***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Individuals with dementia often experience poor quality of life ( QOL ) due to behavioral and psychological symptoms of dementia ( BPSD ) . Music therapy can reduce BPSD , but most studies have focused on patients with mild to moderate dementia . We hypothesized that music intervention would have beneficial effects compared with a no-music control condition , and that interactive music intervention would have stronger effects than passive music intervention . Methods : Thirty-nine individuals with severe Alzheimer 's disease were r and omly and blindly assigned to two music intervention groups ( passive or interactive ) and a no-music Control group . Music intervention involved individualized music . Short-term effects were evaluated via emotional response and stress levels measured with the autonomic nerve index and the Faces Scale . Long-term effects were evaluated by BPSD changes using the Behavioral Pathology in Alzheimer 's Disease ( BEHAVE-AD ) Rating Scale . Results : Passive and interactive music interventions caused short-term parasympathetic dominance . Interactive intervention caused the greatest improvement in emotional state . Greater long-term reduction in BPSD was observed following interactive intervention , compared with passive music intervention and a no-music control condition . Conclusion : Music intervention can reduce stress in individuals with severe dementia , with interactive interventions exhibiting the strongest beneficial effects . Since interactive music intervention can restore residual cognitive and emotional function , this approach may be useful for aiding severe dementia patients ’ relationships with others and improving QOL . The registration number of the trial and the name of the trial registry are UMIN000008801 and “ Examination of Effective Nursing Intervention for Music Therapy for Severe Dementia Elderly Person ” respectively Background / Aims : Numerous studies have indicated the value of music therapy in the management of patients with Alzheimer ’s disease . A recent pilot study demonstrated the feasibility and usefulness of a new music therapy technique . The aim of this controlled , r and omised study was to assess the effects of this new music therapy technique on anxiety and depression in patients with mild to moderate Alzheimer-type dementia . Methods : This was a single-centre , comparative , controlled , r and omised study , with blinded assessment of its results . The duration of follow-up was 24 weeks . The treated group ( n = 15 ) participated in weekly sessions of individual , receptive music therapy . The musical style of the session was chosen by the patient . The vali date d ‘ U ’ technique was employed . The control group ( n = 15 ) participated under the same conditions in reading sessions . The principal endpoint , measured at weeks 1 , 4 , 8 , 16 and 24 , was the level of anxiety ( Hamilton Scale ) . Changes in the depression score ( Geriatric Depression Scale ) were also analyzed as a secondary endpoint . Results : Significant improvements in anxiety ( p < 0.01 ) and depression ( p < 0.01 ) were observed in the music therapy group as from week 4 and until week 16 . The effect of music therapy was sustained for up to 8 weeks after the discontinuation of sessions between weeks 16 and 24 ( p < 0.01 ) . Conclusion : These results confirm the valuable effect of music therapy on  anxiety and depression  in patients with mild to moderate Alzheimer ’s disease . This new music therapy technique is simple to implement and can easily be integrated in a multidisciplinary programme for the management of Alzheimer ’s disease BACKGROUND Music therapy is a potential non-pharmacological treatment for the behavioral and psychological symptoms of dementia , but although some studies have found it to be helpful , most are small and uncontrolled . METHODS This case-control study was carried out by qualified music therapists in two nursing homes and two psychogeriatric wards . The participants were 38 patients with moderate or severe Alzheimer 's disease ( AD ) assigned r and omly to a music therapy group and a control group . RESULTS The study showed a significant reduction in activity disturbances in the music therapy group during a 6-week period measured with the Behavior Pathology in Alzheimer 's Disease Rating Scale ( BEHAVE-AD ) . There was also a significant reduction in the sum of scores of activity disturbances , aggressiveness and anxiety . Other symptoms rated by subscales of the BEHAVE-AD did not decrease significantly . Four weeks later the effects had mostly disappeared . CONCLUSIONS Music therapy is a safe and effective method for treating agitation and anxiety in moderately severe and severe AD . This is in line with the results of some non-controlled studies on music therapy in dementia Objectives : Agitation in nursing home residents with dementia leads to increase in psychotropic medication , decrease in quality of life , and to patient distress and caregiver burden .  Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been method ologically insufficient . The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes , and to explore its effect on psychotropic medication and quality of life . Method : In a crossover trial , 42 participants with dementia were r and omized to a sequence of six weeks of individual music therapy and six weeks of st and ard care . Outcome measures included agitation , quality of life and medication . Results : Agitation disruptiveness increased during st and ard care and decreased during music therapy . The difference at −6.77 ( 95 % CI ( confidence interval ) : −12.71 , −0.83 ) was significant ( p = 0.027 ) , with a medium effect size ( 0.50 ) . The prescription of psychotropic medication increased significantly more often during st and ard care than during music therapy ( p = 0.02 ) . Conclusion : This study shows that six weeks of music therapy  reduces agitation disruptiveness and prevents medication increases in people with dementia . The positive trends in relation to agitation frequency and quality of life call for further research with a larger sample Background Agitated behavior is a widespread problem that adversely affects the health of nursing home residents and increases the cost of their care . Objective To examine whether modifying environmental stimuli by the use of calming music and h and massage affects agitated behavior in persons with dementia . Method A four group , repeated measures experimental design was used to test the effect of a 10-minute exposure to either calming music , h and massage , or calming music and h and massage simultaneously , or no intervention ( control ) on the frequency and type of agitated behaviors in nursing home residents with dementia ( N = 68 ) . A modified version of the Cohen-Mansfield Agitation Inventory was used to record agitated behaviors . Results Each of the experimental interventions reduced agitation more than no intervention . The benefit was sustained and increased up to one hour following the intervention ( F = 6.47 , p < .01 ) . The increase in benefit over time was similar for each intervention group . When types of agitated behaviors were examined separately , none of the interventions significantly reduced physically aggressive behaviors ( F = 1.93 , p = .09 ) , while physically nonaggressive behaviors decreased during each of the interventions ( F = 3.78 , p < 01 ) . No additive benefit result ed from simultaneous exposure to calming music and h and massage . At one hour following any intervention , verbally agitated behavior decreased more than no intervention . Conclusion Calming music and h and massage alter the immediate environment of agitated nursing home residents to a calm structured surrounding , off setting disturbing stimuli , but no additive benefit was found by combining interventions simultaneously We undertook a r and omised controlled trial to assess whether a music therapy ( MT ) scheme of administration , including three working cycles of one month spaced out by one month of no treatment , is effective to reduce behavioural disturbances in severely demented patients . Sixty persons with severe dementia ( 30 in the experimental and 30 in the control group ) were enrolled . Baseline multidimensional assessment included demographics , Mini Mental State Examination ( MMSE ) , Barthel Index and Neuropsychiatry Inventory ( NPI ) for all patients . All the patients of the experimental and control groups received st and ard care ( educational and entertainment activities ) . In addition , the experimental group received three cycles of 12 active MT sessions each , three times a week . Each 30-min session included a group of three patients . Every cycle of treatment was followed by one month of wash-out . At the end of this study , MT treatment result ed to be more effective than st and ard care to reduce behavioural disorders . We observed a significant reduction over time in the NPI global scores in both groups ( F 7,357 = 9.06 , p < 0.001 ) and a significant difference between groups ( F 1,51 = 4.84 , p < 0.05 ) due to a higher reduction of behavioural disturbances in the experimental group at the end of the treatment ( Cohen 's d = 0.63 ) . The analysis of single NPI items shows that delusions , agitation and apathy significantly improved in the experimental , but not in the control group . This study suggests the effectiveness of MT approach with working cycles in reducing behavioural disorders of severely demented patients Background Music therapy ( MT ) has been proposed as valid approach for behavioral and psychologic symptoms ( BPSD ) of dementia . However , studies demonstrating the effectiveness of this approach are lacking . Objective To assess MT effectiveness in reducing BPSD in subjects with dementia . Method Fifty-nine persons with dementia were enrolled in this study . All of them underwent a multidimensional assessment including Mini Mental State Examination , Barthel Index and Neuropsychiatry Inventory at enrolment and after 8 , 16 , and 20 weeks . Subjects were r and omly assigned to experimental ( n=30 ) or control ( n=29 ) group . The MT sessions were evaluated with st and ardized criteria . The experimental group received 30 MT sessions ( 16 wk of treatment ) , whereas the control group received educational support or entertainment activities . Results NPI total score significantly decreased in the experimental group at 8th , 16th , and 20th weeks ( interaction time × group : F3 , 165=5.06 , P=0.002 ) . Specific BPSD ( ie , delusions , agitation , anxiety , apathy , irritability , aberrant motor activity , and night-time disturbances ) significantly improved . The empathetic relationship and the patients ' active participation in the  MT  approach , also improved in the experimental group . Conclusions The study shows that MT is effective to reduce BPSD in patients with moderate-severe dementia BACKGROUND Agitated behaviours are identified by caregivers as the most challenging in dementia care . Alternative approaches reducing occurrence of agitated behaviours and the need for chemical or physical restraints become valuable for institutionalized elders with dementia . OBJECTIVE AND SETTING This study was to evaluate the effects of group music with movement intervention on occurrence of agitated behaviours of institutionalized elders with dementia in Taiwan . METHODS A r and omized controlled trial was used . Thirty-six institutionalized elders with dementia completed the study , with 18 in the experimental group receiving group music with movement intervention twice a week for 4 weeks and 18 in the control group receiving usual care without intervention  . Modified Cohen-Mansfield Agitation Inventory was used to assess agitated behaviours at baseline , weeks 2 and 4 . RESULTS Agitated behaviours were significantly reduced in the experimental group following 4 weeks of group music with movement intervention compared to that of the control group ( p<0.001 ) . CONCLUSIONS Group music with movement intervention can be beneficial in managing agitated behaviours of those with dementia and should be incorporated into care routines in residential facilities OBJECTIVE This experimental study aim ed to evaluate the effects of a group music intervention on anxiety and agitation of institutionalized older adults with dementia . METHODS A total of 60 participants were r and omly assigned to an experimental or a control group . The experimental group received a 30-min music intervention using percussion instruments with familiar music in a group setting in mid afternoon twice weekly for 6 weeks , whereas the control group received usual care with no music intervention . The Rating of Anxiety in Dementia scale was used to assess anxiety , and Cohen-Mansfield Agitation Inventory was used to assess agitation at baseline , week 4 and week 6 . RESULTS Repeated measures analysis of covariance indicated that older adults who received a group music intervention had a significantly lower anxiety score than those in the control group while controlling for pre-test score and cognitive level ( F = 8.98 , p = 0.004 ) . However , the reduction of agitation between two groups was not significantly different . CONCLUSIONS Anxiety and agitation are common in older adults with dementia and have been reported by caregivers as challenging care problems . An innovative group music intervention using percussion instruments with familiar music as a cost-effective approach has the potential to reduce anxiety and improve psychological well-being of those with dementia In a retrospective survey , 487 research projects approved by the Central Oxford Research Ethics Committee between 1984 and 1987 , were studied for evidence of publication bias . As of May , 1990 , 285 of the studies had been analysed by the investigators , and 52 % of these had been published . Studies with statistically significant results were more likely to be published than those finding no difference between the study groups ( adjusted odds ratio [ OR ] 2.32 ; 95 % confidence interval [ Cl ] 1.25 - 4.28 ) . Studies with significant results were also more likely to lead to a greater number of publications and presentations and to be published in journals with a high citation impact factor . An increased likelihood of publication was also associated with a high rating by the investigator of the importance of the study results , and with increasing sample size . The tendency towards publication bias was greater with observational and laboratory-based experimental studies ( OR = 3.79 ; 95 % Cl = 1.47 - 9 
    Output:
    
Music intervention had a medium overall effect on agitation in dementia , suggesting robust clinical relevance .
While the moderate number of studies does not allow for further differentiation between sub-types of music intervention , the sub-group comparisons indicated promising pathways for future systematic review s. This meta- analysis is the first systematic and quantitative overview supporting clinical ly and statistically robust effects of  music intervention  on agitation in dementia .