The short-term impact of music interventions on stress: Results of a multinational cluster-randomized trial using salivary cortisol and alpha-amylase assessments in care home residents with dementia

Objective

Stress can have a negative impact on well-being and quality of life in people with dementia. Our study explored the effect of music as a potentially stress-reducing strategy in care home residents with dementia and depression of 25 care home units included in the multinational cluster-randomized controlled trial Music Interventions for Dementia and Depression in Elderly care (MIDDEL). Methods: Group music therapy consisted of singing well-known songs and reminiscence in small groups, optionally improvising on instruments and moving to music. Choir singing consisted of rehearsing well-known and new songs in larger groups of 10 + participants. During month 1, 3, and 6, saliva samples were collected 10 min before and 15 and 60 min after a session of group music therapy (n = 55), recreational choir singing (n = 72) or a book reading (n = 56) in 183 care home residents, along with a stress visual analogue scale. Results: Of 1014 saliva samples collected, 671 (66 %) were valid for alpha-amylase assay and 633 samples (62 %) for cortisol assay. Significant pre/post session changes were found for salivary cortisol, alpha-amylase, and subjective stress within study arms, although no significant difference was found between study arms. Conclusion: Group interventions, including music therapy, can have a positive impact on stress levels in care home residents with dementia. The level or intensity of participation required from the person with dementia may play a role in the impact of music on stress. Findings indicate it is feasible to collect saliva in persons with dementia non-invasively. Future studies in this population should consider strategies to improve validity of data, such as stimulating saliva flow. ClinicalTrials.gov registration NCT03496675.