ABSTRACT
BACKGROUND: Music therapy is demonstrated to be effective to relieve the agitation among people with dementia, but the comparative effectiveness of methods of music engagement for people with dementia is uncertain. OBJECTIVE: To evaluate the effects on cognitive functions and behavioral symptoms between interactive and receptive music therapies for people with dementia. METHODS: Prospective studies evaluating interactive and receptive music therapies were identified from the OVID databases, included MEDLINE, EMBASE, PsycINFO, and CINAHL. Supplementary search was conducted in Google Scholar. The primary outcome focused on cognitive function; the secondary outcomes were apathy, anxiety, depressive symptoms, agitation, and other behavioral problems. All outcomes were measured by the standard assessment tools. The heterogeneity of studies was examined, and the effects were pooled by meta-analysis. Quality of studies and risk of bias were assessed. RESULTS: Thirty-eight trials involving 1418 participants with dementia were included. The mean age ranged from 75 to 90 years, and the percentage of male participants ranged from 6% to 83%. No significant difference was found between participants receiving interactive or receptive music therapy and usual care in cognitive function; the mean difference (MD) of Mini-Mental State Examination was 0.18 [95% confidence interval (CI) -1.34 to 1.69], and -0.15 (95% CI -0.55 to 0.25), respectively. Participants with receptive music therapy had significant decrease in agitation (Cohen-Mansfield Agitation Inventory: MD = -7.99, 95% CI -5.11 to -0.87) and behavioral problems (Neuropsychiatric Inventory: MD = -3.02 95% CI -5.90 to -0.15) compared to usual care, while no significant difference was found between interactive music therapy and usual care in behavioral problems and psychiatric symptoms. CONCLUSIONS: This study demonstrated that receptive music therapy could reduce agitation, behavioral problems, and anxiety in older people with dementia, and appears to be more effective than interactive music therapy. It is easy and convenient to implement receptive music therapy; therefore, we recommended the use of receptive music therapy in nursing homes, day care centers, and client homes.
Subject(s)
Behavioral Symptoms/therapy , Dementia/psychology , Dementia/therapy , Music Therapy/methods , Anxiety/therapy , Behavior Therapy/methods , Humans , Psychomotor AgitationABSTRACT
A single intradermal injection of 2 mg of dimethyl dioctadecyl ammonium bromide (DDA) in phosphate buffered saline (PBS) could induce polyarthritis in both LEW and DA rats with low incidence and severity whereas 2 mg of DDA in incomplete Freund's adjuvant (IFA) could induce very severe polyarthritis with 100% incidence in LEW rats. Histology of DDA-induced arthritis (DIA) revealed cellular infiltration, synovial hypertrophy, development of granulation tissue, destruction of cartilage and bone deformation in the articular joints. Lymph node cells (LNCs) but not immunoglobulin fractions from the DIA rats successfully transferred the severe disease into the naive recipients. A challenge injection of DDA in IFA in the rats, which had recovered from the DIA, could reactivate the disease. It is thus concluded that DDA has arthritis-inducing ability in the rats which is potentiated by IFA and the DIA is a cell-mediated immune disease which might be a model of experimental arthritis.
Subject(s)
Adjuvants, Immunologic , Arthritis, Experimental/etiology , Disease Models, Animal , Quaternary Ammonium Compounds , Animals , Arthritis, Experimental/immunology , Arthritis, Experimental/pathology , Female , Immunization, Passive , Immunoglobulins/immunology , Lymph Nodes/immunology , Lymph Nodes/pathology , Male , Rats , Rats, Inbred LewABSTRACT
The present study showed a novel finding that the development of adjuvant-induced arthritis (AA) in Lewis rats was completely prevented by incomplete Freund's adjuvant (IFA) injected 21 or 28 days before complete Freund's adjuvant (CFA) challenge. Hexadecane also completely prevented AA and squalane, methyl oleate and pristane moderately prevented AA, though pristane by itself induced mild arthritis in two out of five rats. Concanavalin A-stimulated lymph node cells (LNCs) isolated from AA rats were able to adoptively transfer the severe polyarthritis to all the naive recipients or even to the IFA pretreated recipients with earlier onset and more rapid progression than those of AA. The LNCs from the donors who had been pretreated with IFA and subsequently challenged with CFA could induce mild arthritis in only two out of eight naive recipients, whereas all the recipients who were challenged with CFA immediately after intravenous injection of these LNCs developed significantly less severe arthritis. However, the LNCs from IFA-pretreated donors failed to prevent AA. According to the T helper type 1 (Th1)/Th2 paradigm, it was suggested that the adjuvant-active vehicles such as IFA, hexadecane, squalane, methyl oleate and pristane, can affect and deviate the Th1/Th2 balance of immune responses in host. CFA could promote the propagation of Th2 cells rather than Th1 cells in these vehicle-pretreated rats through as yet undetermined mechanisms, eventually resulting in the prevention of AA. Finally, we discussed a regulatory role of adjuvant vehicles for induction and suppression of AA.