A systematic review and meta-analysis of music therapy for the older adults with depression

The effects of psychosocial interventions on geriatric depression in the mainland of China: A systematic review and meta-analysis

BACKGROUND

The effectiveness of psychosocial interventions for geriatric depression across different treatment settings, regions, and comorbidities in China remains unclear. Therefore, we systematically reviewed studies geared towards reducing geriatric depression in China.

METHODS

Nine databases in Chinese or English from database were searched from inception through June 2024. Randomized controlled trials investigating psychosocial interventions on older adults with depression in China were included. The primary outcome was post-intervention depression measured by self-report instruments. Random-effect model was used to pool the overall effect size Hedge's g.

RESULTS

In 99 studies with a total of 9369 older adults with depression, psychosocial interventions were effective compared with control conditions (Hedges' g: -1·48 [95 % CI: -1·83 to -1·13]). Comorbidity with physical disease significantly affect the pooled effect size (without comorbidity: Hedges' g = -1.19, 95 % CI: -1.42 to -0.95; with comorbidity: Hedges' g = -2.06, 95 % CI: -2.97 to -1.14; p = 0.062), and heterogeneity was substantial (without comorbidity, I2 = 91·3 %, 95 % CI: 89·5 % to 92·7 %; with comorbidity, I2 = 94·3 %, 95 % CI: 93·1 % to 95·4 %). The quality of evidence according to the GRADE criteria was generally moderate.

LIMITATIONS

Significant heterogeneity among the studies reviewed was unavoidable, and the possible publication bias could lead to overestimation of the result.

CONCLUSION

Psychosocial interventions are significantly effective for treating geriatric depression in China regardless of the setting, region, or therapeutic orientation. Policies should support the development and implementation of psychosocial interventions in China, especially in community settings, to reduce disease burden.

'Excellent for mind,body and spirit': Participant, facilitator, and community stakeholder experiences of Music and Movement for Health

BACKGROUND AND PURPOSE

Arts-based interventions are an emerging area of interest in health research for older adults. Music and Movement for Health (MMH) is one such systematically developed interdisciplinary arts-based intervention designed to enhance health and wellbeing of older adults. The objective of this qualitative study was to explore the opinions and experiences of participants, facilitators, and community stakeholders of the MMH intervention.

MATERIALS AND METHODS

This embedded qualitative study was completed as part of a wider evaluation of the MMH intervention. A purposive sample of older adults who had completed MMH (n = 71), facilitators (n = 8) and community stakeholders (n = 4) participated in this study. Data were collected through a combination of focus groups and telephone/virtual interviews. Data were analysed using inductive thematic analysis.

RESULTS

Data analysis led to the generation of the overarching theme 'Positive ageing in place', which encompassed two themes: (1) 'Intersection of exercise and arts' and (2) 'Fostering a sense of belonging', and five subthemes. MMH was viewed as a unique arts-based intervention that combined participants' interest in music and dance and had many perceived physical and psychological benefits. Additionally, MMH provided routine and social opportunities to older adults, which were particularly valued in the aftermath of the COVID-19 pandemic.

CONCLUSION

The provision of exercise through the arts was enjoyable and, resultantly, desirable to many older adults, with perceived positive physical and psychosocial outcomes. Consequently, the use of arts-based interventions for health promotion and social opportunities among older adults warrants further investigation.

TRIAL REGISTRATION

ISRCTN35313497.

A meta-review of systematic reviews on the effectiveness of music therapy on depression, stress, anxiety and cognitive function in adult's with dementia or cognitive impairment

BACKGROUND

Subjective cognitive impairment has been reported to be associated with depressive symptoms, stress and anxiety in older people. This study examines the impact of music interventions on cognitive functioning, depression, anxiety, and stress for adults with dementia or cognitive impairment.

METHOD

We searched Academic Search Complete, CINAHL, Medline, and PsycINFO without restriction to date. Systematic reviews with or without meta-analysis of music interventions were included. Effect sizes were estimated using standardized mean difference (SMD), weighted mean difference (WMD), mean difference (MD), and Hedges g, as reported. Effect sizes were reported as 〈 0.1 = small effect to 〉 0.5 as large effect.

RESULTS

Twenty systematic reviews were included. There is evidence that music interventions can have effects on cognitive abilities compared to standard care, with a small to large decrease in anxiety.

CONCLUSION

Music interventions might have variable effects on improved cognitive functioning, depression, anxiety and stress.

How does group music therapy help in combating the anxiety and depression of dementia patients? A quasi-experimental investigation

This study looked at the effect of group music therapy on dementia patients' levels of feelings of depression and anxiety. Quasi-experiment was carried out (N = 121) in which patients were randomly divided into a control (N = 61) and an experimental group (N = 60). Following a six-weeks, twelve-sessions trial involving both passive and active music therapy, it was discovered that the music group therapy intervention decreased the anxiety and depression levels of dementia patients in the experimental group as compared to the control group, which did not receive any music therapy. It was also noted that after three months of follow-up, participants in the experimental group still maintained a low level of anxiety and depression, but the control group's level remained high, therefore, substantiating the effect of music in lowering anxiety and depression among older ones. We urge the nursing descipline, medical professionals, carers, and care homes to include music therapy in the care they provide for patients with dementia.

The safety and effectiveness of music medicine as an intervention for depression: A systematic evaluation and re-evaluation

BACKGROUND

As the methodological quality and evidence level of the existing systematic reviews (SRs) on music as an intervention for depression have not been thoroughly evaluated, a systematic evaluation and re-evaluation (SERE) was conducted.

METHODS

Multiple databases including PubMed, Web of Science, Embase, China National Knowledge Infrastructure, SinoMed, Wanfang, and the VIP database were searched for SRs and meta-analyses (MAs) on the effectiveness of music as an intervention for depression. The literature screening, evaluation of methodological quality, and assessment of evidence level were carried out by a team of researchers. The methodological quality was evaluated using the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) scale in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria were utilized to assess the level of evidence.

RESULTS

A total of 18 SRs were included in the analysis. The 2020 PRISMA guidelines were utilized to evaluate various aspects such as search terms, funding sources, statistical methods for missing values, subgroup and sensitivity analyses, certainty assessment, excluded literature citations, assessment of publication bias, protocol information, conflicts of interest, and data availability, which were rarely reported. The evaluation of the studies using the AMSTAR 2 scale revealed that one article was rated as high quality, six were rated as low quality, and 11 were rated as very low quality. Based on the GRADE criteria evaluation, the quality of the evidence was found to be inconsistent, with reports primarily consisting of medium-quality evidence.

CONCLUSION

The methodological quality of SRs/MAs of music as an intervention in depression is generally poor, and the level of evidence is generally low.

Effect of music therapy on anxiety and depression in breast cancer patients: systematic review and meta-analysis

