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Accepted Manuscript

Combining music and reminiscence therapy interventions for wellbeing in elderly


populations: A systematic review

Lauren Istvandity, Dr

PII: S1744-3881(17)30060-9
DOI: 10.1016/j.ctcp.2017.03.003
Reference: CTCP 715

To appear in: Complementary Therapies in Clinical Practice

Received Date: 8 February 2017

Accepted Date: 28 March 2017

Please cite this article as: Istvandity L, Combining music and reminiscence therapy interventions for
wellbeing in elderly populations: A systematic review, Complementary Therapies in Clinical Practice
(2017), doi: 10.1016/j.ctcp.2017.03.003.

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TITLE PAGE – Submission to Complementary Therapies in Clinical Practice

Combining music and reminiscence therapy interventions for wellbeing in elderly


populations: A systematic review

Dr Lauren Istvandity
Griffith Centre for Social and Cultural Research

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Griffith University
170 Kessels Rd
Nathan

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Queensland 4111

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Tel: +61 07 3735 7317
Email: l.istvandity@griffith.edu.au

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Combining music and reminiscence therapy interventions for wellbeing in elderly


populations: A systematic review

Abstract

Both music therapy and reminiscence therapy are currently being used to increase aspects of

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wellbeing in older people, including those with memory diseases such as dementia, as
alternatives to pharmacological treatments. There is growing evidence that combining these
therapies in a focused way would provide unique wellbeing outcomes for this population.

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This review aims to report on the existing intervention studies that utilise both music and
reminiscence activities in equal measure in elderly adult populations. A systematic review of

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intervention-based studies published between 1996 and 2016 was carried out: five studies
were included in this review. Included studies were predominantly carried out in aged care
facilities with aged populations affected by a range of conditions; all studies assessed aspects

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of mental well-being. The review found music reminiscence therapy to have positive effects
for participants in four out of five studies. Further research incorporating qualitative methods
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and mapping of intervention procedures would complement existing findings.

Keywords: reminiscence, music therapy, memory, wellbeing, older adults, systematic review
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Introduction

The past decade has seen a great increase in research that theorises, applies and evaluates the
use of alternative wellbeing therapies employing aspects of the arts, especially for the elderly.
Music in particular, has been used to induce health and wellbeing benefits for various age
groups. Often considered separate to music therapy, music, health and wellbeing activities, or
“health musicing” (Bonde, 2011), can manifest in a range of modes including music-making,

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such as singing (Clift et al., 2010; Skingley and Bungay, 2010); listening (Ware, 2013); and
combined with dance (Davidson and Emberly, 2012; Quiroga Murcia, Kreutz, Clift, and
Bongard, 2010). Like other modes of arts-based stimuli, music can be found embedded in

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numerous alternative wellbeing therapies for older people, including reminiscence therapy.

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Reminiscence therapy is a group activity that involves the conversational discussion of
autobiographical memory, which is usually triggered by given topics, tangible items such as
photographs or artefacts, or recordings of music. The activity is often used with older

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populations, frequently in dementia care, and has been shown to most positively affect
cognition (Wang, 2007), mental health, especially depression (Chiang et al., 2010; Watt and
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Cappeliez, 2000; see also meta-analysis by Bohlmeijer, Smit and Cuijpers, 2003), and self-
esteem (Chao et al., 2006), alongside other factors. The therapy has been found to be more
effective when conducted in group settings, over individualised therapy for its socialisation
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benefits (Haslam et al., 2010), despite its evolution from individual “life review”
interventions as conceived by Butler (1963).
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Previous systematic reviews describe past studies of reminiscence therapy as producing


