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NCT03821844: METRIcAL

Music & MEmory: A Pragmatic TRial for Nursing Home Residents With ALzheimer's Disease_part1

Completed NA Results posted Last updated 28 February 2025
What this trial tests

NA trial testing Music and Memory in Dementia in 1,073 participants. Completed in 31 December 2021.

Timeline
3 June 2019
Primary endpoint
1 August 2021
31 December 2021

Quick facts

Lead sponsorBrown University
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposesupportive care
Enrollment1,073
Start date3 June 2019
Primary completion1 August 2021
Estimated completion31 December 2021
Sites4 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Brown University

Who can join

Eligibility, any sex, with Dementia. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Frequency of Agitated and Aggressive Behaviors (Staff Report) Primary · 4-months

The tool used to interview staff about resident behaviors is the Cohen-Mansfield Agitation Inventory. Research staff interview a nursing staff member who knows the resident well to ask how frequently 29 agitated and/or aggressive behaviors occurred in the past week. There are seven response choices for each item, anchored from never (1) to several times per hour (7). Total scores on the Cohen-Mansfield Agitation Inventory range from 29 to 203, with higher scores representing more frequent agitated and/or aggressive behaviors. Adjusted mean overall scores will be compared for treatment and cont

GroupValue95% CI
Music and Memory50.31± 1.35
Usual Care48.04± 1.35
Frequency of Verbal Agitated and Aggressive Behaviors (Direct Observation) Secondary · 4-months

The tool used to directly observe resident behaviors is the Agitation Behavior Mapping Instrument. Research staff observe residents for short intervals (3 minutes per observation) and record the number of times 14 specific verbally and physically agitated behaviors occurred (up to 10 times per observation). Ordinal outcomes quantify the number of physical and verbal agitated behaviors that occurred during the ABMI observations. The levels of these outcomes are None (0), Some (1 - 3) and Many (4 or more) observed behaviors.

None
GroupValue95% CI
Music and Memory0.800.74 – 0.85
Usual Care0.800.74 – 0.85
Some
GroupValue95% CI
Music and Memory0.130.09 – 0.17
Usual Care0.130.10 – 0.17
Many
GroupValue95% CI
Music and Memory0.080.06 – 0.10
Usual Care0.070.03 – 0.09
Frequency of Agitated and Aggressive Behaviors (Administrative Data) Secondary · 4-months

The Aggressive Behavior Scale is a 4-item measure describing the frequency of physical behavioral symptoms directed toward others; verbal behavioral symptoms directed toward others; other behavioral symptoms not directed toward others; and behaviors related to resisting necessary care. For each item, frequency in the past week is reported as: behavior not exhibited (0); behavior occurred 1-3 days (1); behavior occurred 4-6 days (2); or behavior occurred daily (3). The Aggressive Behavior Scale ranges from 0 to 12, with higher scores indicating more frequent agitated and/or aggressive behaviors

GroupValue95% CI
Music and Memory0.42± 0.08
Usual Care0.40± 0.08
Antipsychotic Use Secondary · 4-months

Any antipsychotic use in the past week, based on Minimum Data Set (standardized assessment of nursing home residents). Measure type of mean is chosen based on adjusted percentage with standard errors from a multilevel, difference in difference regression models.

GroupValue95% CI
Music and Memory26.2± 1.4
Usual Care29.6± 1.3
Antianxietal Use Secondary · 4-months

Any antianxietal use in the past week, based on Minimum Data Set (standardized assessment of nursing home residents). Measure type of mean is chosen based on adjusted percentage with standard errors from a multilevel, difference in difference regression models.

GroupValue95% CI
Music and Memory20.8± 1.5
Usual Care24.3± 1.7
Antidepressant Use Secondary · 4-months

Any antidepressant use in the past week and days of use in the past week, based on Minimum Data Set (standardized assessment of nursing home residents). Measure type of mean is chosen based on adjusted percentage with standard errors from a multilevel, difference in difference regression models.

GroupValue95% CI
Music and Memory57.5± 1.5
Usual Care58.8± 1.5
Hypnotic Use Secondary · 4-months

Any hypnotic use in the past week, based on Minimum Data Set (standardized assessment of nursing home residents). Comparison of percent with any use will be compared for treatment and control populations.

GroupValue95% CI
Music and Memory0.83
Usual Care1.22
Depression Secondary · 4-months

The Patient Health Questionnaire is a 9-item screening assessment for depression severity. For each item, respondents indicate the frequency of the symptom in the past 2 weeks using the following choices: never or one day (0); 2-6 days (1); 7-11 days (2); or 12-14 days (3). Total scores range from 0 to 27, with higher scores indicating more frequent depressive symptoms. Average total scores will be compared for treatment and control populations.

