Some studies also looked to see whether there were any lasting effects four weeks or more after treatment ended. We had very little confidence in our results on anxiety and social interaction. We were less confident in our results on emotional well‐being including quality of life, overall behavioural problems, and cognition, but music‐based treatments may have little or no effect on these outcomes.
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From our results, we could be moderately confident that music‐based treatments improve symptoms of depression, but do not help with agitated or aggressive behaviour. First, we looked at outcomes immediately after a course of therapy ended. The quality of the trials and how well they were reported varied, and this affected our confidence in the results. Some trials compared music‐based treatments with usual care, and some compared it with other activities, such as cooking or painting. People with all severities of dementia were included. All of the people in the trials were living in care homes. We found seventeen trials to include in the review and we were able to combine results for at least some outcomes from 620 people. If we judged that the trials were similar enough, then we combined their results in order to estimate the effect of the treatment as accurately as possible. The trials had to have offered at least five sessions of treatment because we thought fewer sessions than this were unlikely to have much effect. The comparison groups might have had no special treatment, or might have been offered a different activity. We searched for trials in which people with dementia were randomly allocated to a music‐based treatment or to a comparison group, and in which any of the outcomes we were interested in were measured. thinking and remembering) problems in people with dementia. We were also interested in evidence about their effects on emotional, behavioural, social or cognitive (e.g. We wanted to see if we could find evidence that treatments based on music improve the emotional well‐being and quality of life of people with dementia. Other professionals may also be trained to provide similar treatments. Music therapists are specially qualified to work with individuals or groups of people, using music to try to help meet their physical, psychological and social needs. Therapy involving music may therefore be especially suitable for people with dementia. In the later stages of dementia it may be difficult for people to communicate with words, but even when they can no longer speak they may still be able to hum or play along with music. Dementia is often associated with emotional and behavioural problems and may lead to a reduction in a person's quality of life. People with dementia gradually develop difficulties with memory, thinking, language and daily activities. The evidence for all long‐term outcomes was also of very low quality. The quality of the evidence on anxiety and social behaviour was very low, so effects were very uncertain. We found moderate‐quality evidence that they reduce depressive symptoms (SMD −0.28, 95% CI −0.48 to −0.07 9 studies, 376 participants), but do not decrease agitation or aggression (SMD −0.08, 95% CI −0.29 to 0.14 12 studies, 515 participants). At the end of treatment, we found low‐quality evidence that music‐based therapeutic interventions may have little or no effect on emotional well‐being and quality of life (standardized mean difference, SMD 0.32, 95% CI −0.08 to 0.71 6 studies, 181 participants), overall behaviour problems (SMD −0.20, 95% CI −0.56 to 0.17 6 studies, 209 participants) and cognition (SMD 0.21, 95% CI −0.04 to 0.45 6 studies, 257 participants). All were at high risk of performance bias and some were at high risk of detection or other bias. The methodological quality of the studies varied.
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Most interventions involved both active and receptive musical elements. Five studies delivered an individual music intervention in the others, the intervention was delivered to groups of participants. Participants in the studies had dementia of varying degrees of severity, but all were resident in institutions.
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Sixteen studies with a total of 620 participants contributed data to meta‐analyses.