mixed outcomes. A Cochrane review conducted by Woods, Spector, Jones, Orrell and Davies
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(2005) indicates some positive effects are evident, however the small number of studies and
the variety of approaches limits generalised appraisal. A more recent review by Westerhof,
Bohlmeijer and Webster (2010) describes theoretical and practical progress in reminiscence
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interventions designed to support mental health outcomes. This review suggests an increasing
strength in the positive effect of the therapy in more recent studies, which are scaffolded by
developments in understanding of reminiscence functions and definitions. Neither review
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evaluates the efficacy of stimuli used in interventions, which are only mentioned in passing.
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While music may be used within reminiscence activities to prompt the recall of memories, it
has also been used for a similar purpose within music therapy. Music therapy has also been
shown to have some positive effects in varied populations, including older people (Hanser
and Thompson, 1994; Lai and Good, 2005) and those with dementia (Svansdottir and
Snaedal, 2006; Wall and Duffy, 2010) and may integrate elements of reminiscence into its
practice with these target groups. Music therapy currently has a greater evidence base and an
established theoretical infrastructure as compared to reminiscence therapy, though systematic
reviews produce mixed conclusions about its efficacy (McDermott, Crellin, Ridder & Orrell,
2012; Ueda, Suzukamo, Sato & Izumi, 2013; Vink, Bruinsma & Scholten, 2003). Though
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recall of memories may become part of a particular music therapy protocol, it is just one of a
raft of tools used in the broader applications of music therapy.

The overlap of the use of music and reminiscence between these two therapies is rather
germane. Studies across the domains of psychology and sociology demonstrate that music
can effectively trigger autobiographical memories with strong emotional content (Cady,
Harris & Knappenberger, 2008; Janata, Tomic & Rakowski, 2007; Schulkind, Hennis &
Rubin, 1999), and that an individual’s personal memories of music are closely tied to their

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self-identity (Bennett, 2013; DeNora, 2000; Frith, 1996) and life story (AUTHOR, A; B). In a
qualitative study of older people’s use of music, Hays and Minichiello (2005) underscore the
importance of music to this demographic, stating that it can connect them to “others who may

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no longer be living, and may also validate memories, give meaning to live, and bring a
greater sense of spirituality” (p. 274). Further to this, preliminary studies suggest that even

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the autobiographical recall of those experiencing cognitive decline such as dementia can be
enhanced by music listening (El Haj, Postal and Allain, 2012). Summarily, this evidence
points to the potential for a focussed, combined application of music and reminiscence in a

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structured setting to produce positive wellbeing outcomes for older populations, with and
without cognitive diseases such as dementia.
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At present, there are no published literature reviews that provide an adequate overview of
studies that integrate both music and reminiscence based activities for therapeutic gain with
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older populations. Similarly, a standardised protocol for the delivery of a music-reminiscence


therapy was not found at the time of this review. Hence, the aim of this systematic review is
to determine the extent to which music and reminiscence activities have been empirically
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assessed as interventions with older people in published studies. Further, the review sought to
describe how such activities were carried out, which aspect/s of health or wellbeing were
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targeted, and how outcomes were evaluated within studies meeting the criteria. The findings
of the review will provide insight into the current state of research, with the view to
generating standardised frameworks and procedures for the practice of music-reminiscence
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therapy.

Methods
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Literature Search Strategy

The author systematically searched academic databases relating to public health and aged
care using a pre-determined search string. The databases included: EBSCOhost, PubMed,
Proquest, CINAHL Plus, Informit Health, MEDLINE, Scopus, Google Scholar, and Wiley
Online Library. The search string allowed for the broad collection of research encompassing
both music or reminiscence interventions in elderly populations: music OR arts AND aged
care OR elderly OR seniors OR ageing OR older people AND reminiscence therapy OR
therapy AND intervention AND wellbeing OR health. Due to the lack of established
terminology for therapeutic activity that includes both music and reminiscence, a broad
search enabled the detection of relevant studies that may not use similar lexicons. The
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database search was restricted to include only full-text, peer-reviewed articles written in
English and published between 1996 and 2016 at the time of the search.

Study Selection Process

In the first stage of inquiry, several key exclusion criteria also applied in line with the search
string. The review was narrowed in terms of co-morbidity via the exclusion of research
incorporating diseases or conditions other than forms of dementia, depression or anxiety (e.g.

