Top film suggestions for people with dementia

Dementia UK has put together a list of film recommendations for people living with demenntia. The list is focussed around films which have music, interactivity and simple plotlines at their heart.

The ability of the arts to help families stay together in the face of dementia has been recognised by Dementia UK’s specialist dementia nurses. Dr. Hilda Hayo, CEO and Chief Admiral Nurse at Dementia UK, said:

“There are certain film genres or styles which can be appealing to someone with dementia. This can include films which do not have complex story lines and films where there is a strong action, comedic or musical element. We are seeing more and more screenings of films to cater for people with dementia and their families. Some of our very own specialist dementia Admiral Nurses have been involved in bringing these screenings to local communities for example. They undoubtedly help to elevate a person with dementia’s mood, helping them stay engaged and connected to their families and wider society.”

Included in the list of recommended films are:

Mamma Mia

What marks Mamma Mia out is the fact that it’s so interactive. People of all ages regularly sing along to the tunes of Abba helping to connect people with dementia. Music and songs can bring out strong feelings in someone with dementia too. Other similar recommendations include The Sound of Music, My Fair Lady and South Pacific.

Laurel and Hardy

Many people diagnosed with dementia grew up with the slapstick routines of Laurel and Hardy allowing many to reminisce. Their comedic routines can bring enjoyment and distraction. Films like this are also great to share with the wider family. They can even help to provide invaluable connection between children and grandparents with dementia. Other similar recommendations include Mr Bean.

Top Gun

This may be a suitable choice for younger people diagnosed with dementia. Top Gun’s straightforward plotline can help to hold a person with dementia’s attention. Other similar recommendations for younger people with dementia include Ghost and Pretty Woman.

Full story at Dementia UK

Music for Dementia 2020 website launches in UK

New website is the first ever central information hub for advice, evidence-based research and expertise on why music is important for people living with dementia and their carers | via Music:Ed

Music for Dementia 2020 will promote a wide range of musical activities available for people living with dementia – from how to compile a playlist to advice on how to find a music therapist.

The website is structured for interactive use by carers, health professionals, practitioners, commissioners, academics and researchers – and, most importantly, people living with dementia. It incorporates case studies, blogs, interactive short films and advice and guidance from across the health, care, dementia and music sectors.

According to Music for Dementia 2020:

‘Research shows that when used appropriately through a personalised approach, music can make the delivery of care more effective and efficient, enabling carers to have more time to create meaningful moments with the people they are caring for. Music enhances people’s experiences of using services and helps people living with dementia to be seen for who they are, beyond their dementia‘.

Related: Commission on Dementia and Music | What would life be – without a song or dance, what are we?

BBC Music website offers dementia lifeline

Evidence shows that music can help people with dementia to feel and live better. Now, a new BBC website aims to help by connecting dementia patients with the songs they love. | Via BBC

The new ‘Music Memories’ site  launched as part of BBC Music Day allows people to browse more than 1,800 songs, classical works and TV theme tunes from the last 100 years, creating a playlist of personally meaningful music. Those playlists can then be shared – along with some basic information about the user’s age, gender and place of birth – allowing carers to identify songs that could help others with a similar background.

Eventually, it’s hoped the site will build a database of music that’s effective at triggering memories.

“Music can have such a powerful effect,” said Snow Patrol star Gary Lightbody, whose father suffers from dementia. “It fires all sorts of things in the brain much more immediately than anything else can, whether it be pictures or old home movies or conversations. Music can somehow take you to a place of your youth, or an important part of your life you may not otherwise have access to.”

Beyond that, music therapy has been shown to alleviate depression, anxiety, hallucinations and mobility problems in patients with mild to moderate Alzheimer’s.

