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      Musik und Bewegung als therapeutische Ressourcen bei Demenz Translated title: Music and exercise as therapeutic resources in dementia

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          Abstract

          In der Betreuung von Menschen mit Demenz spielen Musik und Bewegung seit Jahrzenten eine wichtige Rolle. Die dazu bestehende wissenschaftliche Evidenz ist immer noch relativ klein, wächst aber. Der erst seit knapp zehn Jahren bekannte Umstand, dass das musikalische Gedächtnis bis in fortgeschrittene Demenzstadien intakt bleibt, hat Musik bei Hirnleistungsabbau zunehmend zur therapeutisch genutzten Ressource werden lassen. So können gesungene Texte viel besser erinnert werden als gesprochene. Die gezielte musikalische Stimulierung der frontalen Hirnregionen hat zudem häufig positive Wirkungen auf demenzassoziierte Verhaltensauffälligkeiten. Bewegung kombiniert mit Musik in Form von Tanz oder Rhythmik scheint neben positiven kognitiven Effekten auch mit Verbesserungen des Gleichgewichts und der Gangsicherheit einherzugehen.

          Translated abstract

          Music and exercise have played a major role in the care of people with dementia for decades. The scientific evidence for such interventions is still relatively scarce but growing. The fact which has been known for nearly 10 years that brain regions associated with musical long-term memory remain intact up to advanced stages of dementia made music a major therapeutic resource in cognitive decline. Therefore, sung texts are learned and recalled better than spoken texts. Furthermore, the specific music-related stimulation of frontal brain regions has frequently shown positive effects on conspicuous behavioral disorders associated with dementia. Exercise in combination with music, in the form of dance or eurhythmics, not only seems to positively affect cognition but also balance and gait safety among patients with dementia.

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          Most cited references20

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          Leisure activities and the risk of dementia in the elderly.

          Participation in leisure activities has been associated with a lower risk of dementia. It is unclear whether increased participation in leisure activities lowers the risk of dementia or participation in leisure activities declines during the preclinical phase of dementia. We examined the relation between leisure activities and the risk of dementia in a prospective cohort of 469 subjects older than 75 years of age who resided in the community and did not have dementia at base line. We examined the frequency of participation in leisure activities at enrollment and derived cognitive-activity and physical-activity scales in which the units of measure were activity-days per week. Cox proportional-hazards analysis was used to evaluate the risk of dementia according to the base-line level of participation in leisure activities, with adjustment for age, sex, educational level, presence or absence of chronic medical illnesses, and base-line cognitive status. Over a median follow-up period of 5.1 years, dementia developed in 124 subjects (Alzheimer's disease in 61 subjects, vascular dementia in 30, mixed dementia in 25, and other types of dementia in 8). Among leisure activities, reading, playing board games, playing musical instruments, and dancing were associated with a reduced risk of dementia. A one-point increment in the cognitive-activity score was significantly associated with a reduced risk of dementia (hazard ratio, 0.93 [95 percent confidence interval, 0.90 to 0.97]), but a one-point increment in the physical-activity score was not (hazard ratio, 1.00). The association with the cognitive-activity score persisted after the exclusion of the subjects with possible preclinical dementia at base line. Results were similar for Alzheimer's disease and vascular dementia. In linear mixed models, increased participation in cognitive activities at base line was associated with reduced rates of decline in memory. Participation in leisure activities is associated with a reduced risk of dementia, even after adjustment for base-line cognitive status and after the exclusion of subjects with possible preclinical dementia. Controlled trials are needed to assess the protective effect of cognitive leisure activities on the risk of dementia. Copyright 2003 Massachusetts Medical Society
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            Effects of the Finnish Alzheimer disease exercise trial (FINALEX): a randomized controlled trial.

