Around 46% of residents in U.S. nursing homes have Alzheimer's or other dementias, and 13% of them are treated with antipsychotic medications, according to the National Partnership to Improve Dementia Care in Nursing Homes.
Antipsychotic medications that affect a person’s mental state have been widely prescribed for people living with dementia in nursing facilities to treat their behavioral (social) and psychological (mood) symptoms, though positive results are limited, and the drugs can come with serious side effects. George Mason University College of Public Health faculty are part of a growing group of researchers who are seeking therapeutic ways to improve the quality of life of these residents without medication.
New research, led by principal investigator Megumi Inoue, found that personalized music intervention is effective at reducing the use of antipsychotic and antianxiety medication, alleviating agitation levels, and enhancing mood and social engagement among residents.
Personalized playlists were developed based on family member suggestions regarding what songs, artists, and/or genres the participants listened to when they were around 15 to 25 years old, an age when more memories are available for potential recollection. Facility staff played the personalized playlists for the intervention group twice a week, aiming for at least 30 minutes each session, for four weeks. Participants in the control group continued their usual schedule during these four weeks.
“This study provides evidence that personalized music intervention can be used to manage distressing behavioral and psychological symptoms associated with dementia,” said Inoue, an associate professor in the Department of Social Work. "This low-cost, easily implementable intervention, requiring no special licensure for administration, can significantly enhance the quality of life for nursing facility residents
Overall, the intervention group experienced a decrease in average antipsychotic medication use after the intervention, and the control group, which did not receive any music, had an increase in medication use during the same time period. The observational data also revealed that this intervention can improve the mood of residents living with dementia and help them connect with others, while surveys from administrative staff and activity directors highlighted their positive views of the intervention.
“In addition to improving patients’ quality of life, this intervention can create an improved environment throughout the nursing home,” said Inoue. "For example, if personalized music helps reduce residents’ challenging symptoms, they will become easier to work with for direct care workers. In addition, the reduction of medications to treat residents’ psychological and behavioral symptoms will contribute to creating an overall safer facility because such medications have sedating effects that can cause falls."
She added, "Using the personalized music intervention may be perceived as extra work by some staff members, but ultimately, it can ease their work processes as its positive effects have indirect impacts on their work and facility environment."
“A Personalized Music Intervention in Nursing Home Residents Living With Dementia: Findings From a Randomized Study” was published online in the Journal for Applied Gerontology in June 2024. This research was supported by a Civil Money Penalty (CMP) Fund from the Centers for Medicare and Medicaid Services through the Virginia Department of Medical Assistance Services.
Additional authors include Emily S. Ihara, Catherine J. Tompkins, Shannon Layman, Sarah Nosrat, Morgan Moore, and Kimberly A. McNally from George Mason’s College of Public Health; Meng-Hao Li from George Mason’s Schar School of Policy and Government; Samreen Mehak from George Mason’s Department of Biology; George Mason alumna Kendall Barrett from Wise Mind Psychotherapy; and Catherine Magee from Paving the Way MSI.