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cancer, Parkinson’s disease, disability, suicide). This review is focused on the current state of
intervention procedures involving music, reminiscence, and elderly populations and so
theoretical articles and reviews of literature were excluded. Studies that utilised participants

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that were under the age of 65 years were excluded. Abstracts were reviewed for the presence
of keywords in line with these parameters; potentially relevant articles were downloaded for

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full review (see Figure 1).

The second stage of the review involved examination of full-text articles, and application of

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further exclusion criteria. The first of these was the use of concepts of memory and
reminiscence. This review is concerned with the inclusion of reminiscence activities as part
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of the intervention, however, many studies in the areas of cognitive and psychological
science take measures for levels of memory function as a result of a particular intervention,
but do not include a reminiscence component in their intervention: such studies were
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excluded from the review. Similarly, studies were excluded if reminiscence was listed as an
outcome of an intervention (e.g. increased verbalisation of past experiences, thoughts and
feelings), but did not form an integral part of the intervention itself.
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Data Extraction
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During the second stage of the review, the author populated tables that detailed aspects
relevant to the review such as year of publication, sample size and description, type of
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intervention, frequency and length of intervention and whether it was conducted with groups
or individuals, country of study, and facility type. This method allowed the author to
overview a large amount of studies with ease, and to determine common characteristics.
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Articles selected for review were read several times each for familiarity and study
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characteristics were extracted in further detail (see Table 1). The studies’ commonalities and
differences were synthesized by the author, and appear below.

Results

Of the 1, 658 studies recovered in the database search, five studies were found to exclusively
utilize an intervention combining music and reminiscence therapies: these are the focus of
this review. Presented in Table 1 (see Appendix), these studies comprise Ashida (2000),
Haslam et al. (2014), Mohammadi, Shahabi and Panah (2011), Rawtaer et al. (2015), and
Takahashi and Matsushita (2006).
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A further seven studies were found to use music and reminiscence as part of a wider array of
activities designed to stimulate aspects of participants’ wellbeing in some way. These include
study designs in which music and reminiscence therapy was used in combination with other
leisure activities within one cohort, e.g. gardening (Han et al. 2011; Jo and Song 2015), or
where music was only one source of stimulation for reminiscence, and where outcomes
related specifically to music-based reminiscence were not measured (Cook 1998; Jo and
Song 2015; Kirkland et al. 2014; O’Rourke et al. 2011; Wang 2004). Further to these, a study
by Wang (2007) includes music as just one of the series of topics in a reminiscence-based

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intervention. These studies have been excluded from extended review as the extent to which
the impact of reminiscence on wellbeing was influenced by stimuli other than music is
unclear.

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[Figure 1 around here]

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Research Aims of Selected Studies

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The five studies meeting the criteria principally aimed to improve one or more aspects of
mental health among elderly subjects, including anxiety, depression, or stress, in different
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combinations. One study additionally included measures of cognition and life satisfaction
(Haslam et al. 2014). The study by Ashida (2000) sought to evaluate the use of reminiscence
activities in a music therapy context, focussed exclusively at reducing symptoms of
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depression in older adults with dementia. Mohammadi et al. (2011) were also interested in
exploring the effects a music-based therapy may have on depression levels, in addition to
feelings of stress and anxiety in older adults affected by various conditions of cognitive and
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physical health, including dementia in Iran. Particularly, the researchers wish to understand
the degree to which traditional Persian music can be used to achieve the same positive effects
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found in music therapy studies using Western music. In a different approach, four
psychosocial interventions (Tai Chi exercise, mindfulness awareness practice, music-
reminiscence therapy, and art therapy) were implemented by Rawtaer et al. (2015) in a
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community context with the aim of improving levels of anxiety and depression in
Singaporean elderly. The study carried out by Takahashi and Matsushita (2006) included a
focus on physiological indications in measuring the long-term effects of a music-based
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therapy on stress and blood pressure levels of older adults affected by moderate or severe
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dementia.

