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Participation in the music program did not significantly affect agitation and anxiety in older people with dementia. Both the music and reading group activities, however, gave some participants a 'voice' and increased their verbalization behavior. Agitation was found to be predicted by a number of background factors (namely level of cognitive impairment, length of time in the facility and gender) (Cooke, Moyle, Shum, Harrison, & Murfield, 2010, p. 905-916).

In the final study, a music mediation was achieved to observe the effects of customized music programming on agitation and depression for people suffering with moderate to high levels of dementia. The study involved a two weeks with no-music and then two weeks with music: "music programs were streamed to the rooms of individuals assigned to a music group (N = 19) several hours per day each day for 12 weeks" (Janata, 2012, p. 8-15). The study revealed results that consisted of decreases in "composite scores on the Cohen-Mansfield Agitation Inventory, Neuropsychiatric Inventory, and Cornell Scale for Depression in Dementia" (Janata, 2012, p. 8-15). Not only that, but the reductions were speedy and continuous in both groups. The study demonstrated a unique way to use music and showed positive results that promoted reduction in agitation. "Creating an almost omnipresent musical atmosphere directed at the musical preferences and listening histories of residents in an assisted living facility may reduce average levels of agitation and depression among the residents" (Janata, 2012, p. 8-15).

Ultimately it would not be effective to suggest music therapy as the only treatment option to help reduce sundown agitation in elderly patients with dementia. Standard of care involves a multi-faceted approach along with sleep disorder protocols such as "sleep hygiene" that need to be taken into consideration. Although music therapy has been proven to have some positive results in some studies, others have noted no positive results, mixed results, or no long-term positive results leading to the conclusion that music therapy should be implemented in a treatment protocol for sundown agitation reduction, but not as a stand-alone treatment.

Music therapy has it benefits and should become a part of standard care. Since depression and anxiety are often extremely common in elderly patients with dementia, it is important to note and take into consideration the effectiveness music has on these two concerns. A combination of music therapy and the use of non-pharmacologic and pharmacologic methods like light therapy and pain medication can help relieve many of the symptoms associated with elderly patients with dementia that do not just stem from sundown symptoms. Elderly patients normally have a host of chronic ailments that need to be assessed and treated.

In conclusion, many avenues should be investigated and researched to help treat and sundown agitation in elderly patients with dementia. It will not only result in increased effectiveness in treatment overall, but it will help the many suffering with dementia to live better lives and not become such a burden both emotionally and financially, to their families and the carers in the in-patient facilities. Other avenues should also be researched like social interaction and nutrition (organic food and reduced sugar diets).

References

Alzheimer's Compendium (2011). Sundowning. Retrieved from http://www.alzcompend.info/?p=268

Cohen-Mansfield, J. (2001). Nonpharmacologic Interventions for Inappropriate Behaviors in Dementia: A Review, Summary, and Critique. American Journal of Geriatric Psychiatry, 9(4), 361 -- 381. doi:10.1176/appi.ajgp.9.4.361

Cooke, M.L., Moyle, W., Shum, DH, Harrison, S.D., & Murfield, J.E. (2010). A randomized controlled trial exploring the effect of music on agitated behaviours and anxiety in older people with dementia. Aging & Mental Health, 14(8), 905-916. doi:10.1080/13607861003713190

Janata, P. (2012). Effects of Widespread and Frequent Personalized Music Programming on Agitation and Depression in Assisted Living Facility Residents With Alzheimer-Type Dementia. Music and Medicine, 4(1), 8-15. Retrieved from http://mmd.sagepub.com/content/4/1/8.short

KLAFFKE, S., & STAEDT, J. (2006). Sundowing and circadian rhythm disorders in dementia. Acta neurol. belg, 106, 168-175. Retrieved from http://www.actaneurologica.be/acta/download/2006-4/03-Klaffke%20et%20al.pdf

Ledger, A.J., & Baker, F.A. (2007). An investigation of long-term effects of group music therapy on agitation levels of people with Alzheimer's Disease. Aging & Mental Health,11(3), 330-338. doi:10.1080/13607860600963406

Opie, J., Rosewarne, R., & OConnor, D.W. (1999). The Efficacy of Psychosocial Approaches to Behaviour Disorders in Dementia: A Systematic Literature Review.Australian and New Zealand Journal of Psychiatry, 33(6), 789 -- 799. doi:10.1046/j.1440-1614.1999.00652.x

Rindlisbacher, P., & Hopkins, R.W. (1991). The sundowning syndrome: A conceptual analysis and review. American Journal of Alzheimers Disease and Other Dementias, 6(4), 2-9. doi:10.1177/153331759100600402

Snowden, M., Sato, K., & Roy-Byrne, P. (2003). Assessment and Treatment of Nursing Home Residents with Depression or Behavioral Symptoms Associated with Dementia: A Review of the Literature. Journal of the American Geriatrics Society, 51(9), 1305 -- 1317.

Staedt, J., & Stoppe, G. (2005). Treatment of rest-activity disorders in dementia and special focus on sundowning. International Journal of Geriatric Psychiatry, 20(6), 507 -- 511. doi:10.1002/gps.1307

Wall, M., & Duffy, A. (2010). The effects of music therapy for older peopleā€¦