Authors: (including presenting author): :
Hui WC(1), Chan CW(1), Lai KS(1), Yeung KK(1), Li HS(1)
Affiliation: :
(1)Department of Medicine and Geriatrics, Tai Po Hospital
Keyword 3: :
Music Intervention
Keyword 4: :
Individualised
Keyword 5: :
Non-Pharmacological Intervention
Keyword 6: :
Restraint-free
Introduction: :
Agitation affects 50–80% of people with dementia (PwD), impairing their well-being, burdening caregivers and straining healthcare resources. While pharmacological agents carry risks of adverse effects, non-pharmacological approaches show promise to settle agitation. Individualised music intervention is a cost-effective and safe approach to reduce agitation by leveraging preserved musical memory which remains intact even in advanced dementia. Personally familiar music evokes positive emotions, promotes environmental engagement, supports restraint-free care and decreases pharmacological agents. Technology-based delivery via iPads or Temi robots enhances accessibility and sustainability at low cost. It enables “ twenty-four hours, seven days” on-demand access to personalised playlists.
Objectives: :
(1) To reduce agitation in PwD as measured by the Pittsburgh Agitation Scale (PAS) after seven days. (2) To promote a restraint-free environment. (3) To minimise the use of pharmacological agents.
Methodology: :
This quasi-experimental pre-post study recruited 38 participants via convenience sampling. Inclusion criteria were (1) age ≥65 years, (2) diagnosed dementia and (3) baseline PAS score >0. Those with severe psychiatric conditions were excluded. From July to December 2025, PwD received daily 30-minute individualised music sessions for seven consecutive days. Playlists were tailored to preferences reported by PwD or caregivers, adopting a person-centred approach. Non-communicative PwD received preset playlists with natural sounds. Outcome measures included PAS score change and percentage reductions in physical restraints and pharmacological agents.
Result & Outcome: :
All 38 participants completed the study (mean age 80.8 years, range 69–91, 71.1% male). Mean PAS score decreased significantly from 5.92 to 2.24 (reduction 3.68; t(37)=9.35, p< .001), representing a 62.2% improvement. 89.5% showed ≥ 50% reduction in agitation. Physical restraints were discontinued in 62.9% of applicable cases, with PwD becoming restraint-free for an average of four days. Pharmacological agents were reduced in 47.4% of relevant PwD, including benzodiazepines (22.2%), antidepressants (44.4%) and sedative-hypnotics (44.4%). Individualised music intervention, delivered simply and economically via tablets, yielded marked reductions in agitation as well as physical restraints and pharmacological agents. Although high-quality evidence on reducing pharmacological agents remains limited in Asia, this study demonstrated robust effects, supporting future larger-scale trials as well as deeper qualitative exploration of caregiver and staff experiences for ongoing quality improvement and service enhancement.
