Music-based Application Provides Nonpharmacological Approach to Improving Sleep in Alzheimer Disease

Darina Petrovsky, PhD, RN

Nonpharmacological interventions such as listening to music have emerged as an effective approach to improve sleep health for those who experience sleep disruption. A recently conducted systematic review by Darina Petrovsky, PhD, RN, and colleagues investigated the effects of music interventions on sleep with older adults, at least 50 years old in age.¹

Petrovsky and colleagues yielded 16 studies from five databases centered on two types of music interventions, music listening (n = 11) and multi-component (n = 5). The music listening intervention studies had personalized music according to the patient’s preferences whereas the multi-component studies included music with an additional approach, for example, tai chi.

Petrovsky, assistant professor, Rutgers University, and core member, Rutgers Institute for Health, Health Care Policy and Aging Research, was interviewed by NeurologyLive^® to discuss the current happenings within her lab, the Petrovsky Lab,² on music-based applications for people living with dementia and their caregivers, who may also experience difficulties with sleeping. Petrovsky also talked about past conferences she attended that influenced her work, including the 2022 Alzheimer’s Association International Conference.

NeurologyLive^®: What is currently going on in your lab, the Petrovsky Lab, and have there been any challenges?

Darina Petrovsky, PhD, RN: We have a project right now, research project, funded by the NIH to develop and test a music-based app for individuals living with dementia, and their care partners. We're currently in the first stage of the project where we're developing the prototype of the app. Then, we'll be testing it with a small number of pairs of those living with dementia and their caregivers. Then, rolling out to clinical trials once we have the app ready, hopefully working out the kinks, then start the clinical trial portion of it later in 2023. Right now, we're almost done recruiting for the first stage, just have a few more people to invite to join us. But as you can imagine, recruiting those patients with dementia and caregivers is rather challenging. Not everybody seeks care or seeks treatment or diagnosis of Alzheimer or other type of dementia. We have a couple of clinicians that we work with, but we are not working with all the physicians in New Jersey that are seeing these patients.

Recruitment is always a challenge in any resource, but especially with this population. Some of the efforts that we've done so far is to partner with a clinician to get the word out about our study. Now we're thinking about instead going with the social media route. I know that may not bring us a true representative and diverse sample that we're looking for but I think it will connect us with caregivers, particular from all over the United States. Our study is virtual so we're technically not limiting our recruitment to those residing in the state of New Jersey. Then, the next phase is developing the prototype of the app. I've already started thinking about what that would look like along with the input that we receive at this stage of our work.

Within the past year, have you attended any Alzheimer disease related conferences and if so, what was your experience like at them?

I think pertaining to Alzheimer disease space, I attended the Alzheimer's Association International Conference, AAIC, for the first time. That was in San Diego over the summer. I didn't present anything, but I wanted to get a flavor of what kind of research is being presented there. We can perhaps apply to present at the next conference coming this coming summer, which is taking place in Europe, in Amsterdam. That's where I got to meet the local executive director of the Greater New Jersey chapter of the Alzheimer's Association, Cheryl Ricci-Francione. She and I connected there. It was nice to meet also other chapter leaders as well to get a sense of how vast the association is, and some of the efforts they have to diversify and to provide supports for those who have Alzheimer disease diagnosis, as well as other types of dementia.

I attended two different workshops, and I normally don't travel as much but this summer, they were back-to-back and both focused on Alzheimer disease. One was the summer institute at the Alzheimer's Association, which is meant to bring scientists in both psychosocial areas as well as a public health arena for studying Alzheimer disease to get them connected, to learn more about the association, and to get feedback on their proposals. I thought that was an excellent week that I spent in Chicago, and I met people who do different work than me. The second opportunity I went to was also a week long training in San Diego called the IMPACT AD, and it stands for Institute on Methods and Protocols for Advancement of Clinical Trials in ADRD. That's where we got a pretty intense week-long training to learn all about clinical trials in AD and not just non-drug trials, but also a lot of drug trials and the most recent, disease-modifying therapies.

We talked a lot about aducanumab, the latest drug approved by the FDA for treatment of Alzheimer's disease. I thought that was a very, excellent opportunity for me to not just to network and get to know other people, but really learn the inner workings of large clinical trials, like multi-site clinical trial even know my current study is not at that stage of development. I think eventually, I will have to show my interventions efficacy on a larger scale. It's good to know how others are doing and thinking about how people actually run clinical trials. That was a really great opportunity.

Besides attending the conferences, have you been active in any organizations related to Alzheimer and focus in research?

The Sound Health Network, I'm still engaged with that group because my work focuses on building music-based interventions and sound, as part of music. With that group, one interesting event that we went to recently was in Washington, DC. They had a two-day event where they brought musicians, like music therapists, experts in this field, and not just aging, but this was across all areas, across all the lifespan. We got to meet famous folks, including celebrities like Renee Fleming and the previous director of the NIH, Francis Collins, MD, PhD. That was also a really good way of networking, connecting with people in the space, building relationships. There were some of the cutting edge research that's going on in terms of music and other diseases outside of aging and Alzheimer disease, which is where I live, that's where you find opportunities.

My research coordinator, Sophia Geisser got to go with me. I think she thought it was very exciting as well. I think these are all that I did attend, it was a lot of travel. Two weeks ago, Sophia and I went to present research for my postdoctoral work at the Gerontological Society of America, which is a more interdisciplinary conference on anything aging related, not disease specific. I try to go to that conference every year and I consider that my home conference where I do a lot of service. I present pretty much at every conference. Sofia presented a poster outlining some of the main findings from my postdoctoral project, which served as a sort of a stepping stone for the work that we're doing right now with developing the music based app. That was exciting, we got a lot of feedback and that paper is currently under review. It's been under review for a while, but hopefully, won't be too much longer. So that's an overview and a lot of travel which is unusual for me, but all of these things were happening and I just couldn't resist.

Transcript edited for clarity.

REFERENCES
1. Petrovsky DV, Ramesh P, McPhillips MV, Hodgson NA. Effects of music interventions on sleep in older adults: A systematic review. Geriatr Nurs. 2021;42(4):869-879. doi:10.1016/j.gerinurse.2021.04.014
2. Petrovsky Lab. Homepage. Published 2021. Accessed November 16, 2022. https://sites.rutgers.edu/petrovsky-lab/