Can Musical or Painting Interventions Improve Chronic Pain, Mood, Quality of Life, and Cognition in Patients with Mild Alzheimer’s Disease? Evidence from a Randomized Controlled Trial

Article type: Research Article

Authors: Pongan, Elodie^{a; b; c} | Tillmann, Barbara^d | Leveque, Yohana^d | Trombert, Béatrice^e | Getenet, Jean Claude^a | Auguste, Nicolas^f | Dauphinot, Virginie^{b; c} | El Haouari, Hanane^a | Navez, Malou^a | Dorey, Jean-Michel^g | Krolak-Salmon, Pierre^{b; c} | The LACMé Group | Laurent, Bernard^{a; h} | Rouch, Isabelle^{a; b; c; *}

Collaborators: Auguste, Nicolas | Bachelet, Romain | Brunon, Laurence | Dayot, Jenny | Dorey, Jean-Michel | El Haouari, Hanane | Fatisson, Marion | Ferrer, Marion | Gaillat, Charlotte | Gentil, Claire | Getenet, Jean Claude | Goldet, Karine | Krolak-Salmon, Pierre | Laurent, Bernard | Leroyer, Marie | Leveque, Yohana | Michon, Agnès | Mortreux, Angélique | Navez, Malou | Neagu, Anca | Perrot, Catherine | Pongan, Elodie | Rouch, Isabelle | Solimeo, Mathilde | Tillmann, Barbara | Touzet du Vigier, Anaïs | Vulliez, Elodie

Affiliations: [a] Memory Clinical and Research Center of Saint Etienne (CMRR) Neurology Unit, University Hospital of Saint Etienne, Saint Etienne, France | [b] Memory Clinical and Research Center of Lyon (CMRR), Hospital of Charpennes, University Hospital of Lyon, France | [c] Institute of Aging I-Vie, University Hospital of Lyon, France | [d] INSERM, U1028; CNRS, UMR5292; Psychoacoustic and Auditory Cognition team, Lyon Neuroscience Research Center, Lyon, France | [e] Public Health and Medical Information Unit, University Hospital of Saint-Etienne, Saint Etienne, France | [f] Memory Clinical and Research Center of Saint Etienne (CMRR) Geriatrics Unit, University Hospital of Saint Etienne, Saint Etienne, France | [g] Department of Psychiatry, Hospital Le Vinatier, Bron, France | [h] INSERM, U1028; CNRS, UMR5292; Neuropain team, Lyon Neuroscience Research Center, Lyon, France

Correspondence: [*] Correspondence to: Isabelle Rouch, Memory Clinical and Research Center of Saint Etienne (CMRR), Neurology Unit, Hospital of Saint Etienne, Avenue Albert Raimond, 42055 Saint Etienne, France. Tel.: +33 4 77 12 73 98; Fax: +33 4 77 12 72 79; E-mail: [email protected].

Abstract: Background:Among non-pharmacological therapies, musical intervention is often used for patients with Alzheimer’s disease (AD) and patients presenting chronic pain. However, their efficacy is still under debate. Objective:Our aim was to determine the efficacy of choral singing versus painting sessions on chronic pain, mood, quality of life, and cognition in AD patients. Methods:In this multicenter randomized controlled trial, 59 mild AD patients were randomized to a 12-week singing (SG; n = 31) or painting group (PG; n = 28). Chronic pain, anxiety, depression, and quality of life were assessed before, after, and 1 month after the sessions. Cognitive abilities were assessed before and after interventions. The evolution of these different measures was assessed with mixed linear models. The primary data analysis was by intention-to-treat, and completed by a ‘per protocol’ approach. Results:Both singing and painting interventions led to significant pain reduction (Time effect: F = 4.71; p = 0.01), reduced anxiety (Time effect: F = 10.74; p < 0.0001), improved Quality of Life (Time effect: F = 6.79; p = 0.002), improved digit span (F = 12.93; p = 0.001), and inhibitory processes (Time effect: F = 4.93; p = 0.03). Depression was reduced over time in PG only (Time x Group effect: F = 4.53; p = 0.01). Verbal Memory performance remained stable over time in SG, but decreased in PG (Time x group effect: F = 9.29; p = 0.004). Conclusion:Findings suggest that singing and painting interventions may reduce pain and improve mood, quality of life, and cognition in patients with mild AD, with differential effects of painting for depression and singing for memory performance.

Keywords: Alzheimer’s disease, anxiety, cognitive impairment, depression, music, pain

DOI: 10.3233/JAD-170410

Journal: Journal of Alzheimer's Disease, vol. 60, no. 2, pp. 663-677, 2017