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 therapy on people living with dementia. Equally, there has been very little research that has looked specifically at personalised music, and studies 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 study to develop the methodology needed to create and deliver personalised playlists for people living with dementia, preferably in an hour, and assess the best way to evaluate responses.

The findings from this first phase (to be undertaken in care homes run by the Quantum Care Home Group) will be used to inform a second phase of the study, where we assess the effects of personalised music on people with advanced dementia, their families and carers. The developed methodology and the observational findings from these two stages will inform and be applied to a larger scale intervention study, which we expect to be a randomised clinical trial.

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.

Phase 1 of the Feasibility Study

The first phase of our study will develop usable technology to create and deliver playlists for people living with dementia in a quick manner, 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 if a large scale study is to be conducted.

Our research in phase 1 will include testing the user-friendliness and acceptability of implementing the technology in care homes, including staff and residents’ willingness and confidence in using it. We will also explore what are the most effective tools to assess responses to personalised music. This will include observations of singing along and participation, movement of hands, feet or head and analysis of changes in facial expressions (including using exciting new video analysis technology to do this).

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

Looking into facial expressions as responses to music will be achieved through deep learning-based assessment and will be 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 therapy for enhancing the well-being of people living with dementia and their family, friends and carers.

Phase 2

Once we have our methodology in place, which will require testing, analysing user feedback and updating, we will seek research ethics approval to conduct the second phase of our research. There, we will explore the most appropriate questions, methodology and approaches to include in the design of a larger scale intervention study, which will evaluate the effectiveness of personalised music therapy for residents and carers. We are planning to work with people with advanced dementia and we will use the findings from Phase 1 to conduct the feasibility study to explore whether factors such as music tempo and key, frequency 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.  It will also test the user-friendliness and acceptability of research methods and explore questions to be addressed in a larger scale study.

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

Research methods

The feasibility studies will be a convergent, parallel mixed methods design with both quantitative and qualitative data collected and analysed simultaneously, then compared or related and interpreted.  Phase 2 will be a descriptive within-subject design, examining the individual effects of personalised music therapy on behavioural and psychological symptoms. Reflexive inquiry will be used to seek the views of relatives friends and care home staff about the intervention throughout the study, via the means of focus group discussions and interviews.

As this is a feasibility study, no formal sample size calculation will be used. A sample size of 60 residents, has been selected as it offers a reasonable test of the intervention to assess the feasibility objectives.  The study will take place in up to 10 care homes within the Quantum Care Home Group, with the 60 residents participating across these homes. 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 phase described above and seeking further funding to enable it to progress quickly. We hope to start in autumn 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.