With a new grant from the National Institute on Aging, Brown University researchers plan to conduct a randomized trial of whether a nursing home program that involves listening to a personalized music playlist can improve care and outcomes among residents with dementia.
"While MUSIC & MEMORY has been introduced to many residents with dementia living in nursing homes over the past few years, there is little systematic data on how the program is implemented nor on how it affects the behavior of the population of nursing home residents with dementia," said Vincent Mor, professor of health services, policy and practice at Brown's School of Public Health and principal investigator on the grant of up to $3.7 million over five years. "Our study will remedy this by systematically documenting how well the program is able to positively affect the lives of people who are exposed."
Mor and colleagues recently published encouraging findings about the program, showing that nursing homes certified in the program achieved greater improvement in behavioral problems and antipsychotic prescriptions than similar control sites. But those findings were limited by the retrospective nature of their analysis. The new study promises to make the evidence much clearer, said Rosa Baier, an author of the earlier study who will work with Mor on the new one.
"In this study, we will know exactly who receives the music and how often they listen," said Baier, associate director of Brown's Center for Long-Term Care Quality & Innovation (Q&I Center). "That will help us to more definitely link exposure to the personalized music with any changes in outcomes."
Last summer, Baier led a Retirement Research Foundation grant to capture best practices of implementing MUSIC & MEMORY by working with nursing homes as they implemented it. The first year of the new grant will pilot standardized best practice implementation at four nursing homes.
If all goes well, the team will then work with four nursing home corporations to spread the program to 60 more facilities over the next few years. Sites will be randomly selected to offer the program to residents immediately or after a delay. All the while, the researchers will be tracking behavioral problems, mood and antipsychotic medication use before, during and after implementation among residents who use MUSIC & MEMORY and residents who do not. The researchers will be able to measure resident exposure to the music based on metadata from the iPods they use.
Randomizing large groups of nursing homes to implement interventions, like MUSIC & MEMORY, is a pragmatic way to conduct research in this setting, Baier said, because this mimics how interventions reach patients in the real world. Brown's Q&I Center is pioneering this type of research, she said, with the goal of rigorously testing interventions to improve care for older adults in nursing homes and other care settings.