Working within the preference of people with dementia

Section A: Preferred music interventions’ effect on psychological and behavioural outcomes for people with dementia: a systematic review.

A previous review concluded that preferred music is an effective intervention for managing agitation in people with dementia; however, the majority of the research articles included were pilot studies. A systematic review is carried out in this work to investigate the effect of preferred music on people with dementia. Six search engines yielded 240 papers, of which 12 were eligible. The report reviewed studies that investigated outcomes including agitation, anxiety, depression and overall emotional state. Inconsistent results are found across studies of most outcomes. Methodological issues mean that some studies are prone to bias. Consequently, it is difficult to draw conclusions from the review. The results suggest the need for further investigation into this area of research.

Section B: Development of the video analysis scale of engagement (vase) tool for people with advanced dementia.

The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational tool to appraise a continuous scale of engagement with people with advanced dementia. VASE was designed to enable the rating of moment-by-moment changes in engagement during an intervention, which would be useful for process evaluation in research. An initial version of the Video Analysis Scale of Engagement (VASE) was tested. Face validity and content validity were conducted to validate an operational definition of engagement and develop an acceptable protocol for the tool. Thirty-seven non-professional and professional volunteers were recruited to view and rate people with dementia’s level of engagement in the music activities using the VASE. An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Mixed-linear modelling suggested there that the types of interventions (active or passive music listening), the particular intervention session being rated, five second “stages” of each video and the age of those doing the rating could affect the ratings. Results suggested that raters used the VASE in a dynamic fashion, and that the tool was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable tool in the measurement of engagement of people with advanced dementia in a group activity setting.