A group music intervention using percussion instruments with familiar music to reduce anxiety and agitation of institutionalized older adults with dementia
Open accessAbstract
Objective: This experimental study aimed to evaluate the effects of a group music intervention on anxiety and agitation of institutionalized older adults with dementia. Methods: A total of 60 participants were randomly assigned to an experimental or a control group. The experimental group received a 30‐min music intervention using percussion instruments with familiar music in a group setting in mid afternoon twice weekly for 6 weeks, whereas the control group received usual care with no music intervention. The Rating of Anxiety in Dementia scale was used to assess anxiety, and Cohen‐Mansfield Agitation Inventory was used to assess agitation at baseline, week 4 and week 6. Results: Repeated measures analysis of covariance indicated that older adults who received a group music intervention had a significantly lower anxiety score than those in the control group while controlling for pre‐test score and cognitive level (F = 8.98, p = 0.004). However, the reduction of agitation between two groups was not significantly different. Conclusions: Anxiety and agitation are common in older adults with dementia and have been reported by caregivers as challenging care problems. An innovative group music intervention using percussion instruments with familiar music as a cost‐effective approach has the potential to reduce anxiety and improve psychological well‐being of those with dementia. Copyright © 2011 John Wiley & Sons, Ltd.
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Music intervention had a significant effect in reducing anxiety (p = 0.004).
“Results indicated that music intervention had a significant effect in reducing anxiety (p = 0.004).”
From Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia: A Systematic Review (2015) · cites this paper as [33]
Preliminary evidence suggests mirtazapine may reduce agitation.
“Preliminary evidence suggests mirtazapine may reduce agitation. 15”
From Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials (2014) · cites this paper as [15]
The Methods and Results (p. 623) describe a group music intervention, not treatment with mirtazapine. Searches for mirtazapine and pharmacological treatment found no passage in our copy addressing whether mirtazapine may reduce agitation. (LLM, conf=0.76)
Experimental — accuracy not yet measuredSeveral studies reported the efficacy of music to treat BPSD.
“Several studies reported the efficacy of music to treat BPSD (208–213), to enhance communications, relational processes and participation (199, 214–216), and to maintain or increase cognitive functions (217–222).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [210]
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Yap, A. F., Kwan, Y. H., Tan, C. S., Ibrahim, S. M., & Ang, S. B. (2017) · BMC Complementary and Alternative Medicine · doi:10.1186/s12906-017-1825-x · Cited by 36 · see citing works
“The effects of RMM on the psychological health of participants with improvements in anxiety [35], mood [36], stress, anger and self-esteem [37] has been shown in various other studies as well [38].”
ResultYap, A. F., Kwan, Y. H., & Ang, S. B. (2016) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2016.11.011 · Cited by 33 · see citing works
Chen, M., Chen, K., Chang, C.-L., Chang, Y., Cheng, Y., & Huang, H. (2016) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000000518 · Cited by 31 · see citing works
Ho, R., Fong, T. C. T., Sing, C., Lee, P. H., Leung, A., Chung, K. S., & Kwok, J. K. L. (2018) · Dementia · doi:10.1177/1471301218760023 · Cited by 31 · see citing works
Clare, A., & Camic, P. M. (2019) · Arts & Health · doi:10.1080/17533015.2019.1675732 · Cited by 31 · see citing works
Cheung, D. S. K., Lai, C. K. Y., Wong, F. K. Y., & Leung, M. C. P. (2018) · Dementia · doi:10.1177/1471301218800195 · Cited by 33 · see citing works
Navarro, L., Gómez‐Carballa, A., Pischedda, S., Montoto-Louzao, J., Viz-Lasheras, S., Camino‐Mera, A., Hinault, T., Martinón‐Torres, F., & Salas, A. (2023) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2023.1063536 · Cited by 28 · see citing works
“org There are many other studies focusing on the beneficial effects of music on the psychological or emotional states, specially reducing agitation and anxiety in persons with dementia (Svansdottir and Snaedal, 2006; Raglio et al., 2008; Cooke et al., 2010; Sung et al., 2012; Vink et al., 2013; Cohen-Mansfield, 2014;…”
BackgroundJohnson, J. K., & Chow, M. L. (2015) · Handbook of clinical neurology · doi:10.1016/b978-0-444-62630-1.00037-8 · Cited by 25 · see citing works
“Other studies also report a reduction in anxiety and depression after various music interventions (Ashida, 2000; Han et al., 2010; Sung et al., 2010, 2012).”
