Agitation in dementia is defined as “Inappropriate verbal, vocal, or motor activity unexplained by apparent needs or confusion. Agitated behaviors in dementia can be characterized as disruptive but nonaggressive (i.e., physical and verbal), socially inappropriate, or aggressive (hostile actions directed toward others, self, or objects)” (Tariot, 1999).
For clinicians, such as speech, occupational, and physical therapists, client agitation can be a speed bump in achieving therapeutic progress. It’s a frequent symptom of dementia (with prevalence rates of 20-80% depending on tools of assessment). Agitation can cause reduced engagement during rehabilitation sessions, while also causing lower quality of life for patients and families. PRN medications are often the go-to medical intervention despite limited evidence of efficacy, and reports are showing that those with dementia are often over medicated (Nørgaard, et al., 2017; Bergman, et al., 2007). Music is a much gentler way of reducing agitation and creating a safe environment for patients and their caregivers.
So, what can rehab therapists do?
Research is showing that music is one way to soothe the sympathetic nervous system while simultaneously improving quality of life. Music can inspire feelings of safety and familiarity as well as cue a relaxation response, so that you and your client can get back to working towards their goals.
A meta-analysis on the effect of music interventions on agitation by Pedersen et al. (2017) included 12 studies that showed a medium overall effect. This suggests robust clinical evidence to support using music in a therapeutic way for persons with dementia. Pedersen et al. defined music interventions as “the controlled use of music in a therapeutic setting to accomplish individualized goals within physiological, psychological, and emotional well-being during the treatment of an illness or disease.”
Whether you are a speech language pathologist, occupational therapist, or physical therapist, there are many ways that you can utilize music within your treatment sessions to reduce agitation, but the easiest way to find and use music effectively is with SingFit STUDIO Pro. SingFit’s technology and playlists are developed to enhance engagement for those with cognitive decline and use music as a dynamic part of therapy. That way you can address emotional health and reduce agitation at any time during the rehabilitation session and maximize your therapeutic progress.
Results from Pedersen’s et al. revealed that moderate to severe dementia saw the most benefit from music interventions, although those with mild to moderate dementia also saw benefit. (However, additional research is needed to conclusively state that music is more effective with those with moderate-advanced dementia). The mean effect size of the 12 studies included in this meta analysis: d = 0.61 with a 95% confidence interval (CI) of 0.38–0.84.
Key Takeaway: Music can reduce agitation for those with dementia! Music interventions often use personalized music, which you can easily find for each client with the SingFit STUDIO app.
Citations:
Bergman, A., Olsson, J., Carlsten, A., Waern, M., & Fastbom, J. (2007). Evaluation of the quality of drug therapy among elderly patients in nursing homes. Scandinavian journal of primary health care, 25(1), 9–14. https://doi.org/10.1080/02813430600991980
Pedersen, S. K., Andersen, P. N., Lugo, R. G., Andreassen, M., & Sütterlin, S. (2017). Effects of music on agitation in dementia: a meta-analysis. Frontiers in psychology, 8, 742. Link
Nørgaard, A., Jensen-Dahm, C., Gasse, C., Hansen, E. S., & Waldemar, G. (2017). Psychotropic Polypharmacy in Patients with Dementia: Prevalence and Predictors. Journal of Alzheimer's disease, 56(2), 707–716. https://doi.org/10.3233/JAD-160828
Tariot, P. N. (1999). Treatment of agitation in dementia. Journal of Clinical Psychiatry, 60, 11-20.