Date of Award


Document type


Access Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Degree Program


First Advisor

Dorothy Ann Gilbert

Second Advisor

Cynthia S. Jacelon

Third Advisor

Rebecca A. Ready

Subject Categories



Background: Many older adults with dementia residing in nursing homes or assisted living facilities exhibit behavioral disturbances such as agitation and apathy. In addition they lose their ability to feed themselves and often suffer serious malnutrition as their dietary intake decreases. Music has been linked to decreased agitation in this population and physical activity to music linked to a slower decline in eating ability. Purpose: The purpose of this study was to examine whether a familiar physical activity to familiar music would reduce apathy and agitation and increase eating ability and dietary intake among institutionalized older adults with dementia. Method: Eighty four older residents with early to late-stage dementia were randomly assigned to a usual activity or to a group that received a 25-minute intervention (seated chair exercises and beach ball toss to music of the 1920’s to 1950’s) offered 30 minutes before the noon meal twice a week for three weeks. Prior to the intervention, research assistants observed and recorded participants’ apathy using the Frontal Systems Behavior Scale and agitation using the Cohen-Mansfield Agitation Inventory. Trained research assistants (RAs) conducted the intervention, and then escorted participants in both groups to their noon meals. A second group of RAs, blinded to group, observed apathy and agitation as residents began their meals. At the end of the meals, RAs recorded eating ability using the Functional Independence Measure and the percentage of dietary intake for all participants. Digital photos of trays, pre- and post-meal, were also used to document the percentage. Results: Participants, whose mean age was 85.92 and whose Mini Mental Status Exam scores ranged from 0 to 24, resided in two sites: a nursing home with assisted living and a separate assisted living facility. Repeated measures ANOVA revealed significant differences between groups for apathy (p=.01) and dietary intake (p=.01). There was no significant difference in agitation or eating ability. Discussion: Participation in the intervention was associated with more positive outcomes for apathy and dietary intake. There is evidence that a familiar physical activity to familiar music is an effective approach for institutionalized older adults with dementia.


Included in

Nursing Commons