To systematically evaluate the intervention effect of music therapy on anxiety and depression in breast cancer patients. Randomised controlled trial (RCT) on music therapy for anxiety and depression in breast cancer patients was searched from 7 major databases, PubMed, Embase, the Cochrane Library, WOS, CNIC, Wanfang, and Wipro, spanning the period of library construction to 23 October 2023, and the literature screening of music therapy for anxiety or depression in breast cancer patients was carried out by 2 experimentalists, each of whom conducted a literature screening RCT independently of the other anxiety or depression in a RCT. Methodological quality was evaluated using the PEDro scale; GRADE profiler software for quality of evidence; and RevMan 5.4 was used for effect size merging and forest plots; publication bias tests and sensitivity analyses were performed using Stata 17.0; and standardized mean difference (SMD) and 95% CI were used as the effect statistics. A total of 13 RCTs with 1326 subjects (aged 18-70 years) were included in the literature, with a mean PEDro score of 6.8, and the literature was overall of good methodological quality. Meta-analysis showed that music therapy improved anxiety in breast cancer patients (841 cases), with a combined effect size (SMD = - 0.82, 95% CI [- 1.03, - 0.61] and P < 0.001); and improved depression in breast cancer patients (387 cases) with a combined effect size (SMD = - 0.76, 95% CI [- 1.15, - 0.38], P < 0.001). Subgroup analyses showed that music intervention with off-site music (757 cases) and music choice of non-self-selected music (537 cases) had the best effect on anxiety improvement, with corresponding combined effect sizes (SMD = - 0.88, P < 0.001; SMD = - 0.83, P < 0.001), respectively; followed by an intervention length of < 30 min (589 cases), a frequency of 2 times/day (382 cases), and intervention period of 2-3 weeks (101 cases) had the best effect on anxiety improvement, and the corresponding combined effect sizes were (SMD = - 0.80, P < 0.001; SMD = - 0.91, P < 0.001; SMD = - 1.02, P < 0.001), respectively; and the music selection was the choice of one's own favourite music among the expert recommendations (219 cases) (270 cases) had the best effect on the improvement of depressed mood, with combined effect sizes of (SMD = - 1.15, P < 0.001; SMD = - 0.71, P < 0.001) and music with an intervention duration of 30 min (287 cases), an intervention frequency of 1 time/day (348 cases), and an intervention period of 2-4 weeks (120 cases), respectively, with corresponding combined effect sizes of (SMD = - 0.75, P < 0.001; SMD = - 0.86, P < 0.001; SMD = - 1.06, P < 0.001), respectively. Music therapy can improve anxiety and depression in breast cancer patients, and the level of evidence is moderate. Although the heterogeneity between studies is high, which may lead to bias in the results, we explored the source of heterogeneity through subgroup and sensitivity analyses, providing a good evidence-based basis for clinical practice. The heterogeneity of anxiety and depression was explored by subgroup analysis, with anxiety due to music duration and music cycle; and depression due to intervention cycles and music duration. Sensitivity analyses also identified music duration and music cycle as contributing to the heterogeneity. Also, this study has some limitations since the included literature did not take into account the duration of the disease, education, and family economic status and did not categorize the age stages. This study found that music therapy improves anxiety and depression in breast cancer patients and the results can be used as a basis for clinical practice and researcher enquiry. This research has been registered on the INPLASY platform ( https://inplasy.com/contact/ ) under the number: INPLASY2023100057.

TaKeTiNa Music Therapy for Outpatient Treatment of Depression: Study Protocol for a Randomized Clinical Trial

BACKGROUND/OBJECTIVES

Depression is a prevalent and debilitating illness that significantly affects psychological and physical well-being. Apart from conventional therapies such as psychotherapy and medication, individuals with depression often lack opportunities for activities that are generally perceived as enjoyable, such as music, meditation, and arts, which have demonstrated therapeutic effectiveness. TaKeTiNa music therapy has been employed as a therapeutic intervention for more than two decades. However, there is a notable absence of well-designed clinical trials investigating its antidepressant effects, a gap we aim to address in our current study. Furthermore, shifts in the progression of depression may manifest both psychologically, by influencing emotional states, and physiologically, by leading to alterations in lipid and sphingolipid metabolism, cortisol levels, and immune system function. Our study seeks to analyze the impact of TaKeTiNa music therapy on both levels.

METHODS

This is a prospective monocentric randomized waitlist-controlled clinical trial. It investigates the influence of TaKeTiNa music therapy on patients with major depression in an outpatient setting. Therefore, interested persons are randomly assigned to two groups, an intervention group or a control group, after completing a screening procedure. The intervention group starts with an eight-week TaKeTiNa music therapy intervention. The waiting group receives the same therapy program after completing the follow-up period. Blood and saliva sampling as well as responses to questionnaires are obtained at specific time points.

DISCUSSION

Our study investigates the effects of TaKeTiNa music therapy, a non-pharmacological antidepressant treatment option, on depressive symptoms. We also address functional and causal immunological changes; hormonal changes, such as changes in cortisol levels; and metabolic changes, such as changes in serum lipids and sphingolipids, during the course of depression. We expect that this study will provide evidence to expand the range of treatment options available for depression.

The impact of group music therapy in ameliorating the depression among patients with dementia in care homes: A randomized control trial

Despite the increasing use of music therapy to treat patients with dementia, studies focused on developing nations are still in their embryonic stages. In this view, this study examined the impact of group music therapy intervention in ameliorating depression levels among older people in two care homes. A randomized control trial (RCT) was carried out in which a total of 121 patients were randomly divided into control 61 and experimental group 60. After 6 weeks, 12-session experiment which involved passive and active music therapy, it was found that music group therapy intervention reduced the depression level of older persons in the experimental group, compared to those who were not exposed to the music therapy; control group. The music therapy session also influenced the salivary cortisol of the patients as it was shown to reduce their salivary cortisol levels. It was also observed that after three months of follow-up, participants in the experimental group still maintained a low level of depression and salivary cortisol level, but the control group's level was still high, thus, substantiating the effect of music in reducing depression among older people. We encouraged clinicians, nursing practitioners and care homes in Nigeria to incorporate music therapy as part of the treatment offered to patients with dementia.

Adolescents' Emotion Regulation Strategies Questionnaire-Extended: Further Development and Associations With Mental Health Problems in Adolescence

Emotion regulation (ER) is implicated in a range of psychopathologies and behavioral problems that are prevalent or have their initial onset in adolescence. In this study, we aim to evaluate the psychometric properties (factor structure, internal consistency, and construct validity) of the Adolescents' Emotion Regulation Strategies Questionnaire-Extended (AERSQ-E), a modified and extended version of an ER instrument developed by Zhou et al. Across six sub-studies using data from different Swedish adolescent community samples (1,104 students in total), we generated and validated a 23-item version containing six subscales: rumination/negative thinking, positive reorientation, creative expression, aggressive outlet, social support, and distraction. Assessing test-retest reliability, internal consistency, measurement invariance as well as convergent and discriminant validity, we could establish, with some limitations, the general reliability and validity of the AERSQ-E as a valid measure of ER strategies for use in adolescence.

The effect of music on menopausal symptoms, sleep quality,and depression: a randomized controlled trial

OBJECTIVE

This study aimed to determine the effect of music on menopausal symptoms, sleep quality, and depression levels in menopausal women.

METHODS

This randomized controlled study was carried out between August and December 2022. The study sample consisted of 61 menopausal women (intervention: 30 and control: 31). The intervention group listened to music twice a day for 5 weeks, with a total of 70 sessions. The control group received only routine care. Menopause symptoms, depression levels, and sleep quality were evaluated at the beginning and the end of the study using the Menopausal Symptoms Rating Scale, Beck Depression Inventory, and Pittsburg Sleep Quality Index.

RESULTS

The post-test Menopausal Symptoms Rating Scale, Beck Depression Inventory, and Pittsburg Sleep Quality Index scores of the menopausal women were found to be lower in the intervention group than in the control group (p=0.011, p=0.001, and p=0.006, respectively). When the pre-test and post-test mean scores were compared, the mean menopausal symptoms and depression levels decreased, and sleep quality increased significantly in the intervention group. No significant difference was observed in the control group.

CONCLUSION

This study shows that music may have an effect on reducing the level of menopausal symptoms and depression levels and also increasing the sleep quality of menopausal women.

Combining Complementary and Alternative Medicine (CAM) with Conventional Treatments for Major Depressive Disorder

For many of the complementary and alternative (CAM) medicine methods, it is biologically plausible to expect that they could provide additional benefits in the treatment of major depressive disorder (e.g., enhanced initial response, augmentation, and tolerability) when combined with conventional treatments. Although most likely not comprehensively, herein we critically review current explicit clinical data pertaining to the most extensively evaluated CAMs in this setting: physical activity/exercise, mind and body methods, acupuncture, light therapy, diet, probiotics, various nutrients, and herbal preparations. While the absolute amount of data is enormous, the number of reliable primary studies (randomized controlled trials) and, particularly, meaningful meta-analyses of such studies are very limited. Consequently, the certainty of evidence about benefit or no benefit is very low for each of the addressed CAMs.

Psychedelia: The interplay of music and psychedelics

Music and psychedelics have been intertwined throughout the existence of Homo sapiens, from the early shamanic rituals of the Americas and Africa to the modern use of psychedelic-assisted therapy for a variety of mental health conditions. Across such settings, music has been highly prized for its ability to guide the psychedelic experience. Here, we examine the interplay between music and psychedelics, starting by describing their association with the brain's functional hierarchy that is relied upon for music perception and its psychedelic-induced manipulation, as well as an exploration of the limited research on their mechanistic neural overlap. We explore music's role in Western psychedelic therapy and the use of music in indigenous psychedelic rituals, with a specific focus on ayahuasca and the Santo Daime Church. Furthermore, we explore work relating to the evolution and onset of music and psychedelic use. Finally, we consider music's potential to lead to altered states of consciousness in the absence of psychedelics as well as the development of psychedelic music. Here, we provide an overview of several perspectives on the interaction between psychedelic use and music-a topic with growing interest given increasing excitement relating to the therapeutic efficacy of psychedelic interventions.