The further two identified studies looked at mental health outcomes in more complex ways.
Haslam et al. (2014) extend on previous research that suggested improvements in cognition
and wellbeing arise via the development of a shared sense of group identification that is
encouraged by reminiscence activities (Haslam et al. 2010). The authors note the limitations
of verbal discussion and the recognition and particular treatment of individual identity within
traditional reminiscence therapy. To counter this, the 2014 study incorporates song-based
simple reminiscence in secular and religious music groups. The aim of the study was to
examine whether personal identification with the assigned group improved health outcomes,
which included cognition, anxiety, and also life satisfaction.
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Interventions

All selected studies relied on music that was familiar to participants to stimulate reminiscence
activities. Mohammadi et al. (2011) describe their intervention as “music therapy”, however,
it also involved a significant reminiscence component. Participants (n=19, mean age 69
years) were recruited within a residential facility, and were split between intervention and
control groups. The intervention group participated in Persian music-making with traditional

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instruments, movement, and reminiscence following music listening. The control group did
not participate in this activity. Ninety-minute sessions were held once per week, for ten
weeks.

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Similarly, Takahashi and Matsushita (2006) carried out an intervention they predominantly

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describe as music therapy, which included substantial reminiscence activities. Of 43 recruited
participants (mean age 83 years), 24 were selected for the intervention group which
participated in singing familiar song, playing instruments, and reminiscing as led by the

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group facilitator. The remainder of participants formed a control group that did not
participate in music-reminiscence activities. Sessions were carried out once per week for six
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months. Intervention group participants reportedly also met separately to the sessions of their
own volition, to talk about their recollections from the session, contributing to their emotional
stability and socialisation.
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In a much shorter intervention, 20 aged care residents (mean age 86 years) in Ashida’s study
(2000) participated in a three-week study. The intervention was carried out in the third week,
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in which groups attended five daily 45-minute sessions. The Cornell Scale for Depression in
Dementia was filled out by nursing staff for each participant at the end of each week – the
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first two weeks therefore created baseline data against which the results from the third week
could be compared. Sessions began and ended with a drumming activity to allow interaction
between the facilitator and each participant. The facilitator led the reminiscence section of the
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activity by singing familiar songs related to the theme of the day accompanied by guitar.
Questions relating to the lyrical content were then asked of each participant, enabling sharing
and conversation.
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In a point of different to the above-mentioned studies, Haslam et al. (2014) included a


traditional story-based reminiscence group using set themes as a baseline measure for the
music-based intervention. Participants were forty elderly adults of mixed levels of
independence living in two residential aged-care communities (mean age of 87 years).
Participants were randomly assigned to one of three activity groups – story-based, secular
song, or religious song reminiscence, in which they participated for two thirty minute
sessions per week, for six weeks comprising 12 sessions in total. In both the song-based
groups, facilitators played recorded music from the 1920s to the 1970s, one decade per week,
and encouraged participants to sing along, and to strike up conversations in response to
salient songs. The only difference between the groups was the theme of the music – popular
music or music with religious themes.
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Participants in the study by Rawtaer et al. (2015) were affected by anxiety or depression, and
were screened for cognitive decline, which would result in exclusion from the intervention
stage. Ninety-nine participants that completed the study were recruited from public housing
blocks in the Singaporean community (mean age 71 years). These people were given a choice
of which of the four interventions they would like to take part in (Tai Chi exercise,
mindfulness awareness practice, music-reminiscence therapy, or art therapy). Participants
then undertook this activity with facilitators for ten weeks. After this point, the researchers

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changed their procedure to include all four interventions within one session, at the request of
participants. Along with this change, the session frequency was lessened to fortnightly for the
following 18 weeks, and then once per month for the rest of the year. The music-

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reminiscence element, which is of most interest to this review, comprised guided group
singing to popular songs, followed by conversations of experiences and events.

