OBJECTIVES To study the effects of a nonpharmacologic intervention, Music and Memory (M&M), on residents with dementia and/or behavioral problems living in nursing homes (NHs). DESIGN This was a prospective, mixed-methods cohort study. SETTING AND PARTICIPANTS In total, 4107 residents in 265 California NHs and that reported data at least twice during the 3-year study period were enrolled. MEASURES We used a quarterly rolling enrollment process; participants provided data at baseline and quarterly via an online survey that included select resident level data from the Minimum Data Set (psychotropic drug use, cognition, behaviors, mood, pain, and falls), experience with the M&M program, and resident use of music. NHs were eligible if they were Medicare- and Medicaid-certified and had 15 residents with a diagnosis of dementia or cognitive impairment or exhibited significant behavioral symptoms. RESULTS M&M was associated with reductions in psychotropic medication use, reduced behaviors, and improved mood. The odds of antipsychotic use declined by about 11%, of antianxiety medications by 17%, and antidepressants by 9% per quarter. Aggressive behaviors, depressive symptoms, pain, and falls also declined significantly over time. The odds of residents exhibiting aggressive behaviors declined by 20% per quarter, depressive symptoms by 16%, reported pain by 17%, and falls by 8%. CONCLUSIONS AND IMPLICATIONS This is the largest study of M&M to date. We found clinically and statistically significant reductions in psychotropic medications and improved behaviors in residents using M&M. Although the study showed positive results overall, the lack of a control group was a significant limitation that precluded determining how much more improvement participating residents experienced compared with nonparticipants. Future studies should include a control group so that better conclusions can be drawn regarding the effectiveness of the M&M program.

中文翻译：

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音乐和记忆对加州疗养院居民水平结果的影响

目的 研究非药物干预、音乐和记忆 (M&M) 对居住在疗养院 (NHs) 的痴呆和/或行为问题居民的影响。设计 这是一项前瞻性、混合方法队列研究。设置和参与者 总共有 4107 名居住在 265 个加州 NH 并且在 3 年研究期间至少报告过两次数据的居民。措施 我们采用了季度滚动注册流程；参与者通过在线调查提供基线和季度数据，其中包括来自最小数据集（精神药物使用、认知、行为、情绪、疼痛和跌倒）、M&M 计划的经验以及居民对音乐的使用情况. 如果 NH 获得医疗保险和医疗补助认证，并且有 15 名居民被诊断为痴呆症或认知障碍或表现出明显的行为症状，则他们符合资格。结果 M&M 与精神药物使用减少、行为减少和情绪改善有关。每季度使用抗精神病药的几率下降约 11%，使用抗焦虑药的几率下降 17%，使用抗抑郁药的几率下降 9%。随着时间的推移，攻击性行为、抑郁症状、疼痛和跌倒也显着下降。居民表现出攻击性行为的几率每季度下降 20%，出现抑郁症状的几率下降 16%，报告疼痛的几率下降 17%，下降 8%。结论和意义 这是迄今为止最大的 M&M 研究。我们发现使用 M&M 的居民在临床和统计上显着减少精神药物并改善行为。尽管该研究总体上显示出积极的结果，但缺乏对照组是一个重大限制，无法确定与非参与者相比，参与的居民经历了多少改善。未来的研究应该包括一个控制组，以便可以就 M&M 计划的有效性得出更好的结论。