Development of the Music Therapy in Transition to Long-Term Care Model

Transition to long-term care can be a challenging period for older adults, with high risk for negative outcomes, including depression, anxiety, and fear. However, music therapy has the potential to enhance related protective factors because it emphasizes individual strengths by leveraging culture-specific resources, facilitates relationships and a sense of belonging through joint music-making, and provides opportunities to process and make sense of one's experiences in the "new normal" through sharing of music-related emotions. The purpose of this study was to explore the perspectives of older adult long-term care residents, their care team staff, and their music therapists to develop a conceptual framework for the role of music therapy in older adults' transition and adjustment to long-term care. A grounded theory approach was used to conceptualize this process. Interviews with 17 participants were transcribed and analyzed using open, axial, and selective coding. The resulting theoretical model describes a progression of qualities and benefits of music therapy that leads to residents "feeling their best self." Related categories include: Music therapy is accessible and engaging; Music therapy is personal and meaningful; Music therapy acts as a bridge to other resources; Music therapy facilitates transformation; and Music therapy facilitates community integration. This initial theoretical model provides a foundation for clinical assessment and interventions. Future research is needed for continued testing and refining this theory.

The effect of receptive music therapy on older adults with mild cognitive impairment and depression: a randomized controlled trial

This study aims to evaluate the effects of a receptive music therapy intervention on cognitive functions and depressive symptoms in older adults with MCI. A randomized controlled trial was conducted in Wuhan, China. Eighty older adults, over 65, who had MCI and depression symptoms were randomly divided into the intervention and control groups. The intervention group received usual nursing care plus receptive music therapy intervention four times a week, for eight weeks; the control group received usual nursing care during the same period. The linear regression analysis was used to compare the difference between groups. There was a significant difference in the intervention group for the pre-intervention and post-intervention scores of cognitive function and depression. There was no significant difference in the control group before and after the study period and a significant between-group difference in both cognitive function and depression. In conclusion, receptive music therapy intervention significantly improved cognitive function and reduced depressive symptoms in older adults with MCI. It could be widely used in communities and nursing homes to improve the quality of life of older adults.

Music Intervention for older adults: Evidence Map of Systematic Reviews

BACKGROUND

With the increasing aging population, the health problems of the elderly have received increasing attention. As a non-pharmacological interventions, music intervention has been widely used in clinical practice to improve the physical and mental health of the elderly. This article aims to provide a comprehensive review of existing systematic reviews on the health effects of music interventions for older adults in clinical practice.

METHODS

The study utilized the evidence map methodology, which involved identifying all relevant systematic reviews, meta-analysis from 7 electronic databases from their inception to November 2022. The studies were analyzed using AMSTAR 2.

RESULTS

The researchers identified 67 studies, with the majority published in the past 5 years. The effects of music interventions were categorized into 4 groups of health outcomes: positive (58 results), potentially positive (4 results), inconclusive (2 results), and no effect (3 results). The health outcomes were further classified into 5 groups: psychological well-being, cognitive functioning, physiological responses, quality of life, and overall well-being.

CONCLUSIONS

The study revealed that music interventions for older adults can have positive or potentially positive effects on health outcomes, encompassing psychological well-being, cognitive functioning, physiological responses, quality of life, and overall well-being. However, some studies yielded inconclusive or no effect. The study offers valuable insights for healthcare professionals and serves as a visual resource to access evidence-based information on the use of music interventions in promoting health and addressing various conditions in older adults.

Perceived Quality of Online Music Therapy Sessions by Older Adults Aging at Home

Online delivery is new to the field of music therapy (MT). This research investigated older adults' perceived quality of MT online by certified music therapists. In this feasibility study, applying both process and outcome assessments, nine older adults volunteered to participate. Zoom was used, and a virtual music therapy (VMT) kit was developed as a resource. Surveys and observed technical difficulties revealed that perceived quality varied slightly by level of technical difficulty experienced; however, overall mean perceived quality was 7.2 out of 9. Post-study interviews revealed three main themes: (a) individual experiences with VMT, (b) individuals' suggestions for further development of VMT sessions, and (c) individuals' personal outcomes from VMT sessions. Participants reported overall positive experiences with VMT. Despite a slight decline in perceived quality when more technical difficulties were present, each participant reported a desire for more sessions, and they would recommend it to others.

Soothe the savage beast: Patient perceptions of the benefits of music therapy in an inpatient rehabilitation facility

INTRODUCTION

Despite the known benefits of music therapy (MT) and its potential applications in an inpatient rehabilitation facility (IRF), there remains a lack of access to MT in a significant number of hospitals in the United States. Exploration of stakeholder (e.g., physician, therapist, and patient) perceptions as a potential barrier to uptake has been limited.

OBJECTIVE

To assess the favorability of patients admitted to an IRF toward MT through the domains of knowledge, attitudes, and beliefs. We hypothesized that patient domain scores would reflect a favorable perception of MT across rehabilitation diagnoses.

DESIGN

Descriptive and cross-sectional survey.

SETTING

Free-standing, acute IRF.

PATIENTS

A total of 119 English-speaking, adult patients across three impairment categories (general rehabilitation, spinal cord injury, and brain injury) were recruited over a 3-month period and during each patient's hospital stay.

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

A modified version of the Global Complementary/Alternative and Music Therapy Assessment (GCAMTA) measured the domains of knowledge, attitudes, and beliefs.

RESULTS

An overall response rate of 79.3% was achieved. Most patients (n = 95; 79.8%) scored in either the favorable or neutral ranges of the instrument. Age correlated negatively (r = -0.193, p < .05) with total score, whereas highest level of education correlated positively (rs  = 0.222, p < .05). There were no significant differences in scores across impairment categories (V = 0.068, p = .232). Knowledge scores, controlling for education and age, predicted 30.4% of the variance in attitudes and beliefs scores (R2  = 0.304, p < .001).

CONCLUSIONS

It is unlikely that patient perceptions are a barrier to MT uptake. Younger, more educated patients have higher knowledge, attitudes, and beliefs about MT. Increasing patient knowledge about MT may improve their attitudes and beliefs, thereby further optimizing this therapy for widespread use.

Measuring music engagement in older adults: the UNE music in aging wellness scale (MAWS)

OBJECTIVES

Engagement with music (i.e. listening, moving to the beat, joining in, performance) is documented to enhance cognition, mood, socialization, and a host of other wellness indicators in advancing age. A number of comprehensive scales measure this engagement, but a brief, accessible scale designed for general use with older adults is lacking. This project was undertaken to create and offer preliminary validation of the 7-item Music in Aging Wellness Scale (MAWS).

METHOD

Seven items reflecting aspects of music engagement (ME) were developed by expert opinion (e.g. 'I always tap my foot or sway my body to good music') for completion on a 1-7, strongly disagree to strongly agree, Likert scale. These were subject to exploratory factor analysis (EFA) (n = 349 cases) along with a set of six experimental items on ageism. It was hypothesized these items would cluster by content, thus showing separation into distinct factors.

RESULTS

This was achieved and the resulting measure showed sound internal consistency (0.82), split-half reliability (0.71), and one-year test-retest (0.83). The MAWS total score was found to correlate significantly in expected directions with common gerontological measures. High scorers reported less depression, more mastery, less loneliness, and larger social networks. No association was found for worry-based anxiety and self-reported cognitive decline.

CONCLUSION

This preliminary reliability and validity study suggests that the MAWS may be an appropriate outcome and tracking measure for older adults involved in music-wellness interventions. Future research will further validate MAWS characteristics and associations with other established measures in this important field.

Effects of music therapy on anxiety in patients with cancer: study protocol of a randomised controlled trial

INTRODUCTION

Although music therapy (MT) has been found to reduce anxiety in patients with cancer and delay tumour progression to some extent, its mechanism of action has not been determined. MT may reduce anxiety by reducing the concentrations of proinflammatory cytokines. The present study was designed to evaluate the effects of MT on anxiety and cytokine levels in patients with cancer.