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Evaluation and Measures

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All studies used predominantly quantitative measures based on pre-determined scales or
physiological symptoms. All studies employed pre- and post-test levels except for Haslam et
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al. (2014), in which a group using traditional reminiscence therapy acted as a baseline. This
study engaged several quantitative scales and inventories to examine elements of cognition,
anxiety, and quality of life. Aspects of identity (social and religious) were also measured via
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five point scales. The choice of measures used by Haslam is the most complex of the selected
studies. Rawtaer et al. (2015) screened participants for inclusion using anxiety and depression
inventories, as well as the score on a Mini Mental State Exam (MMSE). The outcomes of the
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study were measured via two self-rated anxiety and depression scales filled out by
participants at the first week of activities, and then at the fourth, tenth, twenty-fourth, and
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fifty-second week after the commencement of the interventions.

Both Mohammadi et al. (2011) and Ashida (2000) confined their evaluation to a single scale.
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Mohammadi et al. (2011) utilized a 21-item questionnaire to obtain data on stress, anxiety,
and depression levels of participants before and after the intervention, while Ashida’s study
(2000) was carried out with particular reference to outcomes on the Cornell Scale for
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Depression in Dementia. In addition, patient behaviour and participation during the session
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was captured and later analysed via video camera, contributing a qualitative dimension to the
analysis.

The use of physiological well-being measures was most prominent in Takahashi and
Matsushita (2006) who measured blood pressure, and cortisol levels via saliva samples from
the intervention group participants before and after each music therapy session for six
months, then again at one and two years after the commencement of the first music therapy
session. Cortisol levels of the control group were recorded before the first music therapy
session, then again at one and two years after the intervention. All participants were also
given an intelligence test at the same intervals.
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Outcomes
Ashida (2000) found participants’ depressive scores significantly decreased immediately after
the intervention activity. Observation revealed an increase in participation over the course of
the sessions. There was some indication from staff members that improvements in
participants’ moods were not long lived after the sessions. Mohammadi et al. (2011) found
statistically significant differences in pre- and post-test results, suggesting improvements in
levels of stress, anxiety, and depression were experienced by participants. Given the long
term nature of their study, Takahashi and Matsushita (2006) were able to use the data of 18

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out of 24 participants who participated for the full two years. The researchers found positive
results in both cortisol levels and blood pressure for those participating in the intervention, as
opposed to the control group, although the changes in cortisol were mitigated in individuals

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with lower intelligence test scores.

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The results of the study conducted by Haslam et al. (2014) showed no significant
improvement in health as a result of the interventions, however, the research did reveal that a
stronger sense of personal identification with the reminiscence group was connected to

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improved cognition and life satisfaction after story-based reminiscence, and improved life
satisfaction and reduced anxiety after religious song reminiscence. These patterns did not
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apply to the secular song activity. In contrast, Rawtaer et al. (2015) noted amongst other
outcomes that at the end of the fourth week, music-reminiscence therapy and art therapy were
the only groups to show a significant improvement in levels of depression and anxiety. In the
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combination phase of interventions (after week 10), the analysis suggested improvements
continued to week 52 relevant to baseline information.
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Discussion
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While only a small number of studies fit the criteria for this review, they nonetheless reveal a
great deal about the current state of research into pairing music and reminiscence therapies.
The focus of these studies collectively is on mental well-being, predominantly the reduction
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of anxiety, depression and stress, the levels of which are measured almost solely through
quantitative methods. Notably, there is little emphasis on other types of well-being, such as
social or emotional well-being, save for the use of a life satisfaction scale by Haslam et al.
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(2014). Much of the evaluation processes involved carers or researchers gathering


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information on participants, except within Rawtaer et al. (2015), in which participants


undertook self-assessment. Three out of the five studies utilised populations affected by
dementia (Ashida, 2000; Mohammadi et al., 2011; Takahashi and Matsushita, 2006), while
one study screened exclusively for elderly participants with diagnosed anxiety or depression
(Rawtaer et al., 2015); participants in all of these studies were gathered from aged care
facilities. The remaining study (Haslam et al., 2014) used participants of varied mobility who
were residing in communities.

