Feasibility study into personalised music for people with dementia

At Music for my Mind we are passionate about the potential for personalised music to enhance the well-being of people living with dementia (850,000 people in the UK alone), their relatives, friends and carers.  

There is increasingly compelling evidence of the importance of sensory experience (for example to ease behavioural and psychological symptoms) as cognitive function deteriorates for people living with dementia. In particular music can enable non-verbal communication for people with advanced dementia.

However, the evidence remains largely anecdotal and more well-conducted randomised-clinical trials are required to understand better the impact of music listening on people living with dementia. Equally, there has been very little research that has looked specifically at personalised music, and what studies there have been in this area have demonstrated mixed results.

This is why we want to help build the evidence base to demonstrate the value of personalised music for people living with dementia to help persuade care professionals to adopt these approaches.

A care home resident enjoying her favourite music with her family.Our first step on this journey will be a feasibility study to explore the most efficient and effective ways of creating and delivering personalised music for people living with mild to moderate dementia and to assess their responses to the music, including trialling automated analysis of changes in facial expression. Ideally, we want to be able to generate personalised playlists for people living with dementia in under an hour.

The findings from this study (to be undertaken in care homes run by the Quantum Care Home Group) will be used to develop our methodologies and to undertake an initial exploration of the effects of the music on behavioural and psychological symptoms in people with dementia including, for example, how factors such as timing of listening influence these effects. The methodologies developed through this study and other observations, will inform and be used in further feasibility studies, including with people with more advanced dementia (subject to obtaining further ethics approvals) and ultimately to inform the design of a larger scale study of the effects of personalised music on the well-being of people living with dementia.

Our hypothesis is that personalised music (i.e. music based on the known preferences of the person living with dementia during their formative years – age 14 to 22) will have an effect on reducing behavioural and psychological symptoms and improving relationships with carers and family.

First Feasibility Study

Our first feasibility study will develop easily usable technology to create and deliver playlists for people living with mild to moderate dementia, based on their background and musical preferences, including building an App that will allow us to do that quickly (we are currently fundraising to cover the costs of building the App). This is essential to be able to conduct a large scale study subsequently.

Our study will include testing the user-friendliness and acceptability of implementing the technology in care homes, including staff and residents’ willingness and confidence to use it. We will explore and develop the most effective tools to assess responses to personalised music, including observations of singing along and participation, movement of hands, feet or head and analysis of changes in facial expressions (including trialling exciting new video analysis technology to do this).

Empatica 4 Measurements during a music session
Empatica 4 Measurements during a music session

Analysis of facial expression changes in response to music will be achieved through deep learning-based assessment (machine-learning) and used either:

  1. as a tool to accelerate the creation of personalised playlists for people living with dementia, and/or
  2. to assess responses to personalised music within a larger scale intervention study to examine the effectiveness of personalised music listening in enhancing the well-being of people living with dementia and their family, friends and carers.

Further Feasibility Study

Once we have settled our methodology for people with mild to moderate dementia, which will require testing, analysing user feedback and updating, we will seek research ethics approval to conduct the second phase of our research, with people with advanced dementia. We will apply the developed methodology from our first study, refine it for use with this group of people (who are less likely to be able to communicate their musical rpeferences themselves) and explore the most appropriate questions and approaches to include in the design of a larger scale intervention study, to evaluate the impacts of personalised music listening for residents and carers. We will use the observational findings from our initial study to explore further whether factors such as music tempo and key, timing of listening and repetition affect the benefits, whether listening prior to difficult care events is beneficial (e.g. washing, toileting, sun-downing, etc.) and if benefits are sustained over time. We will also test further the user-friendliness and acceptability of research methods and explore questions to be addressed in a larger scale study.

These studies will contribute to the evidence that personalised playlists can benefit people living with dementia, which is needed to establish personalised music listening as standard practice within care homes and for it to be included in NICE (National Institute for Health and Care Excellence) guidelines for dementia care.

Research methods

Our feasibility studies will be conducted using a mixed methods approach, involving both quantitative and qualitative data collected and analysed simultaneously, then compared or related and interpreted. Reflexive inquiry will be used to seek the views of residents, relatives, friends and care home staff about the intervention throughout the study, through focus group discussions and interviews.

The study will take place in up to 10 care homes within the Quantum Care Home Group, with 60 residents participating across these homes. A sample size of 60 residents has been selected for the first feasibility study as it offers a sufficiently large group for us to develop different aspects of our methodology and approaches. Up to 60 relatives or friends of participating residents and up to 20 care home staff will be included in the study.

The results will be disseminated on this website and associated social media, peer-reviewed scientific journals; conference presentations and articles in other general publications.

Next Steps

We are excited about this study and its potential to advance understanding of the impact of personalised music on people living with dementia.  We are currently applying for research ethics approval for the first study and seeking further funding to enable it to progress quickly. We hope to start in November 2019 and will report progress on this webpage on a regular basis.

If you would like to get in touch with us with any questions or for further information, you can do so, through our Contact page.