Abstract
Background: Recent research on the efficacy of music-based interventions for people with dementia have focused on specific outcomes and methods, and singing has been noted as a particularly beneficial activity. However, due to heterogeneity of research methods, there is a need to synthesise the findings of both quantitative and qualitative research in order to better understand both the impact and potential mechanisms of singing for people in this population.Method: This systematic review included quantitative, qualitative and mixed-methods studies, and analysed these using a systematic mixed-studies synthesis (with a results-based convergent approach). Quantitative and qualitative data were initially synthesised using a narrative synthesis and thematic synthesis method, respectively, before a final meta-integration method was used to synthesise common themes across the two data forms.Results: Electronic and hand search strategies revealed 1,815 relevant studies, 40 of which met the full eligibility criteria. Narrative synthesis of quantitative data revealed six key outcome areas (quality of life; psychological well-being; cognition; engagement; activities of daily living; care-partner well-being), and thematic synthesis of qualitative data generated seven themes relating to the impact and mechanisms of singing (pragmatic elements; social benefits; mood; identity; memory; flow-on effects; and relationships). Meta-integration identified four key areas relating to the impact and mechanisms of singing for people with dementia and care-partners: psychological well-being, quality of life, cognition, and care-partner well-being.Conclusion: Results from the syntheses suggest that singing can positively impact the lives of people with dementia and their care-partners, although due to heterogeneity of study design and outcome measures, it is difficult to draw conclusions based on quantitative data alone. Qualitative data provides further context and insights from participant perspectives, and when integrated with quantitative data, contextual factors that may influence the benefits that participants experience from singing are revealed.
Highlights
Music is increasingly recognised as a resource for people living with dementia, and in some cases, their family members who support them with informal care
Several recent systematic reviews have synthesised evidence reporting the efficacy of music-based interventions in dementia care (Vasionyte and Madison, 2013; Zhang et al, 2017; van der Steen et al, 2018; Clare and Camic, 2020; Sousa et al, 2020), and there is significant heterogeneity in the design of music-based programs/interventions, singing is recognised as a prominent method (McDermott et al, 2013)
Several papers have reported on singing programs for people living with dementia (McCabe et al, 2015; Osman et al, 2016; Unadkat et al, 2016), no systematic reviews have focused on the efficacy of singing with this population, nor have any explored how singing may be beneficial for people living with dementia and their familial care-partners
Summary
Music is increasingly recognised as a resource for people living with dementia, and in some cases, their family members who support them with informal care. Several recent systematic reviews have synthesised evidence reporting the efficacy of music-based interventions in dementia care (Vasionyte and Madison, 2013; Zhang et al, 2017; van der Steen et al, 2018; Clare and Camic, 2020; Sousa et al, 2020), and there is significant heterogeneity in the design of music-based programs/interventions, singing is recognised as a prominent method (McDermott et al, 2013). It is necessary to examine both quantitative and qualitative research literature to gain a comprehensive understanding of the ways that singing might help people with dementia and their care-partners. For this reason, a mixed-studies approach to systematically reviewing literature has been adopted in this paper. Due to heterogeneity of research methods, there is a need to synthesise the findings of both quantitative and qualitative research in order to better understand both the impact and potential mechanisms of singing for people in this population
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