The details of how the intervention sessions are carried out are frequently omitted, or vaguely
described, within all studies. Interventions across the studies often encouraged a range of
interaction with music, such as singing, moving, and listening, before moving on to
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reminisce. The exception to this appears to be the design by Ashida (2000), who describes a
therapist singing songs while participants listened in order to promote reminiscence; it is
unclear whether participants also sang in this intervention, or only listened. A great deal of
variance was apparent in the design of delivery intervention between studies. The frequency
of sessions, length of individual sessions between studies were widely different, varying for
example from five consecutive days of 45-minute sessions (Ashida, 2000), to weekly 30
minute sessions once per month (Rawtaer et al., 2015). The duration of interventions aligned
with study aims - three of the studies looked to short-term outcomes (Ashida, 2000; Haslam

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et al., 2014; Mohammadi et al., 2011), while two considered effects over longer periods of
time. In light of the outcomes, it is useful to note that both long- and short-term studies
validated the effects of a music-reminiscence therapy. The exception is the result of Rawtaer

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et al.’s study, in which no quantifiable health benefits were found. The data does however
suggest that psycho-social aspects of identity and quality of life were positively affected,

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suggesting that quantitative measures alone may be insufficient for assessing the ways in
which music-reminiscence therapies may be helpful for older people.

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Limitations
There are several limitations that could be seen to effect the outcome of this review. The
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review only includes published studies written in English and with full-text availability
within major databases. Similarly, the review only sort peer-reviewed articles to ensure a
baseline standard of research, and did not include research published in books or conference
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proceedings. It is possible that further studies that are currently unavailable in this format or
language may contribute to an understanding of music and memory interventions. In
addition, the design of this systematic review to specifically seek studies combining music
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and reminiscence may have excluded music-based studies in which reminiscence is only
mentioned in passing. In an effort to review and consolidate this niche area, the review
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excluded studies in which the activity of reminiscence was not purposeful, or was a result of
the therapy interaction, rather than part of the intervention itself. In this way, the review is
limited to a view of reminiscence as an intervention tool, and does not waver from this scope.
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There were numerous limitations evident in the studies matching the review criteria. Leading
these limitation is the lack of detail provided in all selected studies in describing the
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processes of the intervention itself. Rather, brief overviews of the types of activities are
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given, but examples of how facilitators connected memory and music for participants was not
apparent in any of the studies. This reduces the ability for the studies to be replicated, but also
does little to aid the production or legitimation of future research in the area. Further to this,
there is little assessment of the content of memories that were recounted by participants, and
no reflection on the success of some conversation topics or genre of music over others. This
is likely related to the predominant use of quantitative methods that focus on measurable
outcomes of the intervention, but do not assess the process of the intervention itself. The lack
of qualitative measures employed besides observation, which did not seem to play a
significant role in these studies’ findings, is at odds with the qualitative nature of the activity
– listening, singing, remembering, and talking.
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The samples populations are described by most researchers as small in size for statistical
purposes, and can be seen as a product of aged care environments. Four out of the five studies
were conducted in aged care facilities; Rawtaer et al. (2015) were the only researchers to
focus on participants situated within an urban community. This highlights a clear gap in the
literature, in which further research could seek to know more about the effects a music and
memory program might have for elderly people living in the community. Another limitation
regarding participant pools is that the demographic information gathered on participants
appears to be limited. For the most part there is minimal information provided on the cultural,

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ethnic or religious background of participants, and few connections made between these
aspects and the intervention outcomes. The exception here is the research by Mohammadi et
al. (2011) that looks specifically at Persian participants and traditional music. There are

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studies outside the scope of this review that consider these factors such as Chong (2000;
reminiscence with Chinese elderly) and Wray (2012; life review with female UK

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immigrants). These inquiries that suggest ethnicity and culture may play a part in how aspects
of music, memory, and wellbeing are perceived and expressed by individuals, indicating that
further consideration of these factors could result in more nuanced findings.

