Abstract

Background: Multisensory stimulation and individualized music sessions have shown to be two effective non-pharmacological therapies in the management of the psychological and behavioural symptoms (BPSD) in people with severe dementia. However, there is limited evidence demonstrating which one is more effective. Therefore, it is necessary to carry out studies that include both therapies to distinguish the potential benefits of each of them.

Objectives: To compare the effects of a multisensory stimulation environment (MSSE) and individualized music sessions with regards to the mood and behaviour in a sample of institutionalized patients with severe dementia.

Methods: Randomized longitudinal trial with participants stratified according to their cognitive status, being afterward randomly assigned to one of the two study groups (MSSE or individualized music sessions). The sample consisted of 21 participants aged ≥ 65 recruited from a specialized dementia Gerontological Complex sited in A Coruña (Spain). Both groups participated in two 30-min weekly sessions over 16 weeks. Outcomes were agitation (Cohen-Mansfield Agitation Inventory, CMAI), mood (Cornell Scale for Depression in Dementia, CSDD) and anxiety (Rating Anxiety in Dementia, RAID), being assessed at baseline (pre-trial), in the middle (mid-trial), at the end of the intervention (post-trial) and 8 weeks after the intervention (follow-up). Moreover, the participant’s mood and behaviour (Interact Scale) were rated before, during, and after each session.

Results: Immediate effects: Both groups had immediate positive effects on mood and behaviour, reported by Interact scale. MSSE in the Snoezelen room was found to be as effective as individualized music sessions, except during the intervention sessions, with the difference in two of the analysed parameters: ‘tracking observable stimuli’ and ‘relaxed/content’. Short-term effects: Patients in the MSSE group showed significant improvement in their RAID scores compared with the individualized music group over time (post versus pre). With regard to agitation, both groups experienced an improvement in the CMAI total score after the 16 weeks of intervention, with no significant differences between groups. Respecting the effects on mood, in the MSSE group, the CSDD scores remained stable during the intervention, whereas in the individualized music group, they got worse over time, without being significant results. Long-term effects: In the follow-up period, for both groups, the agitation, mood and anxiety scores improved, with no significant differences between the groups.

Conclusions: Both interventions seem to be effective as non-pharmacological treatments for the management of BPSD at immediate and short terms, highlighting the efficacy of nonpharmacological treatments in patients with severe dementia. Future empirical studies with larger samples are needed to confirm our results and to examine the benefits of MSSE in a Snoezelen room versus another type of interventions in people with severe dementia. This work was supported by the Xunta de Galicia (FrailNet network IN607C 2016/08 and ED431C 2017/49).