Effectiveness of group music therapy versus recreational group singing for depressive symptoms of elderly nursing home residents: pragmatic trial

Abstract

Objectives: Several studies have suggested positive effects of music therapy in dementia, but research on age-related depression has been limited and of insufficient quality. The aim of this study was to examine the effect of interactive group music therapy versus recreational group singing on depressive symptoms in elderly nursing home residents.

Method: Residents of two German nursing homes with sufficient length of stay who were not bedridden were invited to participate in a pragmatic trial. A total of 117 participants, grouped into four clusters (based on their wards), were randomised to interactive group music therapy (n = 62; 20 units of 40 minutes, 2×/week) or recreational group singing (n = 55; 10 units of 90 minutes, 1×/week). The level of depressive symptoms was assessed using the Montgomery–Åsberg Depression Rating Scale at baseline (47% with at least mild depression) and follow-up in the 6th and 12th weeks. There was no blinding of assessors.

Results: The level of depressive symptoms improved significantly more in those assigned to music therapy (n = 60) than in recreational singing (n = 53), both in 6th week (mean difference 3.0 scores, 95% CI 1.21 to 4.79, p = 0.001) and 12th week (mean difference 4.50 scores, 95% CI 2.51 to 6.50, p < 0.001).

Conclusion: The results suggest that music therapy decreases depressive symptoms in elderly people in nursing homes more effectively than recreational singing.

Keywords:

• depression
• elderly care
• music therapy
• singing
• effectiveness
• pragmatic trial

Acknowledgements

The authors would like to thank the nursing homes and the residents for their participation in this study, and the geropsychiatric specialists for their additional effort in conducting the evaluations. Monika Geretsegger provided valuable comments on an earlier version of this article. The study was conducted as part of the master's degree programme at the University of Applied Sciences Würzburg – Schweinfurt, Germany.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. It should be noted that even though keywords such as ‘resources’ and ‘quality of relationship’ are important in describing this approach, these elements are not its main focus. Instead, its main focus is the person-centred model of validation (Feil, 2012; Hatfield & McClune, 2001). The principles and techniques of this approach differ from resource-oriented music therapy (Rolvsjord, 2010) by a structuring role of the therapist and focus on reducing symptoms. Working with transference, countertransference and free association as in psychodynamic approaches (Darnley-Smith, 2002) is not an element of this approach.