Des études cliniques confirment l’intérêt de la musicothérapie dans la prise en charge de la maladie d’Alzheimer. La musique modifie les composantes de la maladie, à travers des effets sensoriels, cognitifs, affectifs, comportementaux et sociaux.

Démontrer la faisabilité et évaluer l’effet de la musicothérapie sur l’anxiété, la dépression au stade léger à modéré de la maladie d’Alzheimer et sur la charge ressentie par l’accompagnant principal.

Les patients Alzheimer (MMS : 18–26), habitant Montpellier et disposant d’un accompagnant fiable ont été inclus. Une séance de musicothérapie réceptive hebdomadaire, pendant dix semaines, a été réalisée selon le protocole standardisé de la méthode en U. Le critère principal d’évaluation était la participation régulière aux séances en milieu hospitalier. Les critères secondaires étaient : le score d’anxiété (échelle d’Hamilton), le score de dépression (échelle de Cornell) et le score de la charge ressentie par l’aidant principal (échelle de Zarit). Les évaluations ont eu lieu à S1, S4 et S10.

Cinq patients ont été inclus pour un total de 44 séances réalisées. La participation régulière des patients aux séances a démontré sa faisabilité. On observe par les commentaires verbaux recueillis que la musicothérapie a été très bien acceptée par les patients et les accompagnants. Le score d’anxiété diminue de façon significative à S1, S4 jusqu’à S10 (p<0,001). On a également observé une diminution significative du score de dépression (p<0,001) et de la charge ressentie par l’aidant (p<0,001).

Cette étude préliminaire a permis de démontrer sa faisabilité et de donner des premiers éléments d’efficacité de la musicothérapie dans la prise en charge des patients atteints de la maladie d’Alzheimer. La musicothérapie, méthode simple d’application peut aider à traiter les troubles de l’anxiété et de dépression des patients et permet de réduire la charge physique et morale ressentie par l’accompagnant principal.

The impact of music therapy on dementia care for patients with Alzheimer’s disease (AD) is well-recognized. Music alters the different components of the disease through sensory, cognitive, emotional, behavioral and social impacts. The academic aspect of music therapy in this area was based on the fact that music can alter the various components of the overall evolution of this disease. We found around 10 case studies presenting various results from receptive music therapy sessions on patients with Alzheimer’s disease. The results of these studies point out the interest of music therapy in the multidisciplinary care of Alzheimer’s disease and its related syndromes. It has been deemed useful for significantly reducing the medication given to AD patients. A music therapy protocol, specifically tailored to the patient’s needs has been shown to significantly reduce anxiety, depression and aggressiveness in patients suffering from Alzheimer’s disease. This technique has also demonstrated its impact on helping AD patients recall their previous life experience.

To demonstrate the feasibility and to evaluate the impact of music therapy on anxiety and depression at the early to moderate stage of Alzheimer’s disease and on the main caregiver burden.

Five outpatients suffering from early stage of Alzheimer’s disease (MMS: 18–26) were prospectively included. They were living in Montpellier with a reliable caregiver. A weekly receptive music therapy session was delivered to patients over a 10-week period, according to the U method standardized protocol. This technique was based on the recommendations made by Gardner and Good relating to the importance given to an individualized choice of music. Instrumental tracks were selected from various music styles (classic, jazz, world music…) and were tailored to the patient’s requirements. This individual session was always followed by an interview with the music therapist in order to allow the patient to express the emotions felt during the session and to stimulate the patient’s cognitive functions by recalling memories and images from his past life experience. The main evaluation criterion was regular session attendance at the hospital. Secondary criteria were: anxiety score (Hamilton scale), depression score (Cornell scale) and the burden score felt by the main caregiver (Zarit scale). Evaluations took place at W1, W4 and W10. The score evolution on the Hamilton, Cornell and Zarit scales were tested using the Wilcoxon test on paired data. The significance threshold has conventionally been set at 5% for all tests used. The statistical analysis was done using the SAS software (8th version) (SAS Institute, Cary, N.C.; proc npar1way, proc univariate, proc freq). Alzheimer’s disease is a recognized indication for music therapy. A simple oral consent was collected prior to the study inclusion.

Five patients were included for a total of 44 sessions. The patients’ regular attendance at the music therapy sessions showed its feasibility. Thanks to oral feedback, we were able to see that music therapy was very well-accepted both by patients and caregivers. After the sessions, all patients expressed a sensation of well-being and pleasure, such as: “Music made me feel better, I feel more relaxed”, “I feel better”, “I didn’t know that music could have such an impact on me”… Other verbal comments were collected regarding the patients’ previous life experience: “This music reminds me of my childhood”, “I imagined myself dancing just like I used to in the old days”, “This reminds me of my trip to Italy with my children”… The level of anxiety (Hamilton scale) dropped significantly from 9.4 (±2.2) to 3.4 (±2.6) between the first session and the fourth session (P<0.004). The differences observed between W4–W10 and W1–W10 were close to the threshold of significance due to a major drop in the anxiety level starting at W4 (P=NS). On the Cornell scale, the depression level dropped significantly from 10.8 (±5.3) to 2.2 (±1.9) between the first session and the fourth session (P<0.01). The differences observed between W4–W10 and W1–W10 were not significant (P=NS). The weight of the physical and emotional burden experienced by the main caregiver (Zarit scale) fell significantly from 30.2 (±11.7) to 15.6 (±10.4) between W1–W4 (P<0.002). The differences observed between W4–W10 and W1–W10 were not significant (P=NS).

This preliminary study demonstrates the feasibility as well as the initial efficacy of music therapy in terms of its impact on the overall care for patients suffering from Alzheimer’s disease. This easily applicable technique can be useful in treating anxiety and depression in a patient with Alzheimer’s disease and also in relieving the emotional and physical burden experienced by the main caregiver.