In older people with cognitive impairment or mild or moderate dementia, active music-making therapy improves cognitive functioning by a small amount

Dorris JL, Neely S, Terhorst L, et al. Effects of music participation for mild cognitive impairment and dementia: A systematic review and meta-analysis. J Am Geriatr Soc. 2021 Sep;69(9):2659-67.

Review question

In older people who have probable cognitive (thinking) impairment or mild or moderate dementia, does active music-making therapy improve cognitive functioning and emotional well-being?

Background

Cognitive impairment and dementia are common in older adults. Progression of cognitive impairment and dementia may be reduced by exposing the brain to challenging mental activities. Active music-making may stimulate the brain, but it is not known whether it can help improve cognitive functioning.

How the review was done

The researchers did a systematic review of studies available up to March 2021. They found 21 randomized controlled trials that included a total of 1471 people.

Key features of the studies were:

• people were 65 years of age or older, with an average age between 69 to 88 years;
• people had mild cognitive impairment, probable dementia, mild or moderate dementia, or mild or moderate Alzheimer disease (people with severe dementia were excluded);
• active music-making therapies included rhythm-music and improvisation, reacting to a sound (e.g. hearing a drum) by clapping, singing, music therapy with gross and fine motor movements, playing percussion instruments, or music integrated with exercise;
• active music-making therapies were delivered by professionals;
• active music-making therapy sessions were 30 minutes to 2 hours long, 1 to 5 times per week for 4 to 40 weeks; and
• active music-making therapy was compared with usual care, medications, health education, listening to music, gymnastics, non-musical cognitive tasks or training, walking exercises, dance, self-directed activities, reading, yoga, or painting.

What the researchers found

Compared with control, active music-making therapy:

• improved global cognition (overall thinking) by a small amount; and
• did not clearly affect quality of life, mood, depression, or anxiety.

Conclusion

In older people with probable cognitive impairment or mild or moderate dementia, active music-making therapy improves cognitive functioning by a small amount.

Effect of active music-making therapy vs control in older people with cognitive impairment or dementia*

*Only the outcome that was clearly affected by active music-making therapy is reported here.