P-459 - Music therapy for the treatment of behavioural and psychological symptoms of dementia: a systematic literature review

It has been suggested that Music Therapy (MT) may be a suitable treatment modality for behavioural and psychological symptoms of dementia (BPSD). A Cochrane review in 2004 found the methodological quality of existing studies was generally poor, and better quality research was required. This review aimed to examine the evidence since 2004 to determine whether more rigorous studies have been published. A systematic review of the literature was conducted. MEDLINE, PsycINFO and the Cochrane Library were searched for randomized controlled trials (RCTs) of MT interventions in patients with dementia, between July 2004 and February 2011. Six studies, with 262 participants, reported outcomes in BPSD. The value of MT depends on intervention type and symptom targeted. Two studies evaluated interactive music interventions, focusing on patient-therapist relationships. Both showed significant reductions in BPSD (measured by the Neuropsychiatric Inventory), specifically improvements in delusions, agitation and anxiety. The remaining studies examined passive music listening interventions, with varied results. Two examined individual music listening programmes, showing significant improvements in anxiety, depression and physical agitation, but no effect on verbal agitation. Two others, looking at group therapy, also had mixed success. A music and movement intervention showed improvements in agitated behaviours. However, a group-singing programme had no significant effect on agitation/anxiety. The trials included in this review were high quality single-blind RCTs, leading to reduced bias and stronger evidence base. Although all studies reported positive effects from music, the most significant results came from interactive, targeted programmes, focusing on therapeutic relationships.