The effects of music therapy intervention on agitation behaviors of Alzheimer's disease patients

Author(s): Pickettcooper, P. K.

Journal/Book: J Music Therapy. 1996; 33: 505 11TH St Se, Washington, DC 20003. Natl Assn Music Ther Inc. 2-18.

Abstract: The purpose of this study was to examine the effects of live music therapy on agitation behavior of Alzheimer's Disease (AD) patients during and after music therapy intervention. A second purpose was to determine if there was a difference in the effect of music therapy between those patients who had a musical background and those who did not. A third purpose was to examine if there was a difference between music therapists' and caregivers' post-music therapy agitation scores. Agitation behavior in this study was defined as overt behavior that indicates restlessness, hyperactivity, or subjective distress. The dependent measures included: (a) scores on the Agitation Behavior Scale, and (b) number of dosages of PRN medication. Subjects for this study were 20 residents, 17 females and 3 males, from four different facilities in the Northwest. Their age range was 70 to 96 (M = 82, SD = 6.57). The criteria for selection were: (a) A primary diagnosis of dementia with strong medical and behavioral indications that a post mortem examination would indicate the patients' presenting problems were the result of Alzheimer's disease, (b) the presence of agitation, (c) sufficient verbal ability to answer simple social and activity questions, and (c) the written consent of the patient's guardian or representative. Subjects, grouped by three or four, participated twice a week for 30 minutes for a total of five music therapy sessions, Caregivers having close contact with patients rated subjects' agitation behavior based on their observation of the subjects' behavior during the morning just prior to the beginning of music therapy (baseline). Music therapy sessions were videotaped for post-hoc agitation behavior analysis during music therapy, and for reliability purposes. Once music therapy sessions were over, subjects' behavior was observed for the next 20 minutes by a music therapist and a caregiver. In addition, subjects' charts were reviewed weekly to note the number of dosages of PRN medication administered each day of the week. The results of a two-factor analysis of variance with repeated measures show no effects with respect to music background (F-1 = 1.79, 9 = .20), but identify significant main effects of agitation behavior (F, = 16.33, p = .0001). Subsequent Fisher PLSD tests indicate that subjects appeared significantly more agitated before music therapy (M = 11.46) than during either of the two music therapy observations (M = 7.68 & M = 7.52, respectively) and after music therapy sessions (M = 8.37). No two-way interaction between music background and agitation behavior(f(3) = 1.34, p = .28) was noted. Results of an independent t test between music therapists and caregivers post-music therapy agitation scores indicate no significant differences between scores [t(78) = .67, p = .50]. Implications for music therapy practice are discussed.

Note: Article M Brotons, Willamette Univ, Salem, OR 97301 USA

Keyword(s): NURSING-HOME RESIDENTS; DEMENTIA; SCALE

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