Music activities that most elicit interest and pleasure among older people with mild-to-moderate dementia: a qualitative multiple-case study in Italy.

Literature has well documented the impact of music on the mood of older adults with dementia and underscored that the pleasantness of activities may increase the intervention's efficacy. Nevertheless, it is unclear which music activities may be more effective in triggering interest and pleasure in older adults with mild-to-moderate dementia. Recently, SOUND, a novel and original music-based non-pharmacological intervention, was conducted in Italy with 13 older people aged over 70 years with mild-to-moderate dementia who attended a day-care center. Participants' interest and pleasure were rated and ranked using the Apparent Affect Rating Scale. Field notes were analyzed to develop ideal types of older people with mild-to-moderate dementia who participated in the intervention. Results showed that listening/attention/coordination activities and percussion/rhythmic activities were associated with greater observed interest and pleasure among older people with dementia, compared with elicitive/narrative activities and singing activities. The pleasantness and interest elicited by activities might be influenced by the educational background and music training of facilitators, participants' cognitive profiles, and the social dynamics of the sessions. Five ideal types of older people with moderate dementia were identified as a potential tool to help dementia care professionals and musicians group participants and choose music activities to maximize the benefit of the intervention. Further research is needed to understand how music activities, from being pleasant and interesting, may become a source of stress and discomfort and how ideal types could inform the design of future interventions.