Full story at BBC

Management of behavioral and psychological symptoms in people with Alzheimer’s disease

Kales, H. et al. | Management of behavioral and psychological symptoms in people with Alzheimer’s disease: an international Delphi consensus | Published online: August 2018

Objectives:
Behavioral and psychological symptoms of dementia (BPSD) are nearly universal in dementia, a condition occurring in more than 40 million people worldwide. BPSD present a considerable treatment challenge for prescribers and healthcare professionals. Our purpose was to prioritize existing and emerging treatments for BPSD in Alzheimer’s disease (AD) overall, as well as specifically for agitation and psychosis.

Design:
International Delphi consensus process. Two rounds of feedback were conducted, followed by an in-person meeting to ratify the outcome of the electronic process.

Settings:
2015 International Psychogeriatric Association meeting.

Participants:
Expert panel comprised of 11 international members with clinical and research expertise in BPSD management.

Results:
Consensus outcomes showed a clear preference for an escalating approach to the management of BPSD in AD commencing with the identification of underlying causes. For BPSD overall and for agitation, caregiver training, environmental adaptations, person-centered care, and tailored activities were identified as first-line approaches prior to any pharmacologic approaches. If pharmacologic strategies were needed, citalopram and analgesia were prioritized ahead of antipsychotics. In contrast, for psychosis, pharmacologic options, and in particular, risperidone, were prioritized following the assessment of underlying causes. Two tailored non-drug approaches (DICE and music therapy) were agreed upon as the most promising non-pharmacologic treatment approaches for BPSD overall and agitation, with dextromethorphan/quinidine as a promising potential pharmacologic candidate for agitation. Regarding future treatments for psychosis, the greatest priority was placed on pimavanserin.

Conclusions:
This international consensus panel provided clear suggestions for potential refinement of current treatment criteria and prioritization of emerging therapies.

Music activates regions of the brain spared by Alzheimer’s disease

Researchers are looking to the salience network of the brain to develop music-based treatments to help alleviate anxiety in patients with dementia | University of Utah Health | via ScienceDaily

Previous work has demonstrated the effect of a personalised music program on mood for dementia patients. Researchers at he University of Utah Health  set out to examine a mechanism that activates the attentional network in the salience region of the brain. The results offer a new way to approach anxiety, depression and agitation in patients with dementia.

Researchers helped participants select meaningful songs and trained the patient and caregiver on how to use a portable media player loaded with the self-selected collection of music.

Using a functional MRI, the researchers scanned the patients to image the regions of the brain that lit up when they listened to 20-second clips of music versus silence. The researchers played eight clips of music from the patient’s music collection, eight clips of the same music played in reverse and eight blocks of silence. The researchers compared the images from each scan.

The researchers found that music activates the brain, causing whole regions to communicate. By listening to the personal soundtrack, the visual network, the salience network, the executive network and the cerebellar and corticocerebellar network pairs all showed significantly higher functional connectivity.

Full story at ScienceDaily

 

Music and dementia

In this blog, NHS England’s National Clinical Director for Dementia and the Deputy Chief Allied Health Professions Officer look at how music can trigger golden memories and benefit people with dementia | NHS England

This blog explores the many benefits music can have in the setting of dementia. Music, the authors state, can help reduce anxiety and depression, help maintain speech and language, is helpful at the end of life, enhances quality of life and has a positive impact on carers. The article quotes specific benefits including:

• music provides a ready resource for enjoyment and entertainment, especially when shared with families and loved ones in a shared experience
• bespoke playlists for carers and loved ones for people with dementia can facilitate sharing and very positive interactions

Full blog: Music and dementia: a powerful connector

See also: Commission into Music and Dementia | The International Longevity Centre

An Innovative Approach to Managing Behavioral and Psychological Dementia

The older adult population in long-term care is experiencing significant growth, which includes an increased number of minority admissions. An estimated 48% of long-term care patients are admitted with a diagnosis of dementia | The Journal for Nurse Practitioners

Highlights: 

• Nurse practitioners are in a key position to provide culturally appropriate care in older adults with BPSD
• Personalized music is an evidence-based, patient centered intervention to reduce BPSD
• Regulatory agencies are closely monitoring the management of BPSD in long-term care facilities.
• Personalized music can be an interdisciplinary approach in the management of BPSD

Patient-centered, culturally appropriate care is critical in the management of dementia and treatment of associated behavior and psychological symptoms of dementia (BPSD). The use of personalized music playlists has shown promise in the interdisciplinary treatment of BPSD. Regulatory agencies are closely monitoring the management of BPSD. Accurate diagnosis and treatment of BPSD is an increasingly important skill for the provider.

Full reference: Long, E.M. (2017) An Innovative Approach to Managing Behavioral and Psychological Dementia. The Journal for Nurse Practitioners. Vol. 13 (Issue 7) pp. 475-481

The effect of music therapy on cognitive functions in patients with dementia.

Study investigates Music Therapy as a complementary treatment for older adults with dementia

Abstract

Objectives: The aim of the present study was to meta-analyze the effect of music therapy (MT) on cognitive functions in patients with dementia.

Method: A systematic literature search was performed in Medline, PsycINFO, Embase, CINAHL and RILM up to 8 September 2016. We included all randomized controlled trials that compared MT with standard care, or other non-musical types of intervention, evaluating cognitive outcomes in patients with dementia. Outcomes included global cognition, complex attention, executive function, learning and memory, language, and perceptual-motor skills.

Results: From 1089 potentially relevant records, 110 studies were assessed for eligibility, and 7 met the inclusion criteria, of which 6 contained appropriate data for meta-analysis (330 participants, mean age range 78.8–86.3). Overall, random-effects meta-analyses suggested no significant effects of MT on all outcomes. Subgroup analysis found evidence of a beneficial effect of active MT on global cognition (SMD = 0.29, 95% CI 0.02 to 0.57, p = 0.04).

Conclusion: Despite the limited evidence of the present review, it is important to continue supporting MT as a complementary treatment for older adults with dementia. RCTs with larger sample sizes are needed to better elucidate the impact of MT on cognitive functions.

Full reference: Laura Fusar-Poli, et al.  The effect of music therapy on cognitive functions in patients with dementia: a systematic review and meta-analysis   | Aging & Mental Health | Published online: 10 Jul 2017

Is making music associated with better cognitive functioning?

D. Mansens, D. J. H. Deeg, and H. C. Comijs. The association between singing and/or playing a musical instrument and cognitive functions in older adults. Aging & Mental Health. Published online: 19 May 2017

Objectives: Cognitive decline happens to everyone when aging, but to some more than others. Studies with children, adults, and professional musicians suggest that making music could be associated with better cognitive functioning. In older adults however, this association is less well investigated, which is therefore the aim of this study.

Methods: In this cross-sectional study data from 1101 participants aged 64 and older from the Longitudinal Aging Study Amsterdam were used. Multivariable linear regression analyses were performed to test the association between making music and cognitive functioning and time spent making music and cognitive functioning. ANCOVA analyses were performed to differentiate between participants who made no music, only sang, only played an instrument or both sang and played an instrument in terms of cognitive functioning.

Results: Making music was significantly positively associated with letter fluency, learning and attention/short-term memory. Time spent making music yielded no significant results. The ANCOVA analyses showed higher scores for participants who only played an instrument compared to participants who made no music on learning, working memory and processing speed. For processing speed the instrument only group also had a higher score than participants who only sang.

Discussion: Making music at least once every two weeks and especially playing a musical instrument, is associated with better attention, episodic memory and executive functions. The results suggest that making music might be a potential protective factor for cognitive decline; however, to support this notion a longitudinal study design is needed.

 

Non-pharmacological interventions to treat behavioural disturbances

Abraha, I. et al. (2017) Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series. BMJ Open. 7:e012759

Objective: To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD).

Design: Systematic overview of reviews.

 

Conclusions: A large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD.

Read the full review here