METHODS AND ANALYSIS

This randomised, open, single-centre parallel-controlled trial will randomise 60 patients with malignant tumours who meet the inclusion criteria in a 1:1 ratio to either an MT group or a non-MT (NMT) group. Patients in the MT group will receive emotional nursing care and individualised receptive MT for 1 week, whereas patients in the NMT group will receive emotional nursing care alone. Primary outcomes will include scores on the State-Trait Anxiety Inventory, Distress Thermometer and Hamilton Anxiety Scale. Secondary outcomes will include scores on the Quality of Life Questionnaire C30, serum concentrations of the cytokines interleukin (IL)-1β, tumour necrosis factor-α, IL-2R, IL-4, IL-6, IL-8 and IL-10, serum concentrations of the neurotransmitters 5-hydroxytryptamine, dopamine, norepinephrine, adrenocorticotropic hormone and γ-aminobutyric acid, and determination of gut microbiota populations.

ETHICS AND DISSEMINATION

On 5 August 2020, the study protocol was approved by the Research Ethics Committee of the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine of the Shanghai University of Traditional Chinese Medicine. The findings of this study will be published in peer-reviewed publications and presented at appropriate conferences.

TRIAL REGISTRATION NUMBER

CTR2000035244.

The Effects of a Beauty Program on Self-Perception of Aging and Depression among Community-Dwelling Older Adults in an Agricultural Area in Taiwan

This study aimed to investigate the effects of a beauty program on the self-perception of aging and depression among the community-dwelling older adults in an agricultural area in Taiwan. Twenty-nine older adults aged 65 and above in one agricultural community care center completed the program. Based on cosmetic therapy, the beauty program consisted of 13 sessions focused on facial skin care, make-up application, and massage with essential oils. Each 90 min session of the program was conducted in groups once a week for 13 weeks. This study applied the mixed methods approach, and data were gathered through questionnaire surveys, interviews, and observation. Before and after the beauty program, the elderly individuals' self-perceptions of aging and depression were assessed using the Attitudes towards Old People Scale (ATOPS) and Taiwanese Depression Questionnaire (TDQ), respectively. The participants' ATOPS scores after the program were significantly higher than those examined before the program (p < 0.001), and their TDQ scores were significantly lower than those before the program (p < 0.001). Additionally, the participants' body images were improved, the participants disrupted their stereotypes about makeup, and they were willing to gradually maintain their appearance. Overall, the beauty program was effective for enhancing the self-perceptions of aging and reducing depression in older adults in rural Taiwan. Further research with a larger population of older individuals, male older adults, or frail older adults is needed to examine the specific effects of the beauty program.

Music and Movement for Health: Protocol for a pragmatic cluster-randomised feasibility pilot trial of an arts-based programme for the health and wellbeing of older adults

Background: Arts-based health programmes (ABHP) can enhance the physical and psychosocial health and wellbeing of older people. However, the feasibility and usefulness of such programmes in Ireland are currently unknown. The primary aim of this study is to examine the feasibility of the study design, its application to a music and movement for health programme and associated costs. The secondary aim is to obtain preliminary effect estimates of an ABHP on health and wellbeing in older adults. Methods: This study is a pragmatic cluster-randomised controlled feasibility trial. Community-dwelling adults, aged 65 years or older will be recruited in the mid-west region of Ireland via methods including social prescription, traditional and social media. The clusters, based on geographical region, will be block randomised to either the ABHP or control using 1:1 allocation ratio. The programme will comprise a 1.5-hour music and dance session each week for 12-weeks together with a 1-hour home-based music and movement programme for 12-weeks. A qualitative and quantitative process evaluation of the arts-based health programme will be performed. Outcomes: Primary outcomes for feasibility include recruitment rates (the number of participants recruited per cluster per month); retention rate (the number of participants who complete measures at baseline and at follow up post intervention, and minimum average attendance. Secondary outcomes will include physical function, balance, physical activity, loneliness, social isolation, cognition, mood, as well as quality of life and cost. Conclusions: If this pioneering study finds evidence to support feasibility and acceptability, a future larger-scale definitive trial will be conducted to examine the effectiveness of an arts-based health programme for older adults. This research aims to strengthen collaborative efforts to implement effective, sustainable and cost-effective programmes for older adults to support community connection, enhancing health and wellbeing, in turn reducing demands on the healthcare system. ISRCTN registration: ISRCTN35313497 (18/02/2022).

Intrinsic Capacities, Functional Ability, Physiological Systems, and Caregiver Support: A Targeted Synthesis of Effective Interventions and International Recommendations for Older Adults

The ageing population calls for interventions that can assist older people to age healthily. This study aimed to provide a targeted synthesis of high-level research and current evidence-based recommendations on effective interventions for maintaining or preventing the decline in intrinsic capacity, functional ability, and physiological systems, or for caregiver support. Nestled within the healthy ageing framework by the World Health Organization, available evidence was selected in a targeted manner, with the purpose of providing a synthesis that would allow the application of this knowledge in real life. As such, the outcome variables were examined through an Evidence and Gap Map of interventions for functional ability and through guidelines from leading institutions. Systematic reviews, meta-analyses, and guidelines on community-dwelling older adults with or without minor health limitations were considered. Thirty-eight documents were included and over fifty interventions identified. Physical activity interventions were consistently effective across several domains. Recommendations point to screening, whilst highlighting the importance of behavioural factors in the endeavour to age healthily. There is a wide range of activities which are likely to foster healthy ageing. To encourage their uptake, it is important for communities to offer suitable promotion and support, and to make these accessible to the public.

Exploring the use of music to promote physical activity: From the viewpoint of psychological hedonism

Despite the global efforts to encourage people to regularly participate in physical activity (PA) at moderate-to-vigorous intensity, an inadequate number of adults and adolescents worldwide meet the recommended dose of PA. A major challenge to promoting PA is that sedentary or low-active people experience negative shifts in affective valence (feeling bad versus good) in response to moderate-to-vigorous intensity PA. Interestingly, empirical data indicate that listening to music during acute bouts of PA positively alters affective valence (feeling good versus bad), reduces perceived exertion, and improves physical performance and oxygen utilization efficiency. From the viewpoint of the ancient principle of psychological hedonism - humans have ultimate desires to obtain pleasure and avoid displeasure - we elaborate on three putative mechanisms underlying the affective and ergogenic effects of music on acute bouts of PA: (1) musical pleasure and reward, (2) rhythmic entrainment, and (3) sensory distraction from physical exertion. Given that a positive shift in affective valence during an acute bout of PA is associated with more PA in the future, an important question arises as to whether the affective effect of music on acute PA can be carried over to promote long-term PA. Although this research question seems intuitive, to our knowledge, it has been scarcely investigated. We propose a theoretical model of Music as an Affective Stimulant to Physical Activity (MASPA) to further explain the putative mechanisms underlying the use of music to promote long-term PA. We believe there have been important gaps in music-based interventions in terms of the rationale supporting various components of the intervention and the efficacy of these interventions to promote long-term PA. Our specification of relevant mechanisms and proposal of a new theoretical model may advance our understanding of the optimal use of music as an affective, ergogenic, and sensory stimulant for PA promotion. Future directions are suggested to address the gaps in the literature.

Effects of non-pharmacological interventions on psychological outcomes among older people with frailty: A systematic review and meta-analysis

BACKGROUND

Older people with frailty are more likely to experience negative psychological well-being, depressive symptoms, anxiety, and stress. Deterioration of psychological outcomes, in turn, further aggravates the frailty status among this vulnerable population. Considering the undesirable effects of polypharmacy on older people, the use of non-pharmacological intervention has attracted increasing attention. However, the effects of non-pharmacological interventions on psychological outcomes are not clear.

AIMS

This review aims to systematically identify and synthesise evidence to examine the effectiveness of non-pharmacological interventions on psychological outcomes among older people with frailty.

METHODS

Eight electronic databases, including PubMed, MEDLINE, EMBASE, CINAHL, APA PsycInfo, Cochrane Library, CNKI and WANFANG were searched from inception to 14 November 2022. Randomised controlled trials and clinical controlled trials of non-pharmacological interventions on psychological outcomes in older people with frailty were included. The quality of the included studies was assessed using The Cochrane Risk of Bias Tool v2. Meta-analysis was performed using the RevMan5.3. The certainty of the evidence was evaluated by GRADE approach.

