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DementiaNCT03575026

Effectiveness-Implementation Cluster RCT to Improve Community-dwelling Early Dementia Patients by Music Intervention

A study testing Music-with-movement in people with Dementia, run by The Hong Kong Polytechnic University at 1 site in Hong Kong.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a 12-week cluster randomized controlled trial utilizing music-with-movement (MWM) intervention compared with usual care to investigate the effect of MWM among subjects with early dementia or mild cognitive impairment implemented by their caregivers at home. Read more about this study

Who is it for?
Ages 60 years and older
Conditions the study is for
Dementia
What is being tested?
Music-with-movement
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
100 participants
Where
1 siteHong Kong
Study dates
18 Apr 2018to 31 Jul 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 60 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged 60 or above
  • Cognitively impaired, defined by Global Deterioration Scale 3 or 4
  • Community-dwelling
  • With stable medical condition
  • Able to communicate in Cantonese
  • have a family caregiver who was willing to take part in the study
  • Primary caregiver of the PWeD
  • Related to the PWeD and not a paid live-in care attendant

Who cannot join

  • Suffering from any critical medical or psychiatric illnesses
  • Unable to hear even using hearing aids
  • Unable to sit independently for around 30 minutes
  • Received music intervention within 6 months
  • Participate in any clinical trial within 6 months prior to the start of study
  • Caregivers
  • Suffering from any critical medical or psychiatric illnesses
  • Received music intervention within 6 months prior to the start of study

Trial locations and contacts

1 site in 1 country.

Hong Kong1 site
  • School of Nursing, The Hong Kong Polytechnic University

    Hong Kong

Other trials in Hong Kong

About this study

Official title: Partnership With the Community to Improve the Well-being of People With Mild Cognitive Impairment (MCI)/Early Dementia and Their Caregivers With Music Intervention: an Effectiveness-Implementation Cluster Randomized Clinical Hybrid Trial

This is a 12-week cluster randomized controlled trial utilizing music-with-movement (MWM) intervention compared with usual care to investigate the effect of MWM among subjects with early dementia or mild cognitive impairment implemented by their caregivers at home.

Read the detailed description

Dementia is a neurodegenerative disorder and it can adversely affect patient's cognitive, behavioural, social and emotional functioning. Its prevalence will increase continuously because of the increase in aging population and it is predicted that around 333,000 people in Hong Kong (equivalent to 11% population aged 60 or above) will suffer from dementia in year 2039. The gradual functional decline, communication difficulties, the behavioural symptoms associated with cognitive impairment, may affect the relationships with the family members and the wellbeing. A latest Cochrane Review commented that music-based intervention may be helpful to improve emotional wellbeing and quality of life according to some limited evidences, as well as depressive symptoms, although future studies with larger sample sizes and more rigorous research design are suggested

In 2014 - 2016, our team has modified a music-with-movement intervention designed for nursing home residents with moderate dementia, into a protocol specified for caregiver-delivered home-based intervention to promote the psychosocial wellbeing of people with early dementia in Hong Kong. We found that the dyadic music-with-movement intervention yielded significant reduction on anxiety levels of people with early dementia as compared to control group. Similar, Särkämö and colleagues also found that caregiver-implemented music intervention group have reduced depression of people with early dementia and reduced caregiver burden. With the strong evidence that music intervention is useful in improving the wellbeing of people with early dementia and their family caregiver, it is essential to disseminate the culture-appropriated and validated intervention for promoting health and evaluate its effectiveness in real-practice setting by implementation research.

This research is anchored by a conceptual framework of leisure and subjective wellbeing. This framework explained that through participating in activities outside the obligated works (either paid or unpaid) that is subjectively regarded as leisure, would lead to an improvement of well-being through five psychological mechanisms, namely detachment-relaxation, autonomy, mastery, meaning and affiliation. Caregivers and care-recipients are found relaxed after participating in music intervention because they are temporary detached from the everyday caregiving chaos. Participating in an intervention designed by the participants themselves would increase their sense of autonomy and mastery. During the dyadic music intervention, the caregivers and people with MCI/early dementia would design their activities within the music-with-movement framework after instruction of music therapist that allow them to exercise their choices based on their music preference. Through the interaction in the dyadic intervention, it has been found that through participating in dyadic music intervention, people with dementia and their caregivers have improved in relationship and social inclusiveness. Caregivers would feel their competence or mastery in the skills when leading music intervention. Staff and caregivers reported that activities that address the psychological needs, provide enjoyment, value individuality, reinforce a sense of identity and belonging are meaningful to people with dementia. Therefore, we hypothesized that dyadic music-with-movement intervention would improve the subjective wellbeing of both the people with MCI/early dementia and their caregiver, if there are relevant implementation strategies to increase the ease of uptake of the intervention. For example, stress of caregivers could be relieved by successful music intervention.

