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Article pour les cliniciens

Effects of music participation for mild cognitive impairment and dementia: A systematic review and meta-analysis.



  • Dorris JL
  • Neely S
  • Terhorst L
  • VonVille HM
  • Rodakowski J
J Am Geriatr Soc. 2021 Sep;69(9):2659-2667. doi: 10.1111/jgs.17208. Epub 2021 May 18. (Review)
PMID: 34008208
Lire le résumé Lire résumé des données probantes Lire le texte intégral
Disciplines
  • Médecine familiale (MF)/Médecine générale (MG)
    Relevance - 6/7
    Intérêt médiatique  - 5/7
  • Médecine interne générale - Soins primaires
    Relevance - 6/7
    Intérêt médiatique  - 5/7
  • - Gériatrie
    Relevance - 6/7
    Intérêt médiatique  - 4/7
  • - Neurologie
    Relevance - 5/7
    Intérêt médiatique  - 6/7

Résumé (en anglais)

OBJECTIVES: To examine randomized controlled trials with active music-making interventions, in which older adults with probable mild cognitive impairment (MCI) or dementia physically participate in music, and their effects on cognitive functioning, emotional well-being, and social engagement. Participating in music-making is engaging and has shown diverse benefits. Additionally, this review categorized the music activities of each intervention.

DESIGN: Systematic review and meta-analysis.

SETTING: Long-term care facilities, day centers, specialty outpatient units, and community.

METHODS: Published randomized controlled trials of active music-making interventions to support older adults with probable MCI or dementia were identified (to March 15, 2021) using searches on Medline (Ovid), APA PsycInfo (Ovid), CINAHL (Ebsco), and Embase (Elsevier). The outcomes were cognitive functioning, emotional well-being, and social engagement, including self- and clinician-reported measures such as the Mini-Mental State Examination, Positive and Negative Affect Schedule, and the Beck Depression Inventory. Studies were critically appraised and studies with similar methodology were meta-analyzed.

PARTICIPANTS: Older adults with probable MCI and mild or moderate dementia.

RESULTS: A total of 21 studies with 1472 participants were analyzed for potential effect sizes and intervention activities. Of the 21 studies, nine studies recruiting a total of 495 participants were used to produce a random-effects meta-analytic model for cognitive functioning. Music showed a small, positive effect on cognitive functioning; the combined standard mean difference for the experimental and control group was 0.30 (95% confidence interval [CI] 0.10, 0.51). There was low study heterogeneity, with an I2 of 24% (p = 0.004). Individual studies for emotional well-being in terms of quality of life and mood showed positive effect sizes, d = 1.08 and d = 1.74, respectively. [Corrections added on July 8, 2021, after first online publication: The preceding sentences were revised from: "… control group was 0.31 (95% confidence interval [CI] 0.10,0.52). There was low study heterogeneity, with an I2 of 25% (p = 0.004)."] CONCLUSION: This review shows that music-making has a small but statistically significant effect on cognitive functioning for older adults with probable MCI or dementia. Future music interventions can benefit from rigorous intervention protocols that isolate specific activities.


Commentaires cliniques (en anglais)

Family Medicine (FM)/General Practice (GP)

Solid meta-analysis that supports a small but positive impact of music on those with dementia or mild cognitive impairment.

Geriatrics

As a nonmedication intervention, music therapy may be considered as a first line treatment for cognitive decline, despite the small improvements seen in this review article.

Neurology

Meta-analysis showing small but statistically significant cognitive improvement with music performance.

Neurology

As a neurologist, I would have expected these results. The benefit of this article to me is that it provides evidence when I am asked to give an opinion or advice to my colleagues at our day centers.

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