Music Interventions for Dementia and Depression in Elderly Care (MIDDEL)

  • End date
    Jul 22, 2025
  • participants needed
  • sponsor
    NORCE Norwegian Research Centre AS
Updated on 22 March 2022
depressive symptoms
depressed mood
mini-mental state examination
mental state examination


This study evaluates the effectiveness of two music-based approaches - group music therapy and recreational choir singing - for reducing depression symptoms in people living with dementia. It also examines mechanisms and heterogeneity of treatment effects.


Dementia and depression are highly prevalent and comorbid conditions in older adults and are associated with individual distress, substantial carer burden, and high societal costs.

Music interventions represent a highly promising type of non-pharmacological interventions for both dementia and depression in older adults. They are widely used, but have yet to be rigorously tested in large trials.

The MIDDEL trial is the largest trial of music interventions to date, and the first to compare different music-based interventions - group music therapy (GMT), and recreational choir singing (RCS) - alone and in combination across countries.

MIDDEL is designed as a large, pragmatic, international cluster-randomised controlled trial with a 2x2 factorial design that will compare the effects of GMT, RCS, both, or neither, for care home residents aged 65 years or older with dementia and depressive symptoms.

Study sites will be located in Australia and in five European countries, and a total of 100 care home units will be randomised to one of the four study conditions.

Condition Dementia, Depression
Treatment Standard Care, Group Music Therapy, Recreational Choir Singing
Clinical Study IdentifierNCT03496675
SponsorNORCE Norwegian Research Centre AS
Last Modified on22 March 2022


Yes No Not Sure

Inclusion Criteria

resident (full-time, 24h/day) at a participating care home
dementia as indicated by a Clinical Dementia Rating score of 0.5 or more and a Mini-Mental State Examination (MMSE) score of 26 or less
at least mild depressive symptoms, as indicated by a Montgomery-Åsberg Depression Rating Scale (MADRS) score of at least 8
a clinical diagnosis of dementia according to ICD-10 research criteria
have given written informed consent (may be assent by proxy for those unable to provide consent themselves)

Exclusion Criteria

diagnosis of schizophrenia or Parkinson's disease
severe hearing-impairment
in short-term care
unable to tolerate sitting in a chair for the duration of the sessions
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Additional screening procedures may be conducted by the study team before you can be confirmed eligible to participate.

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If you are confirmed eligible after full screening, you will be required to understand and sign the informed consent if you decide to enroll in the study. Once enrolled you may be asked to make scheduled visits over a period of time.

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Complete your scheduled study participation activities and then you are done. You may receive summary of study results if provided by the sponsor.

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