When the aim is to maximize the uptake of the intervention in the real-life settings as a routine, we have to examine the influence of contextual factors on implementation. Hence, this study have three main objectives:

  1. To test the effectiveness of the dyadic music-with-movement intervention on wellbeing of people with MCI/early dementia, and of their caregivers in real-life settings;
  2. To conduct a process evaluation of the effectiveness-implementation study by gathering information on the implementation process; and
  3. To validate and extend the applicability of "Leisure \& Wellbeing" conceptual framework to the dyads. In this project, one of the implementation strategies to maximize the uptake of the music intervention by the dyads, is to train a team volunteers to support the caregivers and people with MCI/early dementia, which is a unique group of population. There is a general lack of knowledge and inappropriate attitude towards dementia or Alzheimer's disease worldwide. In Hong Kong, it was reported that university students majoring in medicine, nursing, occupational therapy and social work showed inadequate knowledge towards this group of patients. By providing training for volunteers to support participating dyads, it would be able to provide a better understanding on dementia and create a supportive community for dementia. Therefore, we will explore the changes in the following outcomes of the volunteers:
  4. To examine the change of knowledge and attitudes towards dementia of the volunteers before and after participating in the project; and
  5. To examine the change of satisfaction and motivation to volunteering before and after participating in the project.
Conditions
Dementia
Being tested
Music-with-movement, Usual care
Keywords
Early dementia, Caregiver, Anxiety, Well-being
Medical subject headings
Dementia, Anxiety Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Music-with-movementBehavioural

    Subjects will listen their preferred music and move their body actively with music

  • Usual careBehavioural

    Social activity acts as control with similar dose and intensity with intervention arm

Study groups in NCT03575026
Study groupRoleWhat they receive
InterventionExperimentalSubjects will receive 12-week music-with-movement intervention at home by their trained caregivers for 12 weeks, at least 3 sessions per week and 30 minutes for each session.
Receives: Behavioral: Music-with-movement
Wait-list controlPlacebo comparatorSubjects will receive 12-week usual care (social activity) at home. Dose is similar to intervention arm. After the completion of 12-week usual care, subjects will receive the same music intervention as intervention arm.
Receives: Behavioral: Usual care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes in patients' anxiety

    Rating Anxiety in Dementia (RAID), total score (range 0-54), higher indicates higher anxiety level (score>=11 indicates clinically significant anxiety)

    Measured: Baseline, immediate post-intervention (month 3)

  2. Changes in patients' depression

    Cornell scale for depression in dementia (CSDD), total score (range 0-36), higher indicates higher depression

    Measured: Baseline, immediate post-intervention (month 3)

  3. Changes in caregivers' stress and well-being

    Perceived Stress Scale 10 (PSS-10), total score (range 0-40), higher indicates higher perceived stress

    Measured: Baseline, immediate post-intervention (month 3)

  4. Changes in caregivers' stress

    Heart Rate Variability (HRV)

    Measured: Baseline, immediate post-intervention (month 3)

  5. Changes in caregivers' well-being

    Positive Aspects of Caregiving scale (PAC), total score (range 0-44), higher indicates more gain from caregiving experience

    Measured: Baseline, immediate post-intervention (month 3)

  6. Changes in caregivers' relationship with PWD

    Quality of the Caregiver-Care Recipient Relationship, 4 questions (range 0-4 each), higher score indicates better relationship between caregiver and care recipient

    Measured: Baseline, immediate post-intervention (month 3)

Secondary outcomes (4)
  1. Changes in volunteers' satisfaction from volunteering

    Volunteer Satisfaction Index (VSI), 3 sub-scores (Relationship within organization [range 0-70], Personal gain [range 0-70], Relationship with peers [range 0-28]). In any sub-score, higher mean better satisfaction in that aspect

    Measured: Baseline, 3-month post-intervention (month 6)

  2. Changes in volunteers' expectation from volunteering

    Volunteer Functions Inventory (VFI), 6 sub-scores (Protective [range 0-35], Values [range 0-35], Career [range 0-35], Social [range 0-35], Understanding [range 0-35], Enhancement [range 0-35]). In each sub-score, higher score indicates that aspect motivates more that individual to be a volunteer.

    Measured: Baseline, 3-month post-intervention (month 6)

  3. Changes in volunteers' knowledge towards dementia

    Alzheimer's Disease Knowledge Scale (ADKS), total score (range 0-24), higher indicates better knowledge towards Alzheimer's Disease

    Measured: Baseline, 3-month post-intervention (month 6)

  4. Changes in volunteers' attitude towards dementia

    Dementia Attitude Scale (DAS), total score [calculated by summation of 2 sub-scores, range 0-140] and 2 sub-scores (Comfort [range 0-70], Knowledge [range 0-70]). Higher indicates more positive attitude towards people with dementia.