Conclusions
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The studies included in this review reveal the developing nature of empirical testing and
theoretical rationale of therapies combining music and memory. These studies utilised elderly
populations, some affected by cognitive decline, and incorporated aspects of music therapy
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(singing, playing and listening to music) while also drawing a focus to the act of reminiscing
and conversation. The review demonstrates the outcomes of existing research predominantly
positive effects of such therapies upon the mental well-being of participants, especially stress,
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anxiety, and depression, though there is a gap in the effect on other aspects of well-being
(emotional, social). Such findings were achieved principally through quantitative methods,
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with only one study using self-reporting mechanisms. There is a clear need for further use of
qualitative research methods to complement the existing research. Research that concentrates
on the reported effects of therapies via interviews, surveys, and documented observation
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could provide further insights regarding the way the therapy may or may not be perceived as
having benefits for participants.
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The key aspects of successful delivery of the therapy cannot be effectively determined from
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these studies. While there was some consistency in the use of singing and familiar songs,
there is little information given on the delivery process, and the efficacy of session
facilitation is not evaluated in any of the included studies. This highlights a focus on
measuring outcomes, rather than developing protocol strategies, which are not currently
standarised. Future research should incorporate description and reflection of their practices,
to further legitimise research via possible replication, but also in a concerted effort to work
towards an aligned practice method. The small number of existing studies indicates that there
is broad scope for further research in music and reminiscence therapy that looks into both
long and short term outcomes, working with elderly people who are both affected and
unaffected by physical and mental ailments and disease. It is possible that the use of music
and reminiscence together is already occurring informally as a recreational activity in aged
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care centres; however, the documentation of this is yet another direction for future research.
In recent times, there has been an increased call for interventions in aged care that are neither
invasive nor costly: further research into arts-based therapies such as music-reminiscence is
therefore a rational area of focus in contributing to global healthcare solutions, with a firm
foundation of empirical and theoretical research still developing.

Acknowledgements

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Research leading to this publication was supported by St Vincent’s Aged Care, Brisbane,
Australia.

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References

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AUTHOR (A)

AUTHOR (B)

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Appendices
[Figure 1]
[Table 1]
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Table 1: Studies matching inclusion criteria


Author / date Study Aim Population; Intervention; length / Methods and measures Findings Limitations
sample size / frequency / group or
setting /country individual delivery

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Ashida / 2000 Examines use of 20 elderly people Drumming; guided Cornell Scale for Depression Significant decrease in This study uses a small
reminiscence with dementia (3 reminiscence with therapist in Dementia (pre-/post-tested) depressive symptoms and sample size and

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groups and music males, 17 females; performing familiar songs. improvement in mood and acknowledges it does not
therapy techniques 73-94 years) Video-recorded (observation) social interaction reported control for variables that
to decrease 45 mins daily x 5 days immediately after the may have affected the

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symptoms of Residential aged intervention outcome such as
depression care, USA Group delivery
participant’s health,
change of medication,

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group size and level of
normal social interaction.

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The intervention is
protracted to only occur
within one week, making

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it an unusual addition to
participants’ schedules.
Additionally, this study

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only looks at very short
term outcomes.

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Haslam et al. Investigates the 40 elderly people 1) Story reminiscence: guided Self-Administered No effects found on measures This study has a small
/2014 health effects of of mixed mobility group reminiscence on set Gerocognitive Examination of cognition, anxiety, or life sample size. The authors
shared sense of
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(mean age 87 themes (baseline) satisfaction. A stronger sense of acknowledge it does not
group identification years) 2) Secular song reminiscence: Geriatric Anxiety Inventory group identification as a result include a measure of
via song- and story- participants shared and sang of the story reminiscence depressive symptoms and
based reminiscence Residential aged Satisfaction with Life Scale
familiar popular songs and impacted positively upon that a more narrative-style
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care, country conversed cognition and life satisfaction; approach in the song-
Aspects of identity (social,
unknown 3) Religious song reminiscence: group identification following based sessions could have
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religious) were also measured


participants shared and sang religious song resulted in resulted in different
familiar religious songs and increased life satisfaction and outcomes.
conversed reduced anxiety. No positive
effect was found for secular
2 x 30min sessions/week for 6 song.
weeks

Group delivery
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Author / date Study Aim Population; Intervention; length / Methods and measures Findings Limitations
sample size / frequency / group or
setting /country individual delivery

Mohammadi To test whether 19 elderly people Music therapy techniques incl. Depression Anxiety Stress Intervention group showed This study used a small

