Dyadic arts interventions for people living with dementia

Background:
In recent years, evidence for the positive effects of singing with people with dementia has been substantial. Some research has used physiological measures to analyse the impact of singing, however this method has not before been used in a community study with people with dementia; this study explored the interactions between these areas of research.

Method:
A mixed methods, quasi-experimental design was employed in this exploratory, within-subjects study. Physiological measures of stress (salivary cortisol and heart rate) and subjective measures of wellbeing and stress were obtained during a choral singing group from 17 participants, 10 with a dementia and 7 caregivers. Data were also collected during a non-singing control condition. Interviews investigating the influence of the singing group were conducted with caregivers and analysed using thematic analysis.

Results:
Quantitative results showed positive effects of group singing on subjective stress and wellbeing, with some significant increases in composite wellbeing, happiness and optimism. Stress hormone results were mixed but the majority showed a decreasing trend. Heart rate variability significantly increased for people with dementia which may be associated with the significant increase in happiness, as shown in previous research. Qualitatively, group singing was overall reported to have a positive influence on people with dementia and caregivers. These influences included effects on mood and cognition, and positive aspects of the intervention were described.

Conclusions:
The findings suggest that additional research is warranted to further investigate interactions of physiological and psychological variables related to choral singing in people with a dementia. Methodological difficulties of saliva collection with this population need to be addressed if stress hormones are used in future research.