    Measured: Baseline, 3-month post-intervention (month 6)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Jul 2018
  2. Study start18 Apr 2018
  3. Primary completion31 Jul 2019
  4. Study completion31 Jul 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
100 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03575026
Sponsor's protocol ID
5-ZH2P
Status last verified
Sep 2023
First submitted
11 Apr 2018
Last updated
28 Sep 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Alexopoulos GS, Abrams RC, Young RC, Shamoian CA. Cornell Scale for Depression in Dementia. Biol Psychiatry. 1988 Feb 1;23(3):271-84. doi: 10.1016/0006-3223(88)90038-8.

    PubMed 3337862
  • Alexopoulos GS, Abrams RC, Young RC, Shamoian CA. Use of the Cornell scale in nondemented patients. J Am Geriatr Soc. 1988 Mar;36(3):230-6. doi: 10.1111/j.1532-5415.1988.tb01806.x.

    PubMed 3339232
  • Berntson, G. G., & Cacioppo, J. T. (2004). Heart rate variability: Stress and psychiatric conditions. In M. Malik & A. J. Camm (Eds.), Dynamic electrocardiography (pp. 57-64). Oxford, UK: Blackwell Publishing.

  • Cahill S, Pierce M, Werner P, Darley A, Bobersky A. A systematic review of the public's knowledge and understanding of Alzheimer's disease and dementia. Alzheimer Dis Assoc Disord. 2015 Jul-Sep;29(3):255-75. doi: 10.1097/WAD.0000000000000102.

    PubMed 26207322
  • Carpenter BD, Balsis S, Otilingam PG, Hanson PK, Gatz M. The Alzheimer's Disease Knowledge Scale: development and psychometric properties. Gerontologist. 2009 Apr;49(2):236-47. doi: 10.1093/geront/gnp023. Epub 2009 Mar 25.

    PubMed 19363018
  • Cheung DSK, Lai CKY, Wong FKY, Leung MCP. The effects of the music-with-movement intervention on the cognitive functions of people with moderate dementia: a randomized controlled trial. Aging Ment Health. 2018 Mar;22(3):306-315. doi: 10.1080/13607863.2016.1251571. Epub 2016 Nov 7.

    PubMed 27819483
  • Clary EG, Snyder M, Ridge RD, Copeland J, Stukas AA, Haugen J, Miene P. Understanding and assessing the motivations of volunteers: a functional approach. J Pers Soc Psychol. 1998 Jun;74(6):1516-30. doi: 10.1037//0022-3514.74.6.1516.

    PubMed 9654757
  • Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385-96. No abstract available.

    PubMed 6668417
  • Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012 Mar;50(3):217-26. doi: 10.1097/MLR.0b013e3182408812.

    PubMed 22310560
  • Darragh M, Booth RJ, Koschwanez HE, Sollers J 3rd, Broadbent E. Expectation and the placebo effect in inflammatory skin reactions: a randomised-controlled trial. J Psychosom Res. 2013 May;74(5):439-43. doi: 10.1016/j.jpsychores.2012.12.010. Epub 2013 Jan 24.

    PubMed 23597333
  • Galindo-Kuhn, R., & Guzley, R. M. (2002). The volunteer satisfaction index: Construct definition, measurement, development, and validation. Journal of social service research, 28(1), 45-68.

  • Harmer BJ, Orrell M. What is meaningful activity for people with dementia living in care homes? A comparison of the views of older people with dementia, staff and family carers. Aging Ment Health. 2008 Sep;12(5):548-58. doi: 10.1080/13607860802343019.

    PubMed 18855170
  • Liu H, Wang Y, Wang L. A review of non-contact, low-cost physiological information measurement based on photoplethysmographic imaging. Annu Int Conf IEEE Eng Med Biol Soc. 2012;2012:2088-91. doi: 10.1109/EMBC.2012.6346371.

    PubMed 23366332
  • Krueger, R., & Casey, M. (2015). Participants in a focus group. In R. A. Krueger & M. A. Casey (Eds.), Focus Groups: A Practical Guide for Applied Research (5th ed., pp. 77-136). Thousand Oaks, California, USA: SAGE.

  • Kwok, T., Lam, K.-C., Yip, A., & Ho, F. (2011). Knowledge of dementia among undergraduates in the health and social care professions in Hong Kong. Social Work in Mental Health, 9(4), 287-301.

Questions about this trial

What is this clinical trial studying?

A study testing Music-with-movement in people with Dementia, run by The Hong Kong Polytechnic University at 1 site in Hong Kong.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Sep 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in patients' anxiety (time frame: Baseline, immediate post-intervention (month 3)). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03575026, which also lists 47 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Sep 2023.

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