Individualized Music Program is Associated with Improved Outcomes for U.S. Nursing Home Residents with Dementia.

Author: Thomas KS1, Baier R2, Kosar C3, Ogarek J3, Trepman A4, Mor V5
Affiliation: <sup>1</sup>Center for Gerontology &amp; Healthcare Research, Brown University School of Public Health, Providence, RI; Center for Long-Term Care Quality &amp; Innovation, Brown University School of Public Health, Providence, RI; Providence Veterans Affairs Medical Center, Providence, RI. Electronic address: Kali_Thomas@Brown.edu. <sup>2</sup>Center for Gerontology &amp; Healthcare Research, Brown University School of Public Health, Providence, RI; Center for Long-Term Care Quality &amp; Innovation, Brown University School of Public Health, Providence, RI. <sup>3</sup>Center for Gerontology &amp; Healthcare Research, Brown University School of Public Health, Providence, RI. <sup>4</sup>Center for Long-Term Care Quality &amp; Innovation, Brown University School of Public Health, Providence, RI. <sup>5</sup>Center for Gerontology &amp; Healthcare Research, Brown University School of Public Health, Providence, RI; Center for Long-Term Care Quality &amp; Innovation, Brown University School of Public Health, Providence, RI; Providence Veterans Affairs Medical Center, Providence, RI.
Conference/Journal: Am J Geriatr Psychiatry.
Date published: 2017 Apr 14
Other: Pages: S1064-7481(17)30285-3 , Special Notes: doi: 10.1016/j.jagp.2017.04.008. [Epub ahead of print] , Word Count: 255


OBJECTIVES: The objective of this study was to compare resident outcomes before and after implementation of an individualized music program, MUSIC & MEMORY (M&M), designed to address the behavioral and psychological symptoms associated with dementia (BPSD).

SETTING: 98 nursing homes trained in the M&M program during 2013 and 98 matched-pair comparisons.

PARTICIPANTS: Long-stay residents with Alzheimer's disease and related dementias (ADRD) residing in M&M participating facilities (Nā€‰=ā€‰12,905) and comparison facilities (Nā€‰=ā€‰12,811) during 2012-2013.

INTERVENTION: M&M is a facility-level quality improvement program that provides residents with music specific to their personal histories and preferences.

MEASUREMENTS: Discontinuation of anxiolytic and antipsychotic medications, and reductions in behavioral problems and depressed mood in 2012 (pre-intervention) and 2013 (intervention), calculated using Minimum Data Set (MDS) assessments.

RESULTS: The proportion of residents who discontinued antipsychotic medication use over a 6-month period increased from 17.6% to 20.1% among M&M facilities, while remaining stable among comparison facilities (15.9% to 15.2%). The same trend was observed for anxiolytic medications: Discontinuation of anxiolytics increased in M&M facilities (23.5% to 24.4%), while decreasing among comparison facilities (24.8% to 20.0%). M&M facilities also demonstrated increased rates of reduction in behavioral problems (50.9% to 56.5%) versus comparison facilities (55.8% to 55.9%). No differences were observed for depressed mood.

CONCLUSIONS: These results offer the first evidence that the M&M individualized music program is associated with reductions in antipsychotic medication use, anxiolytic medication use, and BPSD symptoms among long-stay nursing home residents with ADRD.

Published by Elsevier Inc.

KEYWORDS: Alzheimer's disease; Music therapy; nonpharmacological intervention; nursing homes

PMID: 28483436 DOI: 10.1016/j.jagp.2017.04.008