The Impact of Music on Stress Biomarkers: Protocol of a Substudy of the Cluster-Randomized Controlled Trial Music Interventions for Dementia and Depression in ELderly Care (MIDDEL)

Naomi L Rasing, Sarah I M Janus, Gunter Kreutz, Vigdis Sveinsdottir, Christian Gold, Urs M Nater, Sytse U Zuidema, Naomi L Rasing, Sarah I M Janus, Gunter Kreutz, Vigdis Sveinsdottir, Christian Gold, Urs M Nater, Sytse U Zuidema

Abstract

Recently, a large cluster-randomized controlled trial was designed-Music Interventions for Dementia and Depression in ELderly care (MIDDEL)-to assess the effectiveness of music interventions on depression in care home residents with dementia (ClinicalTrials.gov NCT03496675). To understand the pathophysiological mechanisms, we observed the effect of repeated music interventions on stress in this population since chronic stress was associated with depression and an increased risk for dementia. An exploratory study was designed to assess: (1) changes in hair cortisol concentrations as an indicator of longer-term stress; (2) whether baseline stress is a predictor of therapy outcome; (3) pre- and post-treatment effects on salivary α-amylase and cortisol response as an indicator of immediate stress in 180-200 care home residents with dementia and depressive symptoms who partake in the MIDDEL trial. Insights into mediatory effects of stress to explain the effect of music interventions will be gained. Hair cortisol concentrations were assessed at baseline and at 3, 6, and 12 months along with the Perceived Stress Scale. Salivary α-amylase and cortisol concentrations were assessed at 1, 3, and 6 months. Saliva was collected just before a session and 15 and 60 min after a session, along with a stress Visual Analogue Scale.

Keywords: alpha-amylase; biomarkers; cortisol; dementia; depression; elderly care; hair; music therapy; music-based therapies and interventions; saliva.

Conflict of interest statement

The authors declare there is no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart illustrating the design of the substudy integrated within the Music Interventions for Dementia and Depression in ELderly care (MIDDEL) trial. * In the CHUs in the combination group (GMT + RCS), no saliva samples were collected.
Figure 2
Figure 2
Schedule of enrolment, interventions, and assessments of the exploratory substudy within the MIDDEL-project. † T0: Before the music sessions start; T1: Within 1 month after the music interventions started or within 1 month after completion of the baseline assessment in the control group; T3: 3 months after the start of the music sessions; T6: 6 months after the start of the music sessions; T12: 12 months after the start of the music sessions. * A. Ten minutes before session; B. Fifteen minutes after session; C. Sixty minutes after session.

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