Measuring Effects of Nondrug Interventions on Behaviors: Music & Memory Pilot Study
Journal of the American Geriatrics Society
BACKGROUND/OBJECTIVES: Most people with Alzheimer disease and related dementias will experience agitated and/or aggressive behaviors during the later stages of the disease. These behaviors cause significant stress for people living with dementia and their caregivers, including nursing home (NH) staff. Addressing these behaviors without the use of chemical restraints is a growing focus of policy makers and professional organizations. Unfortunately, evidence for nonpharmacological strategies for addressing dementia-related behaviors is lacking. DESIGN: Six-month, preintervention-postintervention pilot study. SETTING: US NHs (n = 4). PARTICIPANTS: Residents with advanced dementia (n = 45). INTERVENTION: Music & Memory, an individualized music program in which the music a resident preferred when she/he was young is delivered at early signs of agitation, using a personal music player. MEASUREMENTS: Dementia-related behaviors for the same residents were measured three ways: (1) observationally using the Agitation Behavior Mapping Instrument (ABMI); (2) staff report using the Cohen-Mansfield Agitation Inventory (CMAI); and (3) administratively using the Minimum Data Set-Aggressive Behavior Scale (MDS-ABS). RESULTS: ABMI score was 4.1 (SD = 3.0) preintervention while not listening to the music, 4.4 (SD = 2.3) postintervention while not listening to the music, and 1.6 (SD = 1.5) postintervention while listening to music (P < .01). CMAI score was 61.2 (SD = 16.3) preintervention and 51.2 (SD = 16.1) postintervention (P < .01). MDS-ABS score was 0.8 (SD = 1.6) preintervention and 0.7 (SD = 1.4) postintervention (P = .59). CONCLUSION: Direct observations were most likely to capture behavioral responses, followed by staff interviews. Nursing-home based, pragmatic trials that rely solely on available administrative data may fail to detect effects of nonpharmaceutical interventions on behaviors. Findings are relevant to evaluations of nonpharmaceutical strategies for addressing behaviors in NHs, and will inform a large, National Institute on Aging-funded pragmatic trial beginning spring 2019. J Am Geriatr Soc 67:2134-2138, 2019.
Music and Health Institute Terms
Agitation; Alzheimer's and Related Dementias; Behavioral State; Elderly; Interviews; Long-Term Care Facility; Music Listening; Neurodegenerative Disorders
Elderly; Elderly; Aggression; Alzheimer Disease; Homes for the Aged; Memory; Nursing Homes; Pilot Projects; Psychomotor Agitation; behavior; dementia; pragmatic clinical trials as topic
Quasi-Experimental Study; Quantitative Methods
McCreedy, E. M.; Yang, X.; Baier, R. R.; Rudolph, J. L.; Thomas, K. S.; and Mor, V., "Measuring Effects of Nondrug Interventions on Behaviors: Music & Memory Pilot Study" (2019). Research on Music and Dementia. 30.