Music Interventions for Dementia and Depression in ELderly care (MIDDEL): Protocol and statistical analysis plan for a multinational cluster-randomised trial

Christian Gold*, Jasmin Eickholt, Jörg Assmus, Brynjulf Stige, Jo Dugstad Wake, Felicity Anne Baker, Jeanette Tamplin, Imogen Clark, Young Eun Claire Lee, Stine Lindahl Jacobsen, Hanne Mette Ochsner Ridder, Gunter Kreutz, Dorothea Muthesius, Thomas Wosch, Enrico Ceccato, Alfredo Raglio, Mirella Ruggeri, Annemiek Vink, Sytse Zuidema, Helen Odell-MillerMartin Orrell, Justine Schneider, Christine Kubiak, Renee Romeo, Monika Geretsegger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


Introduction In older adults, dementia and depression are associated with individual distress and high societal costs. Music interventions such as group music therapy (GMT) and recreational choir singing (RCS) have shown promising effects, but their comparative effectiveness across clinical subgroups is unknown. This trial aims to determine effectiveness of GMT, RCS and their combination for care home residents and to examine heterogeneity of treatment effects across subgroups. Methods and analysis This large, pragmatic, multinational cluster-randomised controlled trial with a 2×2 factorial design will compare the effects of GMT, RCS, both or neither, for care home residents aged 65 years or older with dementia and depressive symptoms. We will randomise 100 care home units with ≥1000 residents in total across eight countries. Each intervention will be offered for 6 months (3 months 2 times/week followed by 3 months 1 time/week), with extension allowed if locally available. The primary outcome will be the change in the Montgomery-Åsberg Depression Rating Scale score at 6 months. Secondary outcomes will include depressive symptoms, cognitive functioning, neuropsychiatric symptoms, psychotropic drug use, caregiver burden, quality of life, mortality and costs over at least 12 months. The study has 90% power to detect main effects and is also powered to determine interaction effects with gender, severity and socioeconomic status. Ethics and dissemination Ethical approval has been obtained for one country and will be obtained for all countries. Results will be presented at national and international conferences and published in scientific journals. Trial registration numbers NCT03496675; Pre-results, ACTRN12618000156280.

Original languageEnglish
Article numbere023436
JournalBMJ Open
Issue number3
Publication statusPublished - 1 Mar 2019


  • care homes
  • dementia
  • depression & mood disorders
  • music interventions
  • music therapy
  • neurology
  • old age psychiatry
  • psychiatry


Dive into the research topics of 'Music Interventions for Dementia and Depression in ELderly care (MIDDEL): Protocol and statistical analysis plan for a multinational cluster-randomised trial'. Together they form a unique fingerprint.

Cite this