Pongan Elodie, Tillmann Barbara, Leveque Yohana, Trombert Béatrice, Getenet Jean Claude, Auguste Nicolas, Dauphinot Virginie, El Haouari Hanane, Navez Malou, Dorey Jean-Michel, Krolak-Salmon Pierre, Laurent Bernard, Rouch Isabelle
Memory Clinical and Research Center of Saint Etienne (CMRR) Neurology Unit, University Hospital of Saint Etienne, Saint Etienne, France.
Memory Clinical and Research Center of Lyon (CMRR), Hospital of Charpennes, University Hospital of Lyon, France.
J Alzheimers Dis. 2017;60(2):663-677. doi: 10.3233/JAD-170410.
Among non-pharmacological therapies, musical intervention is often used for patients with Alzheimer's disease (AD) and patients presenting chronic pain. However, their efficacy is still under debate.
Our aim was to determine the efficacy of choral singing versus painting sessions on chronic pain, mood, quality of life, and cognition in AD patients.
In this multicenter randomized controlled trial, 59 mild AD patients were randomized to a 12-week singing (SG; n = 31) or painting group (PG; n = 28). Chronic pain, anxiety, depression, and quality of life were assessed before, after, and 1 month after the sessions. Cognitive abilities were assessed before and after interventions. The evolution of these different measures was assessed with mixed linear models. The primary data analysis was by intention-to-treat, and completed by a 'per protocol' approach.
Both singing and painting interventions led to significant pain reduction (Time effect: F = 4.71; p = 0.01), reduced anxiety (Time effect: F = 10.74; p < 0.0001), improved Quality of Life (Time effect: F = 6.79; p = 0.002), improved digit span (F = 12.93; p = 0.001), and inhibitory processes (Time effect: F = 4.93; p = 0.03). Depression was reduced over time in PG only (Time x Group effect: F = 4.53; p = 0.01). Verbal Memory performance remained stable over time in SG, but decreased in PG (Time x group effect: F = 9.29; p = 0.004).
Findings suggest that singing and painting interventions may reduce pain and improve mood, quality of life, and cognition in patients with mild AD, with differential effects of painting for depression and singing for memory performance.
在非药物治疗中，音乐干预常用于阿尔茨海默病（AD）患者和慢性疼痛患者。然而，其疗效仍存在争议。
我们的目的是确定合唱与绘画课程对AD患者慢性疼痛、情绪、生活质量和认知的疗效。
在这项多中心随机对照试验中，59例轻度AD患者被随机分为12周的歌唱组（SG；n = 31）或绘画组（PG；n = 28）。在课程开始前、结束后和结束后1个月评估慢性疼痛、焦虑、抑郁和生活质量。在干预前后评估认知能力。使用混合线性模型评估这些不同测量指标的变化。主要数据分析采用意向性分析，并以“符合方案”方法完成。
歌唱和绘画干预均导致疼痛显著减轻（时间效应：F = 4.71；p = 0.01），焦虑减轻（时间效应：F = 10.74；p < 0.0001），生活质量改善（时间效应：F = 6.79；p = 0.002），数字广度改善（F = 12.93；p = 0.001），以及抑制过程改善（时间效应：F = 4.93；p = 0.03）。仅绘画组的抑郁随时间减少（时间×组效应：F = 4.53；p = 0.01）。歌唱组的言语记忆表现随时间保持稳定，但绘画组下降（时间×组效应：F = 9.29；p = 0.004）。
研究结果表明，歌唱和绘画干预可能减轻轻度AD患者的疼痛，改善情绪、生活质量和认知，绘画对抑郁有不同影响，歌唱对记忆表现有不同影响。
