Developing a music-based digital therapeutic to help manage the neuropsychiatric symptoms of dementia

Abstract

The greying of the world is leading to a rapid acceleration in both the healthcare costs and caregiver burden that are associated with dementia. There is an urgent need to develop new, easily scalable modalities of support. This perspective paper presents the theoretical background, rationale, and development plans for a music-based digital therapeutic to manage the neuropsychiatric symptoms of dementia, particularly agitation and anxiety. We begin by presenting the findings of a survey we conducted with key opinion leaders. The findings highlight the value of a music-based digital therapeutic for treating neuropsychiatric symptoms, particularly agitation and anxiety. We then consider the neural substrates of these neuropsychiatric symptoms before going on to evaluate randomized control trials on the efficacy of music-based interventions in their treatment. Finally, we present our development plans for the adaptation of an existing music-based digital therapeutic that was previously shown to be efficacious in the treatment of adult anxiety symptoms.

Keywords: agitation; anxiety; artificial intelligence; dementia; digital therapeutics; music; neuropsychiatric symptoms.

Figure 1

Midsaggital view of brain featuring neural degradation that has been associated with anxiety and agitation in dementia: anxiety (blue) = putamen, parietal cortex, and entorhinal cortex (EC); agitation (red) = orbitorfrontal cortex (OFC); dorsolateral prefrontal cortex (dmPFC); anxiety and agitation (purple) = anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), amygdala (Amy), hippocampus (HC), and insula (not depicted in this view).