GroupValue95% CI
Music and Memory2.09± 0.33
Usual Care2.30± 0.33
Frequency of Physical Agitated and Aggressive Behaviors (Direct Observation) Secondary · 4-months

The tool used to directly observe resident behaviors is the Agitation Behavior Mapping Instrument. Research staff observe residents for short intervals (3 minutes per observation) and record the number of times 14 specific verbally and physically agitated behaviors occurred (up to 10 times per observation). We report the proportion of participants with no behaviors, some behaviors (1-3 ), many behaviors (4+)

None
GroupValue95% CI
Music and Memory0.850.80 – 0.90
Usual Care0.900.85 – 0.94
Some
GroupValue95% CI
Music and Memory0.120.08 – 0.17
Usual Care0.090.06 – 0.13
Many
GroupValue95% CI
Music and Memory0.030.02 – 0.04
Usual Care0.010.01 – 0.02
Observed Pleasure Secondary · 4-months

The Observed Emotion Rating Scale is completed by a trained observer to document duration of five observed emotional states (pleasure, anger, anxiety / fear, sadness, and general alertness) during short observations (3 minutes per observation). For each emotional state, the researcher indicates whether or not the emotion was observed: never (1); less than 16 seconds (2); 16-59 seconds (3); 1-2 minutes (4); or 3+ minutes (5). Total scores range from 5 to 25, with higher scores indicating greater duration of observed emotion. We report the proportion of participants with any observed emotion dur

GroupValue95% CI
Music and Memory0.360.30 – 0.43
Usual Care0.290.24 – 0.35
Observed Anger Secondary · 4-months

The Observed Emotion Rating Scale is completed by a trained observer to document duration of five observed emotional states (pleasure, anger, anxiety / fear, sadness, and general alertness) during short observations (3 minutes per observation). For each emotional state, the researcher indicates whether or not the emotion was observed: never (1); less than 16 seconds (2); 16-59 seconds (3); 1-2 minutes (4); or 3+ minutes (5). Total scores range from 5 to 25, with higher scores indicating greater duration of observed emotion. Average observed emotion scores will be compared for treatment and con

GroupValue95% CI
Music and Memory0.040.03 – 0.06
Usual Care0.030.02 – 0.04
Observed Sadness Secondary · 4-months

The Observed Emotion Rating Scale is completed by a trained observer to document duration of five observed emotional states (pleasure, anger, anxiety / fear, sadness, and general alertness) during short observations (3 minutes per observation). For each emotional state, the researcher indicates whether or not the emotion was observed: never (1); less than 16 seconds (2); 16-59 seconds (3); 1-2 minutes (4); or 3+ minutes (5). Total scores range from 5 to 25, with higher scores indicating greater duration of observed emotion. Average observed emotion scores will be compared for treatment and con

GroupValue95% CI
Music and Memory0.070.05 – 0.11
Usual Care0.060.04 – 0.10

Sponsor's own description

The purpose of this trial is to test the effects of a personalized music intervention (Music and Memory, Inc.) on agitated and aggressive behaviors for nursing home residents with dementia.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Pragmatic Trial of Personalized Music for Agitation and Antipsychotic Use in Nursing Home Residents With Dementia.
    McCreedy EM, Sisti A, Gutman R, Dionne L, et al · · 2022 · cited 13× · PMID 35038407 · DOI 10.1016/j.jamda.2021.12.030
  2. Measuring the effects of a personalized music intervention on agitated behaviors among nursing home residents with dementia: design features for cluster-randomized adaptive trial.
    McCreedy EM, Gutman R, Baier R, Rudolph JL, et al · · 2021 · cited 13× · PMID 34620193 · DOI 10.1186/s13063-021-05620-y
  3. Using Structured Observations to Evaluate the Effects of a Personalized Music Intervention on Agitated Behaviors and Mood in Nursing Home Residents With Dementia: Results From an Embedded, Pragmatic Randomized Controlled Trial.
    Sisti A, Gutman R, Mor V, Dionne L, et al · · 2024 · cited 12× · PMID 37973488 · DOI 10.1016/j.jagp.2023.10.016
  4. Measuring implementation fidelity in a cluster-randomized pragmatic trial: development and use of a quantitative multi-component approach.
    Olson MB, McCreedy EM, Baier RR, Shield RR, et al · · 2022 · cited 11× · PMID 35033176 · DOI 10.1186/s13063-022-06002-8
  5. Agreement of Antipsychotic Use between Nursing Home Electronic Records and Minimum Data Set.
    Zhang T, McCreedy E, Dionne L, Conard R, et al · · 2024 · cited 4× · PMID 37573885 · DOI 10.1016/j.jamda.2023.07.005
  6. Personalization of Reminiscence Therapies in the Nursing Home Setting: Lessons from an Embedded Pragmatic Trial of a Music Intervention.
    Davoodi NM, Dionne L, Mor V, McCreedy EM. · · 2023 · cited 4× · PMID 37277100 · DOI 10.1016/j.jamda.2023.04.027
  7. Pragmatic Implementation of a Music Intervention in Nursing Homes Before and During COVID-19.
    McCreedy EM, Dewji A, Dionne L, Zhu E, et al · · 2024 · cited 2× · PMID 38036026 · DOI 10.1016/j.jamda.2023.10.021
  8. Assessing the representativeness of cluster randomized trials: Evidence from two large pragmatic trials in United States nursing homes.
    Joyce NR, Robertson SE, McCreedy E, Ogarek J, et al · · 2023 · cited 2× · PMID 37493171 · DOI 10.1177/17407745231185055

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing