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Measuring Effects of Nondrug Interventions on Behaviors: Music & Memory Pilot Study.

Identifieur interne : 000529 ( Main/Exploration ); précédent : 000528; suivant : 000530

Measuring Effects of Nondrug Interventions on Behaviors: Music & Memory Pilot Study.

Auteurs : Ellen M. Mccreedy [États-Unis] ; Xiaofei Yang [États-Unis] ; Rosa R. Baier [États-Unis] ; James L. Rudolph [États-Unis] ; Kali S. Thomas [États-Unis] ; Vincent Mor [États-Unis]

Source :

RBID : pubmed:31301191

Descripteurs français

English descriptors

Abstract

BACKGROUND/OBJECTIVES

Most people with Alzheimer disease and related dementias will experience agitated and/or aggressive behaviors during the later stages of the disease. These behaviors cause significant stress for people living with dementia and their caregivers, including nursing home (NH) staff. Addressing these behaviors without the use of chemical restraints is a growing focus of policy makers and professional organizations. Unfortunately, evidence for nonpharmacological strategies for addressing dementia-related behaviors is lacking.

DESIGN

Six-month, preintervention-postintervention pilot study.

SETTING

US NHs (n = 4).

PARTICIPANTS

Residents with advanced dementia (n = 45).

INTERVENTION

Music & Memory, an individualized music program in which the music a resident preferred when she/he was young is delivered at early signs of agitation, using a personal music player.

MEASUREMENTS

Dementia-related behaviors for the same residents were measured three ways: (1) observationally using the Agitation Behavior Mapping Instrument (ABMI); (2) staff report using the Cohen-Mansfield Agitation Inventory (CMAI); and (3) administratively using the Minimum Data Set-Aggressive Behavior Scale (MDS-ABS).

RESULTS

ABMI score was 4.1 (SD = 3.0) preintervention while not listening to the music, 4.4 (SD = 2.3) postintervention while not listening to the music, and 1.6 (SD = 1.5) postintervention while listening to music (P < .01). CMAI score was 61.2 (SD = 16.3) preintervention and 51.2 (SD = 16.1) postintervention (P < .01). MDS-ABS score was 0.8 (SD = 1.6) preintervention and 0.7 (SD = 1.4) postintervention (P = .59).

CONCLUSION

Direct observations were most likely to capture behavioral responses, followed by staff interviews. Nursing-home based, pragmatic trials that rely solely on available administrative data may fail to detect effects of nonpharmaceutical interventions on behaviors. Findings are relevant to evaluations of nonpharmaceutical strategies for addressing behaviors in NHs, and will inform a large, National Institute on Aging-funded pragmatic trial beginning spring 2019. J Am Geriatr Soc 67:2134-2138, 2019.


DOI: 10.1111/jgs.16069
PubMed: 31301191
PubMed Central: PMC6822268


Affiliations:


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Le document en format XML

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<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Aggression (MeSH)</term>
<term>Alzheimer Disease (therapy)</term>
<term>Homes for the Aged (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Memory (MeSH)</term>
<term>Music Therapy (methods)</term>
<term>Nursing Homes (MeSH)</term>
<term>Pilot Projects (MeSH)</term>
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<term>Agitation psychomotrice (thérapie)</term>
<term>Agressivité (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Maisons de repos (MeSH)</term>
<term>Maisons de retraite médicalisées (MeSH)</term>
<term>Maladie d'Alzheimer (thérapie)</term>
<term>Musicothérapie (méthodes)</term>
<term>Mémoire (MeSH)</term>
<term>Projets pilotes (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
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<term>Music Therapy</term>
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<term>Musicothérapie</term>
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<term>Alzheimer Disease</term>
<term>Psychomotor Agitation</term>
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<term>Agitation psychomotrice</term>
<term>Maladie d'Alzheimer</term>
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<keywords scheme="MESH" xml:lang="en">
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Aggression</term>
<term>Homes for the Aged</term>
<term>Humans</term>
<term>Memory</term>
<term>Nursing Homes</term>
<term>Pilot Projects</term>
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<keywords scheme="MESH" xml:lang="fr">
<term>Agressivité</term>
<term>Humains</term>
<term>Maisons de repos</term>
<term>Maisons de retraite médicalisées</term>
<term>Mémoire</term>
<term>Projets pilotes</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
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<p>
<b>BACKGROUND/OBJECTIVES</b>
</p>
<p>Most people with Alzheimer disease and related dementias will experience agitated and/or aggressive behaviors during the later stages of the disease. These behaviors cause significant stress for people living with dementia and their caregivers, including nursing home (NH) staff. Addressing these behaviors without the use of chemical restraints is a growing focus of policy makers and professional organizations. Unfortunately, evidence for nonpharmacological strategies for addressing dementia-related behaviors is lacking.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>DESIGN</b>
</p>
<p>Six-month, preintervention-postintervention pilot study.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>SETTING</b>
</p>
<p>US NHs (n = 4).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>PARTICIPANTS</b>
</p>
<p>Residents with advanced dementia (n = 45).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>INTERVENTION</b>
</p>
<p>Music & Memory, an individualized music program in which the music a resident preferred when she/he was young is delivered at early signs of agitation, using a personal music player.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>MEASUREMENTS</b>
</p>
<p>Dementia-related behaviors for the same residents were measured three ways: (1) observationally using the Agitation Behavior Mapping Instrument (ABMI); (2) staff report using the Cohen-Mansfield Agitation Inventory (CMAI); and (3) administratively using the Minimum Data Set-Aggressive Behavior Scale (MDS-ABS).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>ABMI score was 4.1 (SD = 3.0) preintervention while not listening to the music, 4.4 (SD = 2.3) postintervention while not listening to the music, and 1.6 (SD = 1.5) postintervention while listening to music (P < .01). CMAI score was 61.2 (SD = 16.3) preintervention and 51.2 (SD = 16.1) postintervention (P < .01). MDS-ABS score was 0.8 (SD = 1.6) preintervention and 0.7 (SD = 1.4) postintervention (P = .59).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>Direct observations were most likely to capture behavioral responses, followed by staff interviews. Nursing-home based, pragmatic trials that rely solely on available administrative data may fail to detect effects of nonpharmaceutical interventions on behaviors. Findings are relevant to evaluations of nonpharmaceutical strategies for addressing behaviors in NHs, and will inform a large, National Institute on Aging-funded pragmatic trial beginning spring 2019. J Am Geriatr Soc 67:2134-2138, 2019.</p>
</div>
</front>
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<JournalIssue CitedMedium="Internet">
<Volume>67</Volume>
<Issue>10</Issue>
<PubDate>
<Year>2019</Year>
<Month>10</Month>
</PubDate>
</JournalIssue>
<Title>Journal of the American Geriatrics Society</Title>
<ISOAbbreviation>J Am Geriatr Soc</ISOAbbreviation>
</Journal>
<ArticleTitle>Measuring Effects of Nondrug Interventions on Behaviors: Music & Memory Pilot Study.</ArticleTitle>
<Pagination>
<MedlinePgn>2134-2138</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1111/jgs.16069</ELocationID>
<Abstract>
<AbstractText Label="BACKGROUND/OBJECTIVES">Most people with Alzheimer disease and related dementias will experience agitated and/or aggressive behaviors during the later stages of the disease. These behaviors cause significant stress for people living with dementia and their caregivers, including nursing home (NH) staff. Addressing these behaviors without the use of chemical restraints is a growing focus of policy makers and professional organizations. Unfortunately, evidence for nonpharmacological strategies for addressing dementia-related behaviors is lacking.</AbstractText>
<AbstractText Label="DESIGN">Six-month, preintervention-postintervention pilot study.</AbstractText>
<AbstractText Label="SETTING">US NHs (n = 4).</AbstractText>