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et al. / 2011 Iranian music over 65 years (9 playing instruments, singing Scale (DASS-21) – pre-/post- significant improvement in sample size; does not
therapy will reduce female, 10 male, traditional songs, rhythmic testing anxiety, depression, and stress control for cognitive
stress, anxiety and mean age 69 movement, and reminiscing scales as compared to control decline, or separate

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depression in years) with a after listening group affected participants in
elderly aged care range of cognitive analysis.
residents 1 x 90 minute sessions/week for
or physical disease

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or decreased 10 weeks The guidance given to the
mobility group/individuals to
Group delivery facilitate reminiscence is
Residential aged unclear.

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care, Iran

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Rawtaer et al. To evaluate the 99 older adults Tai Chi Exercise: guided Tai Geriatric Depression Scale 4th week: only MRT and AT This study has a small
/ 2015 short- and long- with depression or Chi movements for total 30 (GDS) treatment groups recorded sample size and does not
term effects of a anxiety (25 males, minutes significant decrease in SDS and incorporate a control

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community-based 76 females, mean Geriatric Anxiety Inventory SAS scores. This was group.
psyschosocial age 71 years) Art therapy: participants shown (GAI) maintained for MRT by week
intervention on art and asked to reflect on 52 Use of self-rating scales
Mini Mental State Exam

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mental health of Community – thoughts and feelings may introduce some bias.
older adults public housing, (MMSE)
Mindfulness Awareness Intervention chosen by

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Singapore
Practice: Instructors guided Zung Self-Rating Depression participants, not
meditation with focus on body Scale (SDS) randomised.
sensations, feelings, and
Zung Self-Rating Anxiety
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thoughts. Participants did not remain
Scale (SAS) in single intervention for
Music Reminiscence Therapy: more than 10 weeks.
Measures taken at baseline, 4
Instructor guided discussion of
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weeks, 10 weeks, 24 weeks


past events or experiences after
and 52 weeks.
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group singing of popular songs.


Music was main medium for
reminiscence, though photos
and pictures were also used.

Single intervention 30mins


weekly for 10 weeks; mixed
intervention 30 minutes per
fortnight for 18 weeks; 30
minutes once a month for the
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Author / date Study Aim Population; Intervention; length / Methods and measures Findings Limitations
sample size / frequency / group or
setting /country individual delivery

remainder of the year (24

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weeks)

Group delivery

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Takahashi & Investigated the 43 elderly people MT group: facilitator lead Music therapy group: saliva Individuals who scored highly Uses only physiological
Matsushita / long term with various types singing of familiar songs; led sampling & blood pressure on the intelligence test were measures; small sample
physiological and

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2006 of dementia (5 group reminiscence; playing (pre- and post-session for 6 found to have improved cortisol size; it was difficult to
psychological men, 19 women; instruments in concert context months, plus 1 and 2 years levels compared to the control obtain clear results
effects of music mean age 82.7) after first session) group after two years. through use of salivary
therapy with elderly Control group: did not cortisol levels.

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dementia patients Aged care, Japan participate in music therapy Non-music therapy group: Participants in the music
activities saliva sampling & blood intervention group were found

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pressure before start of first to have lower blood pressure
1x 60 minute session weekly for MT session (baseline), then at levels after two years than those
6 months 6 months, 1 and 2 years after in the control group.

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therapy began.
Group delivery
Both group given HDS-R
intelligence test before

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therapy session, 6 months, 1
and 2 years after sessions

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EP began.
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Figure 1. Selection process

Databases searched: EBSCOhost,


PubMed, Proquest, CINAHL Plus,
Informit Health, MEDLINE,
Scopus, Google Scholar, and
Wiley Online Library (n = 1658)

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Excluded based on
initial criteria

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(n = 1580)

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Full-text articles
obtained (n = 76)

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Excluded (n= 71)
Reasons:
Reminiscence
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interventions that did


not include music; music
interventions that did
not refer to
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reminiscence or memory
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Studies included in
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review (n = 5)
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