RESULTS

A total of 4726 articles were initially identified and screened for title and abstract. Eventually, 13 articles from 11 studies were included in this review. The results of the overall risk of bias indicated that four studies had low risk; five studies had some concerns, and two studies had high risk. Four types of intervention were identified, including physical exercise (n = 3), complementary and alternative medicine (music therapy = 1, acupressure = 1), case management (n = 5), and advance care planning (n = 1). The pooled analysis showed that group-based physical exercise had significant beneficial effects on depressive symptoms (SMD: -0.46, 95% CI: -0.81 to -0.10, p = .01; low certainty). There is no difference between the effects of case management and usual care on depressive symptoms (SMD: 0.02, 95% CI: -0.14 to 0.19, p = .79; high certainty). Narrative synthesis of evidence suggested the effects of complementary and alternative medicine on improving depressive symptoms and general mental status.

CONCLUSIONS

Psychological outcomes in older people with frailty are understudied. Group-based physical exercise could be a strategy to reduce depressive symptoms among older people with frailty. There is limited evidence showing the effects of complementary and alternative medicine on improving psychological outcomes. More rigorous trials are needed to examine the effects of non-pharmacological interventions on psychological outcomes among older people with frailty.

REGISTRATION

(PROSPERO): CRD42022303370.

Music therapy effect on anxiety reduction among patients with cancer: A meta-analysis

Introduction

The study aimed to investigate the effect of music therapy on anxiety alleviation among cancer patients.

Methods

A comprehensive literature research was performed in four electronic databases (PubMed, Embase, Cochrane Library, and Web of Science). Fifteen randomized controlled trials (RCTs) were included. The risk of bias for the RCTs was evaluated by the Cochrane Risk of Bias tool. Anxiety levels were extracted to synthesize the combined effect by using meta-analysis. All analyses were performed using R version 4.0.4.

Results

In total, 15 RCTs met the inclusion criteria involving 1320 cancer patients (662 patients in the experimental group and 658 patients in the controlled group). The majority of interventions were performed with recorded music lasting for 15-60 minutes. Compared with standard care, music intervention had a moderate superiority of anxiety alleviation (SMD: -0.54, 95% CI: [-0.92, -0.16]).

Discussion

Music intervention could reduce cancer-related anxiety moderately. Nevertheless, the result should be interpreted with caution as high heterogeneity in this pooled study. Well-designed trials with higher quality were still warranted in the future.

A Systematic Review of Music-Based Interventions to Improve Treatment Engagement and Mental Health Outcomes for Adolescents and Young Adults

Mental health disorders and suicidality are rising among adolescents and young adults (A-YA) while rates of treatment engagement remain notoriously low. Emerging research supports the potential of music-based interventions to improve mental health, but their efficacy remains unclear for A-YA. This systematic review evaluates the evidence on music-based psychosocial interventions to improve engagement in treatment and/or mental health outcomes among A-YA. This review was prospectively registered with PROSPERO and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-six studies were extracted. There was heterogeneity of designs, populations, measures, and outcomes. A typology of music-based interventions emerged, which is characterized by combinations of three broad categories: 1) Somatosensory, 2) Social-Emotional, and 3) Cognitive-Reflective. Most interventions are Socio-Cognitive and Holistically Integrated (combines all three) followed by Socio-Somatic. All interventions involved Social-Emotional processes. Results indicate that most studies report significant effects for mental health outcomes related to social and emotional improvements and reductions of internalizing symptoms for adolescents. Few studies targeted young adults and effects on engagement were rarely measured. There is a need for more studies that use rigorous methods. This review illuminated a need for interventions that are developmentally and culturally tailored to subgroups. Finally, the field is ripe from more studies that apply experimental therapeutics to conceptualize, operationalize, and test mechanisms of change to improve the understanding of how and for whom music-based interventions work. Recommendations for embedding these innovative strategies into research and practice for A-YA are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10560-022-00893-x.

Factors Related to Depression and Mental Health That Affect the Quality of Life of the Elderly

The purpose of this study was to provide basic data for the healthcare of the elderly by identifying the effects of depression and quality of sleep on the lives of the elderly. The subjects of this study were 120 elderly people who used the elderly welfare center and senior citizen center in one of the cities in South Korea, who understood the purpose of the study and signed the consent form for participation in the study. This study is a descriptive correlation study using a questionnaire to compare and analyze the effects of depression and quality of sleep on the quality of life of the elderly. Data were analyzed using the SPSS 25.0 program. According to general characteristics, the level of depression, quality of sleep, and quality of life were analyzed by frequency, percentage, mean, and standard deviation. The level of depression, quality of sleep, and quality of life, as measured by the general characteristics, were evaluated by the t-test and ANOVA. The quality of life, depression, and quality of sleep were analyzed by Pearson's correlation analysis. Linear regression analysis was performed to analyze the factors influencing sleep quality. As a result of this research, depression, psychological, and social domains had positive correlations, and depression and biological domains had negative correlations. As a result of this research, quality of sleep was found to have a negative correlation with the psychological domain and quality of sleep was found to have a positive correlation with the biological environment domain. Based on this research, this author proposes that research should be attempted later with the elderly who were classified as the elderly who are living alone, the elderly who are living at home, and the elderly at the facilities as the subjects. Therefore, depression and the quality of sleep have a big influence on the health condition of the elderly because they may be the important health problems that cannot be overlooked in terms of the quality of life. Furthermore, there is a need to develop a continuous, specific, and practical healthcare program that can manage depression and quality of sleep in old age.

The Effect of the Art Therapy Interventions on Depression Symptoms Among Older Adults: A Meta-analysis of Controlled Clinical Trials

BACKGROUND

To our knowledge, no systematic reviews and meta-analyses have yet been published that examine the effect of art therapy (AT) interventions on depression symptoms among older adults, and this study aimed to systematically review and meta-analysis of clinical trials, summarize eligible relevant studies and provide a true effect measure for the association between AT and depression symptoms in older adults.

METHODS

The databases of PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials were searched until 15 February 2022. The methodological quality of the included studies was evaluated by the Delphi checklist. The heterogeneity across studies was conducted by chi-squared test and measured its quantity by the I² statistic. We performed this meta-analysis to obtain a summary measure of the mean difference in depression scores between AT and control groups using a random-effects model. All statistical analyses were carried out at a significance level of .05 using Stata software, version 14.

RESULTS

Until 15 February 2022, 222 studies through databases and 199 studies through review of references were included in the present meta-analysis. In total, the analysis covered 8 studies. The difference in mean depression score between the intervention and control groups showed significant reductions in the AT group (MD -.78; 95% CI: -1.17, -.38; I 2 = 67.9%).

CONCLUSION

Our findings suggest that AT can be considered an effective intervention for reducing depression symptoms among older adults and art therapists/psychotherapists can use this method to reduce the symptoms of depression among older adults.

The effect of horticultural therapy on depressive symptoms among the elderly: A systematic review and meta-analysis

Objective

This systematic review and meta-analysis aimed to assess the effectiveness of horticultural therapy on depressive symptoms in the elderly and determine the potential moderators of the intervention effect.

Methods

In early June 2022, randomized controlled trials and Quasi-experimental studies were searched on Web of Science, PsycINFO, CINAHL, EMBASE, Medline, PubMed, CNKI, WANFANG DATA, and CQVIP. Three independent authors proposed the following inclusion criterion for this study: the elderly with applied horticultural therapy intervention compared to non-HT intervention. From a total of 3,068 records, only 34 studies met the inclusion criteria. After the full-text screening, 13 studies were included in the analysis. An assessment of the risk of bias was conducted using RoBINS-I and RoB 2 tools. The comprehensive Meta-Analysis 3.3 tool was used for the meta-analysis.

Results

Meta-analysis suggested that mean depression scores of elderly people who underwent horticultural therapy intervention were significantly lower than those who did not receive HT therapy. More significant effects were found for the elderly with mean age equal to or over 75 years instead of younger than 75 years, in randomized controlled trials instead of quasi-experimental studies, for studies with more than 20 participants receiving horticultural therapy at the same time and place instead of equal to or fewer than 20 horticultural therapy participants.

