Rationale: In persons with dementia (PWDs), music-based interventions have shown positive
effects on emotional, behavioural and cognitive symptoms as well as on psychological
well-being and quality of life. Despite the evidence for the efficacy of music in PWDs,
many issues surround the practicalities of music interventions, especially regarding
their applicability, scalability, and optimization across the dementia care continuum.
Moreover, the individual factors affecting the treatment outcomes of music-based
interventions remain largely unexplored in dementia.
Aims: The purpose of this randomized controlled trial (RCT) is to determine the
applicability and clinical efficacy of conventional music therapy and digital music
rehabilitation for dementia in both home and care home settings. Specifically, the RCT
seeks to determine (i) can conventional music therapy (CMT) and digital music
rehabilitation (DMR) enhance or support cognitive function, mood, and quality of life in
dementia compared to standard care; (ii) how does the efficacy of CMT and DMR differ in
the different stages of dementia; and (iii) how do baseline demographic factors (e.g.,
age, gender, education), musical factors (musical background, music cognition) and neural
factors (e.g., extent of neuropathology, preservation of music networks) affect the
efficacy of the music interventions.
Methods: Participants are 192 PWDs across the dementia care continuum (PWDs with
mild-moderate dementia living at home and PWDs with moderate-severe dementia living in
care homes; N=96 each). Following a three-arm parallel-group RCT design, the PWDs living
at home and at care homes are randomized into three groups (CMT, DMR, standard care; N=32
each]. The CMT and DMR comprise passive and active engagement with music over 10 weeks
(2x60 min sessions/week), implemented either by a music therapist (CMT) or using a novel
digital music content service (DMR). To investigate the efficacy of the music
interventions, participants complete measures of cognitive functioning
(neuropsychological tests) and mood and quality of life (questionnaires, clinical
scales), which are assessed at three time points: baseline (pre-intervention), 3-month
stage (post-intervention) and 6-month stage (follow-up). Additionally, family member and
caregivers of PWDs are asked to answer questionnaires on the psychological well-being of
the PWD (informant-report) and themselves (self-report). To explore the individual
musical and neural factors that may affect the efficacy of music interventions,
participants also complete a musical assessment battery as well as electroencephalography
(EEG) and structural and functional MRI (s/fMRI) measurements at baseline.