Musicothérapie et démence : vers une pratique fondée sur les preuves

Abstract

For several years, there has been an increase in the integration of music therapy in many health and medico-social institutions. Indeed, facility managers and medical staff observe the benefits of this approach. With regard to scientific evaluation, an increasing number of meta-analyses confirm the interest of music therapy among people with dementia. At the same time, neuroscience studies now make it possible to understand the mechanisms explaining the effects of music therapy. In the case of Alzheimer's disease, music is useful because music processing and memory of songs are relatively well preserved and music is a social activity that promotes relationships with others. The notion of evidence-based practice governs interventions in the health sector, guaranteeing the informed choice of practitioners and patients on the basis of a favorable benefit/risk ratio. This approach is based on the clinician's expertise, consideration of the patient's preferences and values and practice based on the best scientific evidence. It combines a patient-centered approach while taking into account the advances of scientific research. The analysis of the existing literature demonstrates the interest of music therapy for people with dementia, even though certain methodological limitations need to be considered. Evidence-based music therapy is thus compatible with current practice among music therapists, and we propose to identify the requirements for it implementation.