Different Pattern of Emotional Benefits Induced by Regular Singing and Music Listening in Dementia

Finland 1 To the Editor: Behavioral and psychological symptoms of dementia (BPSD), such as depression and anxiety are highly prevalent symptoms in persons with dementia (PWDs) and represent one of the most complex, stressful, and costly aspects of dementia care 1. Previous studies have demonstrated that the capacity of music to evoke emotions and memories is often preserved even in severe Alzheimer's disease (AD) 2 and that music therapy or musical activities can enhance mood and social interaction in PWDs, although more evidence is still needed 3-5. In a recent randomized controlled trial (RCT) 6 , we compared the cognitive and emotional effectiveness of two types of caregiver-implemented musical activities, singing and music listening, to standard care in mild-moderate dementia. Both singing and music listening improved performance on the MMSE and attention and executive function tests as well as reduced depression symptoms indexed by the Cornell-Brown Scale for Quality of Life in Dementia (CBS) total score 6. Extending this study, our aim was to determine whether singing and music listening, which differ motorically, cognitively, and emotionally, would show a distinct pattern of emotional benefits on the subscales of the CBS. METHODS In the RCT 6 , 89 PWD-caregiver dyads were randomized to a Singing Group (SG), Music Listening Group (MLG), or Control Group (CG). Inclusion criteria were mild-moderate dementia, no prior severe psychiatric illness or substance abuse, stable medication, and physically able to participate. In the SG and MLG, the dyads participated in a 10-week intervention involving weekly small-group sessions (1.5 h per session) and home training, with a focus on coaching the caregivers to use either singing (SG) or listening (MLG) of familiar songs together with the PWD as a part of everyday care. The CG received standard care and continued with normal daily activities. All PWDs underwent neuropsychological testing, which included assessment of depression and quality of life (QoL), before (baseline) and after (follow-up 1) the intervention and six months post-intervention (follow-up 2). Eighty-four PWDs completed the study up to follow-up 1 and 74 up to follow-up 2. 2 Depression was assessed with the CBS 7 based on PWD interviews and informant reports. The CBS comprises 19 bipolar (rated from-2 to 2) items and five subscales measuring different depression 7. The data were analyzed using General Linear Models (GLM) with follow-up score as a dependent variable, group as a factor, and baseline score as a covariate. Post hoc …