Nurse-Led Active Music Program in Older Adults With Cognitive Impairment

This pilot quasi-experimental study used a single-group pre-post design and was conducted in a long-term care facility in Roquetas de Mar, Almería, Spain. The study was conceived as a proof-of-concept evaluation of a structured non-pharmacological active music intervention delivered in a real-world long-term care setting.

Eleven residents were initially enrolled. Eligible participants were aged 70 years or older, had been permanently residing in the facility for at least one month, and had a documented clinical diagnosis or screening result consistent with mild-to-moderate cognitive impairment.

The intervention consisted of a structured, group-based active music program led by a registered nurse employed at the long-term care facility. It was delivered over four consecutive weeks, with two sessions per week, for a total of eight sessions. Each session lasted approximately 40 minutes and followed a standardized three-phase structure comprising orientation and breathing exercises, active musical and cognitive stimulation, and relaxation and emotional expression.

Activities included group singing, recognition and completion of familiar songs, call-and-response singing, body percussion, simple percussion instruments, coordinated seated movements, and autobiographical reminiscence. The musical repertoire was selected according to participants' biographical and musical preferences.

Feasibility was assessed through participant retention, intervention completion, attendance, and successful delivery of the eight-session program. Acceptability was assessed through overall satisfaction and willingness to participate again. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and depressive symptoms using the 15-item Geriatric Depression Scale (GDS-15), at baseline and after completion of the intervention. Active participation, sustained attention, and social interaction were recorded during each intervention session.

Inclusion criteria

• Age 70 years or older.
• Permanent residence in the long-term care facility for at least one month.
• Documented clinical diagnosis or screening result consistent with mild-to-moderate cognitive impairment.
• Sufficient motor capacity to participate in seated group activities.
• Adequate or corrected hearing ability to understand verbal instructions and participate in the musical activities.
• Written informed consent from the participant or, when applicable, from a family member or legal representative.

Exclusion criteria

• Severe uncorrected hearing impairment.
• Unstable medical condition, decompensated disease, or terminal illness that could compromise safe participation.
• Severe uncontrolled neuropsychiatric symptoms, including delusions, hallucinations, or marked agitation.
• Refusal to participate.