            Few rigorous clinical trials have investigated the effectiveness of exercise on the physical functioning of patients with Alzheimer disease (AD). To investigate the effects of intense and long-term exercise on the physical functioning and mobility of home-dwelling patients with AD and to explore its effects on the use and costs of health and social services. A randomized controlled trial. A total of 210 home-dwelling patients with AD living with their spousal caregiver. The 3 trial arms included (1) group-based exercise (GE; 4-hour sessions with approximately 1-hour training) and (2) tailored home-based exercise (HE; 1-hour training), both twice a week for 1 year, and (3) a control group (CG) receiving the usual community care. The Functional Independence Measure (FIM), the Short Physical Performance Battery, and information on the use and costs of social and health care services. All groups deteriorated in functioning during the year after randomization, but deterioration was significantly faster in the CG than in the HE or GE group at 6 (P = .003) and 12 (P = .015) months. The FIM changes at 12 months were -7.1 (95% CI, -3.7 to -10.5), -10.3 (95% CI, -6.7 to -13.9), and -14.4 (95% CI, -10.9 to -18.0) in the HE group, GE group, and CG, respectively. The HE and GE groups had significantly fewer falls than the CG during the follow-up year. The total costs of health and social services for the HE patient-caregiver dyads (in US dollars per dyad per year) were $25,112 (95% CI, $17,642 to $32,581) (P = .13 for comparison with the CG), $22,066 in the GE group ($15,931 to $28,199; P = .03 vs CG), and $34,121 ($24,559 to $43,681) in the CG. An intensive and long-term exercise program had beneficial effects on the physical functioning of patients with AD without increasing the total costs of health and social services or causing any significant adverse effects. anzctr.org.au Identifier: ACTRN12608000037303.
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              Cognitive, emotional, and social benefits of regular musical activities in early dementia: randomized controlled study.

              During aging, musical activities can help maintain physical and mental health and cognitive abilities, but their rehabilitative use has not been systematically explored in persons with dementia (PWDs). Our aim was to determine the efficacy of a novel music intervention based on coaching the caregivers of PWDs to use either singing or music listening regularly as a part of everyday care. Eighty-nine PWD-caregiver dyads were randomized to a 10-week singing coaching group (n = 30), a 10-week music listening coaching group (n = 29), or a usual care control group (n = 30). The coaching sessions consisted primarily of singing/listening familiar songs coupled occasionally with vocal exercises and rhythmic movements (singing group) and reminiscence and discussions (music listening group). In addition, the intervention included regular musical exercises at home. All PWDs underwent an extensive neuropsychological assessment, which included cognitive tests, as well as mood and quality of life (QOL) scales, before and after the intervention period and 6 months later. In addition, the psychological well-being of family members was repeatedly assessed with questionnaires. Compared with usual care, both singing and music listening improved mood, orientation, and remote episodic memory and to a lesser extent, also attention and executive function and general cognition. Singing also enhanced short-term and working memory and caregiver well-being, whereas music listening had a positive effect on QOL. Regular musical leisure activities can have long-term cognitive, emotional, and social benefits in mild/moderate dementia and could therefore be utilized in dementia care and rehabilitation. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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                Author and article information

                Contributors
                retow.kressig@felixplatter.ch
                Journal
                Inn Med (Heidelb)
                Inn Med (Heidelb)
                Innere Medizin (Heidelberg, Germany)
                Springer Medizin (Heidelberg )
                2731-7080
                2731-7099
                1 December 2022
                1 December 2022
                2023
                : 64
                : 2
                : 147-151
                Affiliations
                [1 ]Universitäre Altersmedizin FELIX PLATTER, Burgfelderstr. 101, 4055 Basel, Schweiz
                [2 ]GRID grid.6612.3, ISNI 0000 0004 1937 0642, Universität Basel, ; Basel, Schweiz
                Author notes
                [Redaktion]

                Cornel Sieber, Winterthur

                Article
                1445
                10.1007/s00108-022-01445-2
                9894993
                36456658
                c344fb21-88fb-42c9-a0ce-b3ba9c13e87d
                © The Author(s) 2022

                Open Access Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden.

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                History
                : 8 November 2022
                Funding
                Funded by: University of Basel
                Categories
                Schwerpunkt: Neurodegenerative Erkrankungen
                Custom metadata
                © The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2023

                musiktherapie,bewegung,alzheimer-erkrankung,tanztherapie,musikalisches gedächtnis,music therapy,exercise,alzheimerʼs disease,eurhythmics,musical memory

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