Effects of #music participation for mild #cognitive impairment and #dementia: A systematic review and meta-analysis

To examine randomized controlled trials with active music-making interventions, in which older adults with probable mild cognitive impairment (MCI) or dementia physically participate in music, and their effects on cognitive functioning, emotional well-being, and social engagement. Participating in music-making is engaging and has shown diverse benefits. Additionally, this review categorized the music activities of each intervention.

Design
Systematic review and meta-analysis.

Setting
Long-term care facilities, day centers, specialty outpatient units, and community.

Methods
Published randomized controlled trials of active music-making interventions to support older adults with probable MCI or dementia were identified (to March 15, 2021) using searches on Medline (Ovid), APA PsycInfo (Ovid), CINAHL (Ebsco), and Embase (Elsevier). The outcomes were cognitive functioning, emotional well-being, and social engagement, including self- and clinician-reported measures such as the Mini-Mental State Examination, Positive and Negative Affect Schedule, and the Beck Depression Inventory. Studies were critically appraised and studies with similar methodology were meta-analyzed.

Participants
Older adults with probable MCI and mild or moderate dementia.

Results
A total of 21 studies with 1472 participants were analyzed for potential effect sizes and intervention activities. Of the 21 studies, nine studies recruiting a total of 495 participants were used to produce a random-effects meta-analytic model for cognitive functioning. Music showed a small, positive effect on cognitive functioning; the combined standard mean difference for the experimental and control group was 0.31 (95% confidence interval [CI] 0.10, 0.52). There was low study heterogeneity, with an I2 of 25% (p = 0.004). Individual studies for emotional well-being in terms of quality of life and mood showed positive effect sizes, d = 1.08 and d = 1.74, respectively.

Conclusion
This review shows that music-making has a small but statistically significant effect on cognitive functioning for older adults with probable MCI or dementia. Future music interventions can benefit from rigorous intervention protocols that isolate specific activities

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