Sukumar M, Thanneeru Suresh Kumar, Sutar Roshan Fakirchand, Sahu Anjan, Agrawal Amit
Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Indian J Palliat Care. 2024 Oct-Dec;30(4):296-303. doi: 10.25259/IJPC_23_2024. Epub 2024 Sep 25.
The older population is susceptible to dementia, Alzheimer's and depression. A growing elderly population poses a burden on caregivers and society. If their cognitive and psychological health is maintained, they may not need to depend on others for their needs, thereby reducing the burden on caregivers. This, in turn, may lead to a decrease in the necessity for consulting healthcare providers for psychological health, subsequently reducing the overall cost of healthcare. There are numerous options for improving cognitive and mental health in the elderly, one of which is music therapy (MT). In this systematic review, we aim to demonstrate the efficacy of MT in enhancing psychological health among the geriatric population afflicted with dementia and depression. A systematic search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across PubMed, Scopus, ScienceDirect, and Cochrane databases. The inclusion criteria were randomized controlled trials (RCTs) that explored the use of MT in elderly patients with or without depression, dementia, or Alzheimer's. Non-RCTs, retrospective and prospective observational studies, case reports, and case series were excluded. Out of 76 records identified, eight articles were selected for qualitative synthesis and three for meta-analysis. These studies, conducted between 2010 and 2020, involved a total of 605 subjects, with 330 receiving MT and the remainder serving as controls. The interventions varied in terms of music type, duration, and setting, with outcome measures including depression scales, quality of life assessments, and cognitive examinations. The meta-analysis of depression scores indicated a positive effect of MT, though a wide confidence interval warrants caution. The quality assessment revealed varying risks of bias, highlighting the need for further research to confirm the positive role of MT. In conclusion, MT emerges as a promising intervention, but it is accompanied by considerable limitations and heterogeneity among studies. This emphasizes the need for further RCTs that specifically address the identified limitations, including issues related to sample size, control group selection, and potential confounding factors. Conducting more robust research in these areas is crucial to establishing a clearer understanding of the therapeutic benefits of music in the elderly population.
老年人群易患痴呆症、阿尔茨海默病和抑郁症。老年人口的不断增长给护理人员和社会带来了负担。如果他们的认知和心理健康能够得到维持，他们可能无需依赖他人来满足自身需求，从而减轻护理人员的负担。这进而可能导致因心理健康问题咨询医疗服务提供者的必要性降低，从而减少医疗保健的总体成本。改善老年人认知和心理健康有多种选择，其中之一是音乐疗法（MT）。在本系统评价中，我们旨在证明音乐疗法在改善患有痴呆症和抑郁症的老年人群心理健康方面的疗效。我们按照系统评价和Meta分析的首选报告项目（PRISMA）指南，在PubMed、Scopus、ScienceDirect和Cochrane数据库中进行了系统检索。纳入标准为探索音乐疗法在患有或未患有抑郁症、痴呆症或阿尔茨海默病的老年患者中应用的随机对照试验（RCT）。非随机对照试验、回顾性和前瞻性观察性研究、病例报告和病例系列均被排除。在识别出的76条记录中，8篇文章被选入进行定性综合分析，3篇被选入进行Meta分析。这些研究在2010年至2020年期间开展，共涉及605名受试者，其中330名接受音乐疗法，其余作为对照。干预措施在音乐类型、时长和环境方面各不相同，结果测量包括抑郁量表、生活质量评估和认知检查。抑郁评分的Meta分析表明音乐疗法有积极效果，不过较宽的置信区间需要谨慎对待。质量评估显示存在不同程度的偏倚风险，这突出表明需要进一步研究以证实音乐疗法的积极作用。总之，音乐疗法是一种有前景的干预措施，但研究中存在相当多的局限性和异质性。这强调需要开展进一步的随机对照试验，专门解决已识别的局限性，包括与样本量、对照组选择和潜在混杂因素相关的问题。在这些领域进行更有力的研究对于更清楚地了解音乐对老年人群的治疗益处至关重要。
