Music Interventions for Dementia and Depression in Elderly Care

Music Interventions for Dementia and Depression in Elderly Care: International Cluster-randomised Controlled Trial

This study evaluates the effectiveness of two music-based approaches - group music therapy and recreational choir singing - for reducing depression symptoms in people living with dementia. It also examines mechanisms and heterogeneity of treatment effects.

Dementia and depression are highly prevalent and comorbid conditions in older adults and are associated with individual distress, substantial carer burden, and high societal costs.

Music interventions represent a highly promising type of non-pharmacological interventions for both dementia and depression in older adults. They are widely used, but have yet to be rigorously tested in large trials.

The MIDDEL trial is the largest trial of music interventions to date, and the first to compare different music-based interventions - group music therapy (GMT), and recreational choir singing (RCS) - alone and in combination across countries.

MIDDEL is designed as a large, pragmatic, international cluster-randomised controlled trial with a 2x2 factorial design that will compare the effects of GMT, RCS, both, or neither, for care home residents aged 65 years or older with dementia and depressive symptoms.

Study sites will be located in Australia and in five European countries, and a total of 100 care home units will be randomised to one of the four study conditions.

Inclusion Criteria:

• resident (full-time, 24h/day) at a participating care home;
• dementia as indicated by a Clinical Dementia Rating score of 0.5 or more and a Mini-Mental State Examination (MMSE) score of 26 or less;
• at least mild depressive symptoms, as indicated by a Montgomery-Åsberg Depression Rating Scale (MADRS) score of at least 8;
• a clinical diagnosis of dementia according to ICD-10 research criteria;
• have given written informed consent (may be assent by proxy for those unable to provide consent themselves).

Exclusion Criteria:

• diagnosis of schizophrenia or Parkinson's disease;
• severe hearing-impairment;
• in short-term care;
• unable to tolerate sitting in a chair for the duration of the sessions.