<AbstractText Label="PARTICIPANTS">Residents with advanced dementia (n = 45).</AbstractText>
<AbstractText Label="INTERVENTION">Music & Memory, an individualized music program in which the music a resident preferred when she/he was young is delivered at early signs of agitation, using a personal music player.</AbstractText>
<AbstractText Label="MEASUREMENTS">Dementia-related behaviors for the same residents were measured three ways: (1) observationally using the Agitation Behavior Mapping Instrument (ABMI); (2) staff report using the Cohen-Mansfield Agitation Inventory (CMAI); and (3) administratively using the Minimum Data Set-Aggressive Behavior Scale (MDS-ABS).</AbstractText>
<AbstractText Label="RESULTS">ABMI score was 4.1 (SD = 3.0) preintervention while not listening to the music, 4.4 (SD = 2.3) postintervention while not listening to the music, and 1.6 (SD = 1.5) postintervention while listening to music (P < .01). CMAI score was 61.2 (SD = 16.3) preintervention and 51.2 (SD = 16.1) postintervention (P < .01). MDS-ABS score was 0.8 (SD = 1.6) preintervention and 0.7 (SD = 1.4) postintervention (P = .59).</AbstractText>
<AbstractText Label="CONCLUSION">Direct observations were most likely to capture behavioral responses, followed by staff interviews. Nursing-home based, pragmatic trials that rely solely on available administrative data may fail to detect effects of nonpharmaceutical interventions on behaviors. Findings are relevant to evaluations of nonpharmaceutical strategies for addressing behaviors in NHs, and will inform a large, National Institute on Aging-funded pragmatic trial beginning spring 2019. J Am Geriatr Soc 67:2134-2138, 2019.</AbstractText>
<CopyrightInformation>© 2019 The American Geriatrics Society.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>McCreedy</LastName>
<ForeName>Ellen M</ForeName>
<Initials>EM</Initials>
<Identifier Source="ORCID">0000-0003-4063-8220</Identifier>
<AffiliationInfo>
<Affiliation>Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Yang</LastName>
<ForeName>Xiaofei</ForeName>
<Initials>X</Initials>
<AffiliationInfo>
<Affiliation>Department of Biostatistics, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Baier</LastName>
<ForeName>Rosa R</ForeName>
<Initials>RR</Initials>
<AffiliationInfo>
<Affiliation>Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Center for Long-Term Care Quality and Innovation, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Rudolph</LastName>
<ForeName>James L</ForeName>
<Initials>JL</Initials>
<AffiliationInfo>
<Affiliation>Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Center of Innovation in Long Term Services and Supports, Providence Veterans Affairs (VA) Medical Center, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Thomas</LastName>
<ForeName>Kali S</ForeName>
<Initials>KS</Initials>
<AffiliationInfo>
<Affiliation>Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Center of Innovation in Long Term Services and Supports, Providence Veterans Affairs (VA) Medical Center, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Mor</LastName>
<ForeName>Vincent</ForeName>
<Initials>V</Initials>
<AffiliationInfo>
<Affiliation>Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Center for Long-Term Care Quality and Innovation, Brown University School of Public Health, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Center of Innovation in Long Term Services and Supports, Providence Veterans Affairs (VA) Medical Center, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y">
<Grant>
<GrantID>R21 AG057451</GrantID>
<Acronym>AG</Acronym>
<Agency>NIA NIH HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant>
<GrantID>R33 AG057451</GrantID>
<Acronym>AG</Acronym>
<Agency>NIA NIH HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant>
<GrantID>R21AG057451</GrantID>
<Acronym>AG</Acronym>
<Agency>NIA NIH HHS</Agency>
<Country>United States</Country>
</Grant>
</GrantList>
<PublicationTypeList>
<PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
<PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType>
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<ArticleDate DateType="Electronic">
<Year>2019</Year>
<Month>07</Month>
<Day>13</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo>
<Country>United States</Country>
<MedlineTA>J Am Geriatr Soc</MedlineTA>
<NlmUniqueID>7503062</NlmUniqueID>
<ISSNLinking>0002-8614</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList>
<MeshHeading>
<DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000374" MajorTopicYN="Y">Aggression</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000544" MajorTopicYN="N">Alzheimer Disease</DescriptorName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006707" MajorTopicYN="N">Homes for the Aged</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008568" MajorTopicYN="N">Memory</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D009147" MajorTopicYN="N">Music Therapy</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D009735" MajorTopicYN="N">Nursing Homes</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D010865" MajorTopicYN="N">Pilot Projects</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011595" MajorTopicYN="N">Psychomotor Agitation</DescriptorName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="Y">behavior</Keyword>
<Keyword MajorTopicYN="Y">dementia</Keyword>
<Keyword MajorTopicYN="Y">music</Keyword>
<Keyword MajorTopicYN="Y">nursing homes</Keyword>
<Keyword MajorTopicYN="Y">pragmatic clinical trials as topic</Keyword>
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<Month>03</Month>
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<Year>2019</Year>
<Month>06</Month>
<Day>07</Day>
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<Year>2019</Year>
<Month>06</Month>
<Day>10</Day>
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<Month>7</Month>
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