Zhang, J., Yu, Z., Zhang, N., Zhao, W., Wei, B., He, R., Xue, H., Zhu, B., & Mao, Y. (2023) · Aging & Mental Health · doi:10.1080/13607863.2023.2214091 · Cited by 24 · see citing works
Music therapy to reduce agitation in dementia.
Craig, J. (2014) · PubMed · Cited by 24 · see citing works
Uğur, H. G., Orak, O. S., Aktaş, Y. Y., Enginyurt, Ö., & Saglambilen, O. (2018) · Complementary Medicine Research · doi:10.1159/000490348 · Cited by 24 · see citing works
Ballard, C. G., Orrell, M. W., Moniz-Cook, E. D., Woods, B. T., Whitaker, R., Corbett, A., Aarsland, D., Murray, J., Lawrence, V. C., Testad, I., et al. (2020) · Programme Grants for Applied Research · doi:10.3310/pgfar08060 · Cited by 24 · see citing works
Sousa, L., Neves, M. J., Moura, B., Schneider, J. M., & Fernandes, L. P. N. S. (2021) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5568 · Cited by 22 · see citing works
A scoping review: Sensory interventions for older adults living with dementia
Hayden, L., Passarelli, C., Shepley, S., & Tigno, W. (2022) · Dementia · doi:10.1177/14713012211067027 · Cited by 22 · see citing works
McCabe, L., Greasley‐Adams, C., & Goodson, K. (2013) · Dementia · doi:10.1177/1471301213508128 · Cited by 21 · see citing works
CREIGHTON, A. S., Davison, T. E., & Kissane, D. W. (2017) · International Psychogeriatrics · doi:10.1017/s1041610217002599 · Cited by 20 · see citing works
“…studies utilized the RAID to assess the effects of psychological interventions on anxiety in RACF residents (Cooke et al., 2010; Sung et al., 2010; Sung et al., 2012; Wenborn et al., 2013), with two finding significant decreases in anxiety postparticipation in a music intervention and when…”
MethodD’Aniello, G. E., Cammisuli, D. M., Cattaneo, A., Manzoni, G. M., Molinari, E., & Castelnuovo, G. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11060455 · Cited by 38 · see citing works
“[32] investigated the effects of group music sessions of 30 min, twice a week for 6 weeks in institutionalized elders with dementia (i.”
BackgroundCheung, A. T., Li, W. H. C., Ho, L. L. K., Ho, K. Y., Lam, K. K. W., & Chung, J. O. K. (2019) · Journal of Clinical Nursing · doi:10.1111/jocn.15023 · Cited by 17 · see citing works
Development and treatment of aggression in individuals with dementia
Gilmore, M., Stebbins, L., Argüelles-Borge, S., Trinidad, B., & Golden, C. J. (2020) · Aggression and Violent Behavior · doi:10.1016/j.avb.2020.101415 · Cited by 17 · see citing works
Ting, B., Chen, D. T.-L., Hsu, W.-T., Liang, C., Malau, I. A., Li, W.-C., Lee, S.-L., Jingling, L., & Su, K. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12175497 · Cited by 16 · see citing works
“Five of the included articles were at high risk of performance bias due to the nature of MI [31,32,36,42,43].”
