REVIEWING THE ROLE OF MUSIC IN THE MANAGEMENT OF AGITATION IN PEOPLE WITH ALZHEIMER'S DISEASE: CAN IT BE ADDED TO THE OCCUPATIONAL THERAPY TOOLKIT?

摘要

Purpose: This review explores the current use of music in the management of agitated behavioural symptoms of Alzheimer’s disease (AD) and dementia, the effects of music on these symptoms and the potential therapeutic use of music in the context of occupational therapy. Methods: A literature search was conducted using the keywords ‘Alzheimer’s disease’, ‘dementia’, ‘agitation’, ‘behavioural symptoms’, ‘music’ and ‘music therapy’. Databases searched were: Medline, CINAHL, Ovid, OTDBase, OT Seeker, PsychINFO and Cochrane Database of Systematic Reviews. Secondary sources were identified using a forward search from key articles. For inclusion, articles needed to be published in English and peer reviewed. Articles were restricted to those exploring music and/or music therapy for management of agitated behaviours in AD or dementia and have clinical relevance to occupational therapy. Databases were searched for articles between January 1990 and June 2010. Results: 32 articles were identified in the primary search. A total of 16 research based articles met criteria and are included in the review. One research article was published by an occupational therapist (Casby & Holm, 1994). In addition, eight literature reviews and one Cochrane review were identified. Publications excluded from this review included: two articles not available in English; seven articles exploring topics not relevant to the review; one article due to uncertainty if participants had dementia; and three articles not targeting agitation as an outcome of the intervention. Multiple authors have found substantial improvements in behavioural symptoms of dementia using musical interventions, although many of these studies have methodological limitations. Conclusions: Despite sufficient evidence to warrant the use of music as a creative, individualised and non-pharmacological strategy for the management of behavioural symptoms of AD, to date there is little documented evidence on the use of music by occupational therapists working in dementia care. The potential for music to improve participation and function in daily life, reduce caregiver stress and enhance wellbeing suggest music could substantially add to the occupational therapists tool kit.