A Personalized, Telehealth Music Therapy Intervention for Lonely Older Adults: A Feasibility Study

Abstract

<h3>Introduction</h3> Music listening interventions, facilitated by a qualified music therapist, have been shown to reduce late-life depression and anxiety but their impact on loneliness has not been well-studied. Risks associated with loneliness in older adults include depression, cognitive decline, poorer disease outcomes and premature mortality. This study evaluated the feasibility of a remotely-delivered, personalized music therapy intervention for older adults living alone during the COVID-19 pandemic, and assessed measures of socioemotional well-being before, during, and after the intervention. <h3>Methods</h3> We recruited community-dwelling cognitively unimpaired older adults who lived alone, endorsed loneliness and were able to use Zoom video conferencing. Individuals with cognitive impairment (TICS < 31), moderate-severe depression (GDS > 10), or hearing impairment were excluded. Eight weekly, individual music therapy sessions were conducted with a board-certified music therapist via Zoom to develop personalized music playlists and to learn specific music listening techniques. Participants listened to playlists for one hour daily, completed a daily journal, and answered online questionnaires at weeks 0 (pre), 4 (mid), and 8 (post). The primary outcome was the PROMIS Social Isolation Scale [PROMS] score. Other questionnaires included the Behavioral Activation for Depression Scale [BADS], Positive Affect and Well-Being Scale [PAWB], Perceived Stress Scale [PSS], Brief Symptom Inventory [BSI], and the Snaith-Hamilton Pleasure Scale [SHAPS]). Qualitative data were collected at week 8 for thematic analysis. <h3>Results</h3> From March to August 2021, 11 participants were enrolled (mean age 74.82 [66-85], 88% women), eight completed the study, and one dropped out, leaving two actively enrolled. Among those who completed, numerical scores for loneliness and all other outcomes changed in an improved direction. Pre- and post-study mean scores and baseline standard deviation for those who completed are reported: PROMS (x¯=20.0, 16.8; sd=5.88), BADS (x¯=36.3, 40.8; sd=10.48), PAWB (x¯=33.5, 37.1; sd=6.61), PSS (x¯=14.5, 11.6; sd=7.89), BSI (x¯=33.3, 23.5; sd=17.1), SHAPS (x¯=47.0, 50.62; sd=6.74). Qualitative interviews were notable for themes of joy and improvements in sleep, health, focus, and physical pain. Participants also reported increased connectedness to culture, country of origin, loved ones, and the music therapist. <h3>Conclusions</h3> Recruitment and participant acceptability of a virtual, personalized music therapy intervention have been positive. Interim data analysis points to a possible improvement in loneliness and other outcome measures, though limited by low statistical power. Music therapy appears to be a novel and feasible approach to address loneliness and emotional wellbeing in at-risk community-dwelling older adults.