Conclusions

This evidence supported that horticultural therapy had a significant positive effect on the depressive symptoms outcomes for the elderly. Therefore, our data revealed that horticultural therapy could be considered as a part of therapy in depressive symptoms reduction programs. Due to the high degree of heterogeneity and the limited number of studies, a future review is warranted to determine the effects of horticultural therapy on depressive symptoms reduction in the elderly.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=272464, identifier: CRD42021272464.

Music-based casual video game training alleviates symptoms of subthreshold depression

Objectives

In this preregistered study, we investigated the beneficial effects of music-based casual video game training on the depression, anxiety and stress symptoms in a cohort of young individuals with subthreshold depression and the underlying mechanisms.

Methods

The study included 56 young individuals (18–26 years of age) with subthreshold or mild depression based on the Beck Depression Inventory-II (BDI-II) scores between 14 and 19. They were randomly assigned into the experimental group (n = 28) or the control group (n = 28). The experimental group underwent music-based casual video game training for 4 weeks. During the same time, the control group participants conducted daily life activities without any intervention. The study participants in the two groups were analyzed using the Depression Anxiety and Stress Scale (DASS-21) during the baseline before the intervention, as well as DASS-21, Positive and negative Affect Scale (PANAS), General Self-efficacy Scale (GSES), and the Emotional Regulation Questionnaire (ERQ) twice a week during the 4 weeks of intervention.

Results

The depression, anxiety, and stress symptoms were significantly reduced in the experimental group participants after 4 weeks of music-based video game training compared with the control group. The DAS scores in the experimental group were alleviated in the third and fourth weeks of training compared with the control group. Moreover, analysis using the general linear model demonstrated that the number of training weeks and self-efficacy were associated with significant reduction in depression, anxiety and stress. Furthermore, our results demonstrated that self-efficacy was correlated with positive emotion and emotional regulation.

Conclusion

Our study showed that music-based casual video game training significantly decreased depression, anxiety, and stress in the young individuals with subthreshold depression by enhancing self-efficacy.

Comparative effects of music interventions on depression in older adults: A systematic review and network meta-analysis

BACKGROUND

The effect of different music interventions on depression in older adults is varied. We aimed to explore the comparative effect of different music intervention features on depression in older adults.

METHODS

We searched PubMed, EMBASE, CENTRAL, CINAHL, and ProQuest Dissertations&Theses from inception to October 2021 for randomized controlled trials (RCTs) of music interventions in participants aged ≥60 years. Music interventions were classified based on the TIP (theme, intensity, and provider/platform) framework. The theme was divided into: 1) active music therapy (ACT); 2) receptive music therapy (Recep); and 3) music medicine (MM). The intensity was classified as high (>60 minutes/week), and low (≤60 minutes/week). The provider was classified as a music therapist (MT) or a non-music therapist (NonMT). Summary standardized mean differences (SMD) of level of depression with 95% confidence interval (CI) were estimated using a frequentist framework with a random-effects model. The certainty of evidence was evaluated using the Confidence in Network Meta-Analysis (CINeMA) approach. This study was registered with PROSPERO (CRD42021247165).

FINDINGS

Fifteen RCTs involving 1,144 older adults (mean age 67.9-86.6 years) were included. When compared with usual care, the most effective music intervention was active music therapy >60 minutes/week by music therapist (Act/High/MT) (SMD -3.00; 95%CI, -3.64,-2.35), followed by music medicine >60 minutes/week by non-music therapist (MM/High/NonMT) (SMD -2.06; 95%CI, -2.78,-1.35) with moderate and high certainty of evidence, respectively. Depression scores in older adults treated with ACT/High/MT was also significantly lower than all other interventions, except MM/High/NonMT. Low intensity music interventions other than Act/Low/MT had no impact on depression.

INTERPRETATION

Although active music therapy >60 minutes/week by music therapist is the most effective intervention to alleviate depression in older adults, music medicine by listening to music of older adult's own preference >60 minutes/week is an alternative approach in settings with limited resources.

FUNDING

None.

Music and Movement for Health: Protocol for a pragmatic cluster-randomised feasibility pilot trial of an arts-based programme for the health and wellbeing of older adults

Background: Arts-based health programmes (ABHP) can enhance the physical and psychosocial health and wellbeing of older people. However, the feasibility and usefulness of such programmes in Ireland are currently unknown. The primary aim of this study is to examine the feasibility of the study design, its application to a music and movement for health programme and associated costs. The secondary aim is to obtain preliminary effect estimates of an ABHP on health and wellbeing in older adults. Methods: This study is a pragmatic cluster-randomised controlled feasibility trial. Community-dwelling adults, aged 65 years or older will be recruited in the mid-west region of Ireland via methods including social prescription, traditional and social media. The clusters, based on geographical region, will be block randomised to either the ABHP or control using 1:1 allocation ratio. The programme will comprise a 1.5-hour music and dance session each week for 12-weeks together with a 1-hour home-based music and movement programme for 12-weeks. A qualitative and quantitative process evaluation of the arts-based health programme will be performed. Outcomes: Primary outcomes for feasibility include recruitment rates (the number of participants recruited per cluster per month); retention rate (the number of participants who complete measures at baseline and at follow up post intervention, and minimum average attendance. Secondary outcomes will include physical function, balance, physical activity, loneliness, social isolation, cognition, mood, as well as quality of life and cost. Conclusions: If this pioneering study finds evidence to support feasibility and acceptability, a future larger-scale definitive trial will be conducted to examine the effectiveness of an arts-based health programme for older adults. This research aims to strengthen collaborative efforts to implement effective, sustainable and cost-effective programmes for older adults to support community connection, enhancing health and wellbeing, in turn reducing demands on the healthcare system. ISRCTN registration: ISRCTN35313497 (18/02/2022).

Can Music Therapy Improve the Quality of Life of Institutionalized Elderly People?

INTRODUCTION

The current population has new characteristics that require changes to be made in the public health system. In the case of the elderly, the concrete aspects of their health must be known to improve the system, in search of a better quality of life and as much independence as possible.

METHOD

The aim of this study was to verify the efficiency of a music therapy program with institutionalized elderly participants to avoid depressive symptoms and improve social interaction and creativity. This is a group case study that uses a pretest-post-test descriptive design. The program was divided into sixteen sessions, two sessions each week. As inclusion and exclusion criteria, physical dependency and cognitive state were used.

RESULTS

The results present an improvement in the physical dimensions of quality of life and an increase in creativity and social interaction. It is recommended that the sessions in the program, aiming to achieve a greater efficiency, are extended because the elderly have very ingrained habits and routines that are very hard to eliminate.

DISCUSSION AND CONCLUSIONS

Music therapy, a non-pharmacological and worthwhile treatment, is a therapeutic option with proven benefits. Music therapy has the potential to improve health and quality of life in the elderly and also foster the amelioration of various chronic illnesses, such as depression.

Engagement in leisure activities and depression in older adults in the United States: Longitudinal evidence from the Health and Retirement Study

Background

Receptive cultural engagement (e.g. attending theaters and museums) can reduce depression in older adults. However, whether specific participatory leisure activities are associated with lower rates of depression remains unknown. We aimed to test whether engagement in a diverse range of leisure activities, all of which could involve artistic or creative elements, was associated with concurrent and subsequent depression.

Methods

Using longitudinal data from 19,134 participants aged over 50 in the Health and Retirement Study, engagement in leisure activities was measured every four years, and depression every two years, between 2008 and 2016. Leisure activities included: reading books, magazines, or newspapers; writing; baking/cooking something special; making clothes, knitting, or embroidery (sewing); working on hobbies/projects; going to sport, social, or other clubs; and attending non-religious organization meetings. A score of three or more on the Center for Epidemiologic Studies Depression Scale indicated depression. We fitted population-averaged panel data models using generalized estimating equations with a logit link.