BackgroundInfluentialTai, S., Wang, L.-C., & Yang, Y.-H. (2015) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s82572 · Cited by 16 · see citing works
Sleep in older adults and in subjects with dementia
Frohnhofen, H., Schlitzer, J., & Netzer, N. (2017) · Zeitschrift für Gerontologie und Geriatrie (Print) · doi:10.1007/s00391-017-1289-0 · Cited by 16 · see citing works
Hallam, S., & Himonides, E. (2022) · Open Book Publishers · doi:10.11647/obp.0292.08 · Cited by 16 · see citing works
Tz-Han, L., Wu, W., Chen, I., & Huang, H. (2022) · Geriatric Nursing · doi:10.1016/j.gerinurse.2022.11.014 · Cited by 15 · see citing works
Nwokenna, E. N., Sewagegn, A. A., & Falade, T. A. (2022) · Medicine · doi:10.1097/md.0000000000032112 · Cited by 17 · see citing works
“[40] According to another previous study, individuals who participated in a group music intervention had lower levels of stress than those in the control group.[41] In addition, previous findings show that music reduces pain and improves mood.”
ResultModifiable factors associated with anxiety in persons with dementia: An integrative review
Hwang, Y., Massimo, L. M., & Hodgson, N. A. (2020) · Geriatric Nursing · doi:10.1016/j.gerinurse.2020.06.003 · Cited by 13 · see citing works
Russo, F., Mallik, A., Thomson, Z., James, A. D. R. S., Dupuis, K., & Cohen, D. (2023) · Frontiers in Digital Health · doi:10.3389/fdgth.2023.1064115 · Cited by 11 · see citing works
Kondo, E., Tabei, K., Okuno, R., & Akazawa, K. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.831523 · Cited by 11 · see citing works
Yao, C., Lee, B., Hong, H., & Su, Y. (2022) · Educational Gerontology · doi:10.1080/03601277.2022.2099076 · Cited by 11 · see citing works
Atchison, K., Watt, J. A., Ewert, D., Toohey, A. M., Ismail, Z., & Goodarzi, Z. (2022) · Age and Ageing · doi:10.1093/ageing/afac195 · Cited by 11 · see citing works
Fitzsimmons, S., Barba, B., & Stump, M. (2014) · Journal of Gerontological Nursing · doi:10.3928/00989134-20141215-01 · Cited by 11 · see citing works
The Assessments of Music Therapy for Dementia Based on the Cochrane Review
Abe, M., Tabei, K., & Satoh, M. (2022) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000521231 · Cited by 11 · see citing works
Lu, L., Lan, S., Lan, S., & Hsieh, Y. (2024) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000542464 · Cited by 7 · see citing works
The Positive Impact of African Drumming on Elderly Participants’ Mood and Demeanour
Roy, M. M., Devroop, K., & Bohn, A. (2019) · Muziki · doi:10.1080/18125980.2020.1794945 · Cited by 7 · see citing works
Hallam, S., & Himonides, E. (2022) · Open Book Publishers · doi:10.11647/obp.0292.14 · Cited by 7 · see citing works
Hu, J. Y., & Xu, L. (2025) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2025.106048 · Cited by 7 · see citing works
Mei, Z., Zhang, Y., Zhao, W., Lam, C., Luo, S., Wang, S., & Luo, S. (2025) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2025.101951 · Cited by 5 · see citing works
Effects of group music sessions on cognitive and psychological functions in healthy older adults
Shinada, T., Takahashi, M., Uno, A., Soga, K., & Taki, Y. (2025) · Frontiers in Aging · doi:10.3389/fragi.2025.1513359 · Cited by 5 · see citing works
“Music sessions have been incorporated as loop work for patients with dementia, and there have been improvements in psychological state, such as anxiety levels, after six weeks of percussion group sessions among older adults with dementia (Sung et al., 2012).”
