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 Music therapy might also improve emotional well-being among those
with dementia, researchers found. But they didn't find any benefits
when it came to cognition and behavioral issues such as agitation or
aggression, according to the report in the Cochrane Library journal.
Although the benefits of music therapy weren't large, "small effects
are valuable, too, because even a small improvement or maintaining a
certain level while otherwise a decline is expected is very
important for people with dementia and those caring for them," said
study leader Jenny van der Steen, a researcher with the department
of public health and primary care at Leiden University Medical
Center.
"These outcomes are closely linked to quality of life and may be
more relevant than improving or delaying decline in cognition for
the patients under study - mostly nursing home patients," van der
Steen said in an email.
For the analysis, van der Steen and colleagues pooled data from 21
smaller randomized trials involving a total of 1097 patients.
Patients in the trials received either music based therapies that
involved at least five sessions, or usual care or some other
activity with or without music.
Participants in the studies had dementia of varying degrees of
severity and the majority were residents in institutions. Seven of
the studies provided individual music therapy, while the others
delivered the intervention in a group setting.
The new findings could have a significant impact on dementia
patients, said Dr. Alexander Pantelyat, an assistant professor of
neurology at the Johns Hopkins University School of Medicine and
co-director of the Johns Hopkins Center for Music and Medicine.
"The alternative to these behavioral interventions is drugs with
black box warning labels saying that they increase the risk of
death," Pantelyat said. "The fact that they could be moderately
confident that music-based treatments could improve symptoms of
depression and overall behavioral problems would make this
actionable from my standpoint even though the number of studies was
low."
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It's not surprising that music therapy could help those with
dementia, Pantelyat said. "It's known that areas that process music
in the brain overlap with the emotional areas and those that process
language," he added. "If a song from somebody's youth is played it's
possible it will bring back memories associated with the first time
they heard it. And that speaks to the need for a tailored approach.
Not a 'one song fits all' approach."
Other research, in healthy volunteers, has shown that music taps
into the reward centers of the brain, Pantelyat said. "These are the
same areas of the brain, such as the nucleus accumbens, that are
activated by drugs such as cocaine," he added. "It's a very powerful
effect. And if you're motivated to continue to go back to a
personally meaningful song or genre, the benefits could potentially
be sustained for a long time."
The new findings highlight the need for more studies involving
larger groups of patients, said Dr. Borna Bonakdarpour, an assistant
professor of neurology at Northwestern University's Cognitive
Neurology and Alzheimer's Disease Center.
Bonakdarpour believes that music therapy can also be used to improve
social interactions. "We are doing some interventions here to see if
it can improve interactions between patients and caregivers," he
said. "We have preliminary data that suggests it helps."
Bonakdarpour also believes that music therapy might allow some
patients to skip powerful and risky medications. "For severe
psychiatric issues we will still have to use medications, but the
question is, can we (avoid) some of these medications that have side
effects that can sometimes be pretty significant," he said.
SOURCE: http://bit.ly/2KZpwAM Cochrane Database of Systematic
Reviews, online July 23, 2018.
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