Foundational frameworks supporting selection of music and outcome measures in studies of cognition among older adults with mild cognitive impairment (MCI): An integrative review

ABSTRACT

Introduction

Foundational frameworks are formal theories or intervention rationales used to justify choices of and ensure congruence between variables. What are the characteristics of foundational frameworks in studies of music interventions designed to improve cognition among people with mild cognitive impairment (MCI), and are choices of music intervention and outcome measures congruent with them? This review addresses this question and allows practitioners to evaluate research-based clinical strategies and to transfer these protocols into effective practice.

Method

Experimental studies were included if they enrolled only people with MCI, focused exclusively on cognition and used music as a primary intervention. Thirteen studies met the full inclusion criteria and were selected based on consultation between the two authors. Searches were conducted between April and July 2020 and updated in August 2022. Integrative review methodology was used to extract, analyze and evaluate information pertaining to each research question, and included a quality appraisal.

Results

Results found that eight studies relied primarily on prior research to justify selection of music interventions. Twenty-five different outcome measures were used across all studies, and while music experiences appeared to be connected to the constructs represented in these measures, some connections were indirect or unclear. Finally, there was considerable variation in the depth and degree of congruence between explanatory frameworks and choices regarding music interventions and outcome measures.

Discussion

Findings from this review are important for the development of future theoretical models, clinical research, and evidence-based treatment protocols in this emerging area of practice.

KEYWORDS:

• Music
• music interventions
• cognitive improvement
• cognitive dysfunction
• mild cognitive impairment
• integrative review

Acknowledgements

The authors wish to acknowledge the assistance of Dr. Concetta Tomaino in providing review and critique of earlier drafts of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Appendix.

Sample of search results.

Additional information

Funding

No funding was received for this study.

Notes on contributors

Daniel B. Tague

Daniel B. Tague, PhD, MT-BC. Currently the Chair and Assistant Professor of Music Therapy at Southern Methodist University and previously, the Director of Music Therapy at Shenandoah University. Dr. Tague is a former World Commissioner for Clinical Practice in the World Federation of Music Therapy and now serves as an elected member of the Commission on the Education and Clinical Training of 21st Century Music Therapist for the American Music Therapy Association. Dr. Tague’s research is wide-ranging but often maintains a focus on clinical practice and teaching. As Co-PI on recent international and national research surveys into clinical practice and the effects of online teaching during COVID, he has helped to develop key information about music therapy client populations, needs and clinical practice. Dr. Tague’s clinical work has included music therapy with neonatal infants to older adults with dementia in settings that range from client homes and schools to inpatient medical and mental health facilities.

Anne W. Lipe

Anne Lipe, Ph.D. Received her early music therapy training at East Carolina University and completed her doctorate in Human Growth and Development at the University of Maryland in 1995. A music therapy practitioner for 40 years, she worked in nursing homes and adult day care centers, in general hospitals and hospice care. As a music therapy educator, she taught in several universities including Tennessee Technological University, Marywood University, Converse College and Shenandoah University. She has presented and been published in the area of music therapy and dementia, and has conducted psychometric research on the Music-Based Evaluation of Cognitive Functioning which she developed for older adults with dementia. She holds a Graduate Certificate in Spiritual Direction from the Washington Theological Union, and has presented at numerous conferences on the interface between music therapy and spirituality. She is retired and living with her husband in North Carolina.