Results

Engaging in some leisure activities, such as clubs, hobbies/projects, and baking/cooking was associated with reduced depression, independent of confounders. Concurrently, spending time on hobbies/projects (monthly OR = 0.80, 95% CI = 0.72–0.88; weekly OR = 0.81, 95% CI = 0.73–0.89) and clubs (monthly OR = 0.85, 95% CI = 0.77–0.94; weekly OR = 0.78, 95% CI = 0.69–0.88) was associated with lower odds of depression versus not engaging. Longitudinally, the odds of depression two years later were reduced amongst people engaging in weekly baking/cooking (OR = 0.85, 95% CI = 0.75–0.95), hobbies (OR = 0.81, 95% CI = 0.71–0.92), and clubs (OR = 0.82, 95% CI = 0.71–0.94). Writing, reading, sewing, and attending non-religious organizations were not consistently associated with depression.

Conclusions

Engagement in some leisure activities is associated with reduced odds of depression. We should consider how older adults can be supported to actively participate in leisure activities as health-promoting behaviors.

•

Some leisure activities associated with reduced odds of depression in older adults.

•

Going to sport, social, or other clubs most strongly associated with less depression.

•

Doing hobbies/projects and baking/cooking something special also associated.

•

No evidence that more artistic or creative activities were associated with depression.

Crafting Life Stories in Photocollage: An Online Creative Art-Based Intervention for Older Adults

Creative arts therapies (CAT) provide a safe and creative environment for older adults to process life experiences and maintain personal growth while aging. There is a growing need to make creative arts therapies more accessible to the aging population, as many have limited access to these services. This need has been catalyzed by the advent of the COVID-19 pandemic. Tele-CAT offers a possible solution. This study explored the experiences of older adults who participated in an online creative process of digital photocollage based on CAT. Twenty-four Italian and Israeli community-dwelling older adults aged 78 to 92 participated in this research through Zoom teleconferencing software. Transcriptions of the sessions and the art produced through the photocollage were qualitatively analyzed through Thematic Analysis. The findings show that the projective stimuli of digital photographs supported older adults' narratives and engaged them in a more embodied emotional experience. Participant experiences involved artistic enjoyment within a positive and safe interaction with therapists. The creation of digital photocollages allowed the participants to process their life experiences and create an integrative view of their life, a vital developmental task in late life. These results point to the advantages and challenges of tele-CAT for older adults.

Sensory Stimulation Via the Visual, Auditory, Olfactory and Gustatory Systems Can Modulate Mood and Depression

Depression is one of the most common mental disorders, predicted to be the leading cause of disease burden by the next decade. There is great deal of emphasis on the central origin and potential therapeutics of depression whereby the symptomatology of depression has been interpreted and treated as brain generated dysfunctions filtering down to the periphery. This top-down approach has found strong support from clinical work and basic neuroscientific research. Nevertheless, despite great advances in our knowledge of the etiology and therapeutics of depression, success in treatment is still by no means assured.. As a consequence, a wide net has been cast by both clinicians and researchers in search of more efficient therapies for mood disorders. As a complementary view, the present integrative review advocates approaching mood and depression from the opposite perspective: a bottom-up view that starts from the periphery. Specifically, evidence is provided to show that sensory stimulation via the visual, auditory, olfactory and gustatory systems can modulate depression. The review shows how -depending on several parameters- unisensory stimulation via these modalities can ameliorate or aggravate depressive symptoms. Moreover, the review emphasizes the bidirectional relationship between sensory stimulation and depression. Just as peripheral stimulation can modulate depression, depression in turn affects-and in most cases impairs-sensory reception. Furthermore, the review suggests that combined use of multisensory stimulation may have synergistic ameliorative effects on depressive symptoms over and above what has so far been documented for unisensory stimulation.

The State of Music Therapy Studies in the Past 20 Years: A Bibliometric Analysis

Purpose: Music therapy is increasingly being used to address physical, emotional, cognitive, and social needs of individuals. However, publications on the global trends of music therapy using bibliometric analysis are rare. The study aimed to use the CiteSpace software to provide global scientific research about music therapy from 2000 to 2019.

Methods: Publications between 2000 and 2019 related to music therapy were searched from the Web of Science (WoS) database. The CiteSpace V software was used to perform co-citation analysis about authors, and visualize the collaborations between countries or regions into a network map. Linear regression was applied to analyze the overall publication trend.

Results: In this study, a total of 1,004 studies met the inclusion criteria. These works were written by 2,531 authors from 1,219 institutions. The results revealed that music therapy publications had significant growth over time because the linear regression results revealed that the percentages had a notable increase from 2000 to 2019 (t = 14.621, P < 0.001). The United States had the largest number of published studies (362 publications), along with the following outputs: citations on WoS (5,752), citations per study (15.89), and a high H-index value (37). The three keywords “efficacy,” “health,” and “older adults,” emphasized the research trends in terms of the strongest citation bursts.

Conclusions: The overall trend in music therapy is positive. The findings provide useful information for music therapy researchers to identify new directions related to collaborators, popular issues, and research frontiers. The development prospects of music therapy could be expected, and future scholars could pay attention to the clinical significance of music therapy to improve the quality of life of people.

Effects of music therapy on cancer-related fatigue, anxiety, and depression in patients with digestive tumors: A protocol for systematic review and meta-analysis

BACKGROUND

Digestive tumor is one of the most common cancers, its symptoms and treatment will bring patients with anxiety, depression and other negative emotions, and cause cancer-related fatigue. As a new complementary replacement therapy, music therapy can greatly reduce cancer-related fatigue, anxiety and depression, and achieve good clinical results, but there is a lack of evidence-based medicine. The purpose of this study is to evaluate the effect of music therapy on cancer-related fatigue, anxiety, and depression in patients with digestive tumors by meta-analysis.

METHOD

Computer search of Chinese and English databases: Wanfang, VP Information Chinese Journal Service Platform, China National Knowledge Infrastructure, Chinese BioMedicine Literature Database and pubmed, embase, cochrane, web of science. A comprehensive collection of relevant studies on the effects of music therapy on digestive tract cancer-related fatigue, anxiety and depression, the retrieval time is from the date of establishment to March 2021. According to the inclusion and exclusion criteria, the literature is selected, the quality of the literature is evaluated and the data are extracted. The data are analyzed by meta-analysis.

RESULT

The purpose of this study is to evaluate the effect of music therapy on digestive tract cancer-related fatigue, anxiety, and depression by European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire, Hamilton Depression Scale, and Hamilton Anxiety Scale .

CONCLUSION

This study will provide reliable evidence-based evidence for the clinical application of music therapy in the treatment of digestive tract cancer-related fatigue and anxiety and depression.

OSF REGISTRATION NUMBER

DOI 10.17605/OSF.IO/UR4GV.

The efficacy of combined music therapy and Tai Chi for major depressive disorder: Study protocol for a randomized controlled trial

BACKGROUND

There are no clinical trials evaluating the efficacy of combined music and Tai Chi therapy for patients with major depression. Therefore, the primary objective of the present study was to evaluate the efficacy of Tai Chi and music therapy on psychological status and quality of life among patients with major depressive disorder in China.

METHODS

This work is a part of a comprehensive research project to assess and provide intervention that potentially improves psychological status and quality of life among patients with major depressive disorder. This research project has been received ethical approval from the Medical Research and Ethics Committee in Taizhou Second People's Hospital (no. tzey2020023). After the introductory briefing, the acceptance to take the presession questionnaire implied the participant's consent to participate in the study. Eligible participants are divided into 3 groups according to completely randomized design: combined group (music therapy + Tai Chi), music therapy alone group, and Tai Chi alone group. The analyses will be performed using SPSS 22.0.0 (SPSS Inc, Chicago, IL).

RESULTS

This protocol will provide a reliable theoretical basis for the following research.

CONCLUSION

The sample came from a single health center. Therefore, the results cannot be generalized for the entire population.

TRIAL REGISTRATION

This study protocol was registered in Research Registry (researchregistry6597).

Current Research on Complementary and Alternative Medicine (CAM) in the Treatment of Major Depressive Disorder: An Evidence-Based Review

Complementary and alternative medicine (CAM) encompasses a wide range of different non-mainstream therapies that have been increasingly used for treatment or adjunctive treatment of various ailments with mood disorders and "depressive difficulties" being two of the commonly CAM (self-)medicated conditions. We focus specifically on clinically diagnosed (in line with the standard criteria) depressive disorders, primarily major depressive disorder (MDD), and overview evidence of efficacy/safety of a range of CAM modalities addressing exclusively randomized controlled trials (RCTs) and systematic reviews/meta-analyses of RCTs. The list of addressed CAM interventions is not exhaustive: due to space limitation, addressed are interventions with at least a few conducted RCTs in the specific clinical conditions. We try to provide numerical and meaningful data as much as it is possible and to (a) indicate situations in which the reported data/estimates might have been "too enthusiastic" and (b) warn about heterogeneity of results that, together with other possible limitations (various biases and imprecision), results in uncertainty about the effects.

