence suggest that musical interventions could improve
      behaviour, emotion and even cognition in patients with AD. However, very few studies respond
      to the methodological constraints required for clinical controlled trials carried out in well
      selected groups of patients. The efficiency of such care approaches is not scientifically
      proved yet and the impact of musical interventions has rarely been compared to another
      pleasant intervention, leaving open the question about the specific benefits of music in
      patients with dementia. The main goal of this research project is to demonstrate short and
      longer-term efficiencies and the specificity of musical interventions in dementia by
      investigating their effects not only in patients but also in familial and professional
      caregivers.
    

Detailed description: 
      To generalize previous results showing that non pharmacological therapy based on musical
      interventions improved emotional state in patients with severe AD to a larger sample of
      patients and to demonstrate the possible effects on caregivers, the investigators carried out
      a randomized controlled study with three parallel arms in institutionalized patients with
      severe AD (study 1) and in patients with mild AD leaving at home (study 2) to compare the
      impact of two interventions, a musical and a non-musical (cooking), to a control group
      (without any intervention). The control activity (cooking) was selected because it shares
      different features with music. Both interventions provide pleasure, are multisensory and may
      trigger old memories. In addition, both activities can be carried out in groups. A protocol
      consisting of various selected tests and questionnaires was used to assess the emotional,
      behavioural and cognitive abilities. Professional and familial caregivers also filled out
      other questionnaires to assess potential indirect benefits from both interventions on
      caregiver burnout and familial caregiver burden. Six assessments were proposed, two before,
      two during and two after interventions (follow-up) to respectively evaluate short and
      longer-term benefits of both interventions whereas test -retest effects will be controlled.
      Psychologists in charge to these assessments will be blind in regard to patients' group
      (musical versus cooking sessions, no intervention). Data were analyzed with methods from
      social psychology to decode non-verbal behaviours (e.g. visual contact) and emotional indexes
      in facial and verbal expressions and with methods from classical neuropsychology and from
      health domain. The collaboration between the two university teams from Lille and the special
      care unit (Pole EHPAD-USLD in Reims Hospital) provided complementary skills to this project
      that ensured its feasibility.
    

Intervention name(s): Musical intervention; Non-musical (cooking) intervention; Control with no intervention
Intervention type(s): Behavioral; Behavioral; Behavioral
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Double (Care Provider, Outcomes Assessor)
Primary purpose: Supportive Care