International Psychogeriatrics

Keep music live: music and the alleviation of apathy in dementia subjects

Clive Holmes a1c1, Andrew Knights a2, Christine Dean a1, Sarah Hodkinson a2 and Vivienne Hopkins a1
a1 School of Medicine, University of Southampton, U.K.
a2 School of Music, University of Southampton, U.K.

Article author query
holmes c   [PubMed][Google Scholar] 
knights a   [PubMed][Google Scholar] 
dean c   [PubMed][Google Scholar] 
hodkinson s   [PubMed][Google Scholar] 
hopkins v   [PubMed][Google Scholar] 


Background: A recent Cochrane report concluded that more and better quality research is required to investigate the effectiveness of music therapy in reducing problems in behavioral, social, emotional and cognitive domains in patients with dementia. This randomized placebo-controlled trial with blinded observer rater aimed to explore whether music, live or pre-recorded, is effective in the treatment of apathy in subjects with moderate to severe dementia.

Methods: Thirty-two subjects meeting ICD-10 diagnostic criteria for moderate to severe dementia and fulfilling diagnostic criteria for apathy were exposed to live interactive music, passive pre-recorded music or silence for 30 minutes. Each subject was randomized to 30-minute music or silent periods and was video recorded and the muted recording analyzed every 3 minutes using dementia care mapping to assess the quality of engagement to the blinded music intervention.

Results: Compared to low baseline levels of positive engagement (12.5%) in the silent placebo period, the majority of subjects (69%), regardless of dementia severity, showed a significant and positive engagement to live music. Engagement to pre-recorded music was non-significant, with just 25% of all subjects showing positive engagement. No subjects showed any evidence of experiencing a state of ill-being during either the live or pre-recorded music sessions.

Conclusions: During the intervention, live interactive music has immediate and positive engagement effects in dementia subjects with apathy, regardless of the severity of their dementia. Pre-recorded music is non-harmful but less clearly beneficial.

(Received January 9 2006)
(returned for revision March 21 2006)
(revised version received May 1 2006)
(Accepted May 2 2006)
(Published Online June 29 2006)

Key Words: music therapy; behavioral and psychological symptoms of dementia.

c1 Correspondence should be addressed to: Professor Clive Holmes, University of Southampton, School of Medicine, Clinical Neurosciences Division, Memory Assessment and Research Centre, Moorgreen Hospital, Botley Rd, West End, Southampton SO30 3JB, U.K. Phone: +44 023 8047 5216; Fax: +44 023 8046 3022. Email: