Paper · m-cst · mcdc · 2025
Comparative Effects of Live and Recorded Music on Quality of Life in People Living with Dementia: A Cohort Study
12 participants, 24 weeks, 240 paired observations of live-versus-recorded music sessions.
J. Harry Whalley, James E. Armstrong, Mark Brill, Lara James
Abstract
This mixed-methods cohort study aimed to compare the effects of live and recorded music sessions on quality of life and behaviour in people living with dementia (PLWD) attending a dementia club. Twelve (12) participants were exposed to alternating live and recorded music sessions over a 24-week longitudinal study with 240 paired observations. Quality of Life in Alzheimer's Disease (QoL-AD) scores were collected pre- and post-session, supplemented by qualitative observations from healthcare professionals. Alternating live/recorded sessions allowed within-subject comparisons. Both live and recorded music significantly improved QoL-AD scores, with live music demonstrating more consistent positive effects across quality of life domains. Recorded music elicited stronger autobiographical memories in some participants but showed greater variability in responses. Rich interview data from three caregivers provided contextual insights. The findings suggest an integrated approach leveraging strengths of both modalities may optimise therapeutic outcomes for PLWD. The average improvement in social connection was significantly greater for participants in live sessions (M = 0.99, SD = 1.01) compared to recorded sessions (M = 0.14, SD = 0.89); t(242) = 6.45, p < .001.
In plain language
A specific question underlying M-CST’s design: does it really matter whether the music is live or recorded? MCDC’s framework argues that group M-CST sessions are where the dual-purpose principle does most of its work, and that the live-music context is part of the reason. This study tests that proposition.
Twelve people living with dementia attended a dementia club over twenty-four weeks, with sessions alternating between live and recorded music so each participant acted as their own control. Quality-of-life scores were collected before and after each session, with 240 paired observations in total. Both formats produced measurable improvement; but on the social-connection dimension — one of the QoL-AD scale’s subscales, and a domain MCDC cares about specifically — live music produced a roughly sevenfold larger change than recorded, with the effect highly statistically significant.
That result does not make recorded music unimportant — recorded music produced stronger autobiographical-memory responses in some participants — but it does put numbers on a specific thing M-CST sessions do that a playlist cannot replicate. The right clinical answer, the paper argues, is to use both: live music for structured session work, recorded for individual daily use.
Novel contributions
- Direct within-subject comparison of live and recorded music on QoL-AD in a dementia-club setting, something the Cochrane reviews have had to rely on between-studies comparisons to approximate.
- A specific, measurable social-connection advantage for live music (effect size ~0.85 SD), which gives the MCDC framework a concrete evidence anchor for why its Component 1 is a group-based, facilitator-led programme rather than a personalised playlist service.
Status and availability
- Status: under review.
- Corresponding author: J. Harry Whalley, UCA ·
hwhalley@uca.ac.uk - Affiliation: Audio Research Cluster, University for the Creative Arts
- Keywords: PLWD; dementia; music; live; recorded; music facilitation; QoL-AD
Open questions for Harry
- The dementia-club setting — was this Lifecare (Edinburgh), or a separate setting? The ACT trial at Lifecare was also 24 weeks in 2023 (n = 16); confirm whether the two studies are the same cohort, overlapping, or distinct.
- Dr James E. Armstrong appears as a co-author here but isn't on the MCDC white paper or the ACT manuscript — if he's a regular collaborator, he should probably have an About entry too. Confirm role.
- Target journal and expected publication.