Koger S M, Brotons M
Psychology, Willamette University, Willamette University, 900 State Street, Salem, OR 97302, USA.
Cochrane Database Syst Rev. 2000(3):CD001121. doi: 10.1002/14651858.CD001121.
While music/music therapy does not represent a treatment of dementia, its use is based on a possible beneficial effect on symptoms including social, emotional and cognitive skills and for decreasing behavioral problems of individuals with dementias. Thus, there are clear implications for patients' and caregivers' quality of life. However, quantification and documentation of the evidence of this effect is necessary. Professional music therapists are accountable for providing efficient, beneficial treatment. Furthermore, music therapists are responsible for assessing, designing and implementing music therapy treatments, monitoring client progress, and reformulating their practice according to data collected and new advancements in the field. If they wait until sufficient valid, empirical data on all aspects of a disability or music response are available before attempting to design a therapy session, they may well reach retirement age before even one client can be served. On the other hand, promulgating the efficacy of music therapy in general, or of specific music therapy techniques, in the absence of any substantiation other than intuition or tradition borders on professional recklessness.
To gather and evaluate the evidence for the effectiveness of music therapy for dementia symptoms.
All available sources of references were searched in March 2000 for randomised controlled trials of music therapy used as an intervention in dementia. The search terms included 'controlled trial or study, music, therapy, dementia, Alzheimer's, cognitive impairment' and derivatives of these.
The reviewers assessed the methodological quality of the studies available for inclusion. The criteria used are presence and adequacy of a control condition, independent assessment of patients' performance (ie standardized ratings carried out by a person other than the music therapist) and the number of participants (no fewer than three).
No randomised controlled trials, or trials with quantitative data suitable for analysis were found.
The research into music therapy to date has lacked methodological design rigour. However, the research evidence available provides sufficient grounds on which to justify further investigations into the use of music therapy in dementia patients. In this context, the reviewers discuss some of the issues and research from the studies that were considered for inclusion.
REVIEWER'S CONCLUSIONS: This review was not able to identify reliable empirical evidence on which to justify the use of music therapy as a treatment for dementia. However, the evidence available suggests that music therapy may be beneficial in treating or managing dementia symptoms, and the predominant conclusion of this review is the highlighting of the need for better designed studies of the intervention.
虽然音乐/音乐疗法并非痴呆症的一种治疗方法，但其应用基于对包括社交、情感和认知技能在内的症状可能产生的有益影响，以及用于减少痴呆症患者的行为问题。因此，这对患者及其护理人员的生活质量有着明显的影响。然而，有必要对这种影响的证据进行量化和记录。专业音乐治疗师有责任提供高效、有益的治疗。此外，音乐治疗师负责评估、设计和实施音乐治疗方案，监测患者的进展情况，并根据收集到的数据和该领域的新进展重新制定治疗方案。如果他们要等到获得关于残疾或音乐反应各方面的足够有效实证数据后才尝试设计治疗课程，那么在能够为哪怕一位患者提供服务之前，他们很可能已经到了退休年龄。另一方面，在除直觉或传统之外没有任何证据支持的情况下，宣扬音乐疗法的总体疗效或特定音乐治疗技术的疗效，近乎于职业上的鲁莽行为。
收集并评估音乐疗法对痴呆症状有效性的证据。
2000年3月检索了所有可用的参考文献来源，以查找将音乐疗法用作痴呆症干预措施的随机对照试验。检索词包括“对照试验或研究、音乐、疗法、痴呆、阿尔茨海默病、认知障碍”以及这些词的派生词。
评审人员评估了可供纳入研究的方法学质量。所使用的标准包括对照条件的存在和充分性、对患者表现的独立评估（即由音乐治疗师以外的人员进行的标准化评分）以及参与者的数量（不少于三人）。
未找到随机对照试验，或未找到适合分析的定量数据试验。
迄今为止对音乐疗法的研究缺乏方法学设计的严谨性。然而，现有的研究证据为进一步研究音乐疗法在痴呆症患者中的应用提供了充分的依据。在此背景下，评审人员讨论了一些被考虑纳入研究中的问题和研究情况。
本综述未能找到可靠的实证证据来证明将音乐疗法用作痴呆症治疗方法的合理性。然而，现有证据表明音乐疗法可能对治疗或管理痴呆症状有益，本综述的主要结论是强调需要对该干预措施进行设计更完善的研究。
