Baker Felicity Anne, Pac Soo Vanessa, Bloska Jodie, Blauth Laura, Bukowska Anna A, Flynn Libby, Hsu Ming Hung, Janus Edyta, Johansson Kjersti, Kvamme Tone, Lautenschlager Nicola, Miller Hayley, Pool Jonathan, Smrokowska-Reichmann Agnieszka, Stensæth Karette, Teggelove Kate, Warnke Sven, Wosch Thomas, Odell-Miller Helen, Lamb Karen, Braat Sabine, Sousa Tanara Vieira, Tamplin Jeanette
Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia.
Centre for Research in Music and Health, Norwegian Academy of Music, Norway.
EClinicalMedicine. 2023 Oct 2;65:102224. doi: 10.1016/j.eclinm.2023.102224. eCollection 2023 Nov.
Music interventions provided by qualified therapists within residential aged care are effective at attenuating behavioural and psychological symptoms (BPSD) of people with dementia (PwD). The impact of music interventions on dementia symptom management when provided by family caregivers is unclear.
We implemented a community-based, large, pragmatic, international, superiority, single-masked randomised controlled trial to evaluate if caregiver-delivered music was superior to usual care alone (UC) on reducing BPSD of PwD measured by the Neuropsychiatric Inventory-Questionnaire (NPI-Q). The study included an active control (reading). People with dementia (NPI-Q score ≥6) and their caregiver (dyads) from one of five countries were randomly allocated to caregiver-delivered music, reading, or UC with a 1:1:1 allocation stratified by site. Caregivers received three online protocolised music or reading training sessions delivered by therapists and were recommended to provide five 30-min reading or music activities per week (minimum twice weekly) over 90-days. The NPI-Q severity assessment of PwD was completed online by masked assessors at baseline, 90- (primary) and 180-days post-randomisation and analysed on an intention-to-treat basis using a likelihood-based longitudinal data analysis model. ACTRN12618001799246; ClinicalTrials.govNCT03907748.
Between 27th November 2019 and 7th July 2022, we randomised 432 eligible of 805 screened dyads (music n = 143, reading n = 144, UC n = 145). There was no statistical or clinically important difference in the change from baseline BPSD between caregiver-delivered music (-0.15, 95% CI -1.41 to 1.10, p = 0.81) or reading (-1.12, 95% CI -2.38 to 0.14, p = 0.082) and UC alone at 90-days. No related adverse events occurred.
Our findings suggested that music interventions and reading interventions delivered by trained caregivers in community contexts do not decrease enduring BPSD symptoms.
Our funding was provided by National Health and Medical Research Council, Australia; The Research Council of Norway; Federal Ministry of Education and Research, Germany; National Centre for Research and Development, Poland; Alzheimer's Society, UK, as part of the Joint Programme for Neurodegenerative Diseases consortia scheme.
在老年护理机构中，由合格治疗师提供的音乐干预措施可有效减轻痴呆症患者的行为和心理症状（BPSD）。家庭护理人员提供音乐干预对痴呆症症状管理的影响尚不清楚。
我们开展了一项基于社区的大型务实国际优效性单盲随机对照试验，以评估护理人员提供的音乐干预在通过神经精神科问卷（NPI-Q）测量减少痴呆症患者BPSD方面是否优于单纯常规护理（UC）。该研究包括一个积极对照（阅读）。来自五个国家之一的痴呆症患者（NPI-Q评分≥6）及其护理人员（配对）被随机分配到护理人员提供的音乐组、阅读组或UC组，按1:1:1分配并按地点分层。护理人员接受治疗师提供的三次在线标准化音乐或阅读培训课程，并被建议在90天内每周提供五次30分钟的阅读或音乐活动（每周至少两次）。痴呆症患者的NPI-Q严重程度评估由盲态评估人员在基线、随机分组后90天（主要）和180天在线完成，并使用基于似然性的纵向数据分析模型在意向性分析基础上进行分析。澳大利亚新西兰临床试验注册号：ACTRN12618001799246；美国国立医学图书馆临床试验注册中心标识符：NCT03907748。
在2019年11月27日至2022年7月7日期间，我们将805对筛查配对中的432对符合条件的配对进行了随机分组（音乐组n = 143，阅读组n = 144，UC组n = 145）。在90天时，护理人员提供的音乐组（-0.15，95%CI -1.41至1.10，p = 0.81）或阅读组（-1.12，95%CI -2.38至0.14，p = 0.082）与单纯UC组相比，从基线BPSD的变化上没有统计学或临床重要差异。未发生相关不良事件。
我们的研究结果表明，在社区环境中，由经过培训的护理人员提供的音乐干预和阅读干预不会减轻持续性BPSD症状。
我们的资金由澳大利亚国家卫生与医学研究委员会、挪威研究理事会、德国联邦教育与研究部、波兰国家研究与发展中心、英国阿尔茨海默病协会提供，作为神经退行性疾病联合项目联盟计划的一部分。