Effects of music therapy on depression: A meta-analysis of randomized controlled trials

Background

We aimed to determine and compare the effects of music therapy and music medicine on depression, and explore the potential factors associated with the effect.

Methods

PubMed (MEDLINE), Ovid-Embase, the Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, and Clinical Evidence were searched to identify studies evaluating the effectiveness of music-based intervention on depression from inception to May 2020. Standardized mean differences (SMDs) were estimated with random-effect model and fixed-effect model.

Results

A total of 55 RCTs were included in our meta-analysis. Music therapy exhibited a significant reduction in depressive symptom (SMD = −0.66; 95% CI = -0.86 to -0.46; P<0.001) compared with the control group; while, music medicine exhibited a stronger effect in reducing depressive symptom (SMD = −1.33; 95% CI = -1.96 to -0.70; P<0.001). Among the specific music therapy methods, recreative music therapy (SMD = -1.41; 95% CI = -2.63 to -0.20; P<0.001), guided imagery and music (SMD = -1.08; 95% CI = -1.72 to -0.43; P<0.001), music-assisted relaxation (SMD = -0.81; 95% CI = -1.24 to -0.38; P<0.001), music and imagery (SMD = -0.38; 95% CI = -0.81 to 0.06; P = 0.312), improvisational music therapy (SMD = -0.27; 95% CI = -0.49 to -0.05; P = 0.001), music and discuss (SMD = -0.26; 95% CI = -1.12 to 0.60; P = 0.225) exhibited a different effect respectively. Music therapy and music medicine both exhibited a stronger effects of short and medium length compared with long intervention periods.

Conclusions

A different effect of music therapy and music medicine on depression was observed in our present meta-analysis, and the effect might be affected by the therapy process.

Playback theatre in adult day centers: A creative group intervention for community-dwelling older adults

The literature indicates that theatre and drama-based interventions have the potential to improve older adults' well-being and health. The goal of the current study was to characterize the process of a creative group intervention in adult day centers (ADCs), which integrates playback theatre and life-review principles. Our objective was to provide an evidence-informed framework for drama therapy interventions, which would allow older adults to bring up and explore their life-stories in a dramatic creative process in their own community. A total of 27 participants ranging in age from 63 to 91, took part in one of three playback theatre groups. The playback theatre group intervention comprised 12 weekly sessions. All sessions were videotaped to capture the lived experience of the creative process and were analyzed in post-intervention interviews. In addition, focus group meetings were conducted with 13 ADC staff members to decipher further the effects of the participation as perceived by people outside the groups. Three types of potential transformation were identified in the qualitative analysis: the evolution of life stories, evolution of playfulness, and expansion of social engagement. The results indicate the potential of the integrative framework to serve as a creative intervention in ADC communities, as well as its potential to bring about a personal transformation and expand it to enable a person's social engagement in the community. The findings imply the potential benefits of using playback theatre groups to supplement the routine care provided in ADCs.

Evidence-based recommendations to assist adults with depression to become lifelong movers

Depression is the most common and prevalent mental disorder today, affecting an estimated 1 in 4 Canadians at some point in their lifetime. Physical activity is recommended as a primary treatment for mild to moderate depression and a secondary treatment for moderate to severe depression. Despite this, specific guidelines are still lacking on how to best promote physical activity in this population. Accordingly, this policy brief provides evidence-based recommendations for primary care providers and allied health professionals to promote lifelong physical activity in individuals with depression. Recommendations include asking for permission to discuss physical activity with the individual; framing physical activity as something that they have control over in order to feel better; clarifying that incorporating even a few more minutes of weekly physical activity is better than nothing and that mild forms are enough to achieve mental health benefits; and providing choices of activities to try and accompanying them on their first few sessions. Moreover, this article highlights the importance of promoting physical activity enjoyment for this population, which can be done by guiding the individual to slowly build up the frequency, duration and intensity of activity; encouraging them to be self-compassionate toward physical activity; suggesting they engage in outdoor activity, listen to music, and/or participate with a buddy or group; and incorporate self-monitoring or journalling to solidify the link between physical activity and improved mood. Practitioners are encouraged to use these evidence-informed recommendations-especially maximizing choices, enhancing physical activity enjoyment and emphasizing personal preferences-to help individuals with depression move, recover and flourish. These recommendations may also be used to tailor future interventions and inform policy guidelines to reduce depression rates in Canada.

"Music Makes My Old Heart Beat": A Randomised Controlled Study on the Benefits of the Use of Music in Comprehensive Care for Institutionalised Older Adults

BACKGROUND

Research on the therapeutic use of music is growing, but the lack of experimental rigour and outcomes diversity has impeded researchers from obtaining clear evidence of the multiple benefits of music interventions in older adults. We explored the outcomes of a music-complemented intervention integrated into the therapeutic activities of institutionalised elderly people.

METHODS

A randomised controlled study with baseline, post-intervention, and 2-week follow-up measures was carried out with 50 residents in a caring institution. Several indicators of physical health, cognitive functioning, emotional well-being, pain, and happiness were assessed at all phases.

RESULTS

Mixed factorial ANOVAs showed a positive impact of the music intervention on the outcomes in the intervention group (effect sizes up to .78) compared to the stability in the control (waiting list) group. Notably, the benefits seemed to be temporary, as they decreased progressively after the discontinuation of the intervention.

CONCLUSIONS

This study demonstrates the effects of a planned music-based intervention on several health- and well-being-related outcomes and has important applications regarding the use of music as a complement in therapeutic interventions with elderly people. The implementation of music therapy within the comprehensive care of institutionalised people must be maintained over time for the effects to be durable.

Effect of complementary therapies on functional capacity and quality of life among prefrail and frail older adults: A systematic review of randomized controlled trials

OBJECTIVE

Investigate the effects of complementary therapies on functional capacity and quality of life among prefrail and frail older adults.

MATERIALS AND METHOD

An electronic search was performed in the PubMed, EMBASE, Web of Science, Cochrane Library, LILACS and PEDro databases for relevant articles published up to September 2019. Only randomized controlled trials with interventions involving complementary therapies for prefrail and frail older adults were included. This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Cochrane recommendations. The methodological quality of the selected studies was appraised using the PEDro scale and the evidence was synthesized using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) scale.

RESULTS

Fifteen studies met the inclusion criteria and were selected for the present review. Six different complementary therapies were identified and the main findings were related to Tai Chi. A very low to moderate level of evidence was found regarding the effectiveness of Tai Chi in terms a functional capacity (balance, mobility, gait speed, functional reach and lower limb muscle strength) and a low level of evidence was found regarding its effect on quality of life. To the other complementary therapies it was not possible to synthetize evidence level.

CONCLUSION

Tai chi may be used as an important resource to improve functional capacity and quality of life among prefrail and frail older adults.

Computational Paradigm to Elucidate the Effects of Arts-Based Approaches: Art and Music Studies and Implications for Research and Therapy

Art therapy and music therapy, as well as other arts-based approaches and interventions, help to mitigate symptoms in serious and chronic diseases and to improve the well-being and quality of life for both healthy individuals and patients. Artistic creation is also researched and practiced intending to empower and understand individuals, groups, and communities. However, much research is required in order to learn how arts-based approaches operate and to enhance their effectivity. The complex and simultaneous occurrences involving the dynamics of the creation work, the client, and the therapist in a typical arts setting are difficult to grasp, consequently affecting their objective analyses. Here we employ our Computational Paradigm which enables the quantitative and rigorous tracking, analyzing, and documenting of the underlying dynamic processes, and describe its application in recent past and current real-world art and music studies with human participants. We aim to study emergent artistic behaviors of individuals and collectives in response to art and music making. Significant insights obtained include demographic variation factors such as gender and age, empirical behavioral patterns, and quantitative expressiveness and its change. We discuss the implications of the findings for therapy and research, such as causality for behavioral diversification and audio-visual cross-modality, and also offer directions for future applications and technology enhancements.