Xu, W., Zhang, G., Liu, Q., Zhang, S., Zhao, M., Bai, X., Liu, H., Duan, W., Bai, J., Chen, Y., et al. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116781 · Cited by 5 · see citing works
Development and validation of the Music Cognitive Test: A music-based cognitive screening test
Mangiacotti, A. M. A., Cipriani, G., Ward, E. V., Franco, F., & Biasutti, M. (2022) · Psychology of Music · doi:10.1177/03057356221100851 · Cited by 5 · see citing works
“Music therapy (MT, see World Federation of Music Therapy, 2011 for definition) and music interventions have increasingly been used both as rehabilitation treatments to support individuals with cognitive and neuropsychiatric decline (i.e., Biasutti & Mangiacotti, 2018, 2021; Hsu et al., 2015; Sung et al., 2012) and as…”
MethodEffects of Music Therapy on Agitation in Dementia: Systematic Review and Meta-analysis
Kong, E., & Park, M. (2015) · Korean Journal of Adult Nursing · doi:10.7475/kjan.2015.27.1.106 · Cited by 5 · see citing works
“1차 선정된 31편의 연구는 원문을 검토하였으며, 그 중 불충분한 자료로 효과크기를 산출할 수 없는 연구 8편, 무 작위 설험설계가 아닌 연구 7편, 신뢰도와 타당도가 증명되지 않은 측정도구를 사용한 연구 3편, 결과변수에 초조행동이 포 함되지 않은 연구 2편, 음악요법이 주된 중재가 아닌 연구 1 편, 선정기준에 적합하지 않는 연구 21편을 제외하여 총 10편 이 선정되었다[24-33].”
Wong, T. C. (2022) · Frontiers of Nursing · doi:10.2478/fon-2022-0020 · Cited by 4 · see citing works
Quattrini, S., Merizzi, A., Caciula, I., Napradean, L., Azevedo, M. J., Costa, S., & Santini, S. (2024) · BMC Medical Education · doi:10.1186/s12909-024-05651-4 · Cited by 4 · see citing works
“Passive and active music activities can have positive effects on older people with dementia’s behavior and mood [7], particularly agitation [8], anxiety [9] and depression [10].”
BackgroundAlm, A. K., Danielsson, S., & Kristiansen, L. P. (2018) · Open Journal of Nursing · doi:10.4236/ojn.2018.87034 · Cited by 4 · see citing works
“[12], however, did not found that music therapy gave any significant difference regarding the symptom of agitation.”
BackgroundRegier, N. G., & Gitlin, L. N. (2017) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-017-0105-1 · Cited by 4 · see citing works
Music and Nursing Home Residents with Dementia: A Literature Review
Coxey, J. P., Kameg, B., Novosel, L. M., & Lee, H. (2021) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2021.03.011 · Cited by 3 · see citing works
Ballard, C. G., Mills, K., Soto, M., Cummings, J. L., Mintzer, J. E., Grossberg, G. T., Ikeda, M., Pathak, S. S., Fischer, C. E., & McDermid, J. (2025) · International Psychogeriatrics · doi:10.1016/j.inpsyc.2025.100118 · Cited by 3 · see citing works
Subthreshold Anxiety in Later Life
Grenier, S., & Richer, M. (2021) · Cambridge University Press eBooks · doi:10.1017/9781139087469.004 · Cited by 3 · see citing works
- Authors
- Sung, H., Lee, W., Li, T., & Watson, R.
- Affiliations
- Tzu Chi College of Technology (TW)
- National Taiwan Sport University (TW)
- University of Sheffield (GB)
- Corresponding author
- Sung, Huei‐chuan
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2011-08-08
- Volume
- 27
- Issue
- 6
- Pages
- 621-627
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- OpenAlex
- W1520905257
- Cited by
- 174
- References
- 32
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 10 · 2023: 5 · 2022: 33 · 2021: 12 · 2020: 13 · 2019: 13 · 2018: 15 · 2017: 15 · 2016: 16 · 2015: 12 · 2014: 10 · 2013: 6 · 2012: 2
- FWCI
- 7.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Repository@Hull (Worktribe) (University of Hull) (submittedVersion, cc-by)
- Funders
- National Science Council
- Topics
- Social Sciences › Psychology › Social Psychology › Music Therapy and Health
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Education › Music Education and Analysis
- Keywords
- percussion instruments, familiar music, dementia, anxiety, agitation, institutionalized elderly, nursing home residents, non-pharmacological treatment, psychological well-being
- MeSH terms
- Aged, Aged, 80 and over, Analysis of Variance, Anxiety, Dementia, Female, Humans, Male, Music Therapy, Psychiatric Status Rating Scales, Psychomotor Agitation, Psychotherapy, Group, Residential Facilities, Taiwan, Outcome Assessment, Health Care
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