A systematic review of the wellbeing outcomes of music and singing in adults and the processes by which wellbeing outcomes are achieved

What music and singing interventions work to improve wellbeing of adults?

The review sought to address the question: ‘What are the wellbeing outcomes of music and singing for adults and what are the processes by which wellbeing outcomes are achieved?’ 

The resulting outputs are three volumes detailing an overview of the review process and a discussion of the findings for:

1. healthy adults (39 studies)
2. adults with identified health conditions such as stroke, COPD and mental health conditions (16 studies)
3. adults with dementia (6 studies)

The review included empirical research that assessed the relationship between music and singing interventions with subjective wellbeing (excluding clinical treatment), published from 1996 – June 2016.

We also included systematic reviews published between 2010 and 2016. Grey literature and practice reports published from 2013 were included (see Daykin et al. 2016).

We have not included clinical studies of music and singing, including interventions for patients in hospital, where the focus is on clinical outcomes such as pain management or coping with symptoms or hospitalisation or studies where the focus is on clinical outcomes or dementia symptom management.

While there was a great deal of heterogeneity across the studies, it was possible to undertake an exploratory meta-analysis on music/singing and anxiety and depression in health adults which suggested that music participation in healthy people can reduce depression.

There is high quality evidence that music and singing activities can enhance and maintain subjective wellbeing in healthy adults.

The strongest evidence surrounds music and singing for older people and includes effects of music, particularly singing, on morale, mental health-related quality of life, loneliness, anxiety and depression. 

There is also moderate quality evidence for wellbeing outcomes of music and singing for specific sub groups including young adults, marginalised groups and people in justice settings. Outcomes for these groups include changes in mood, anxiety and sense of purpose. 

In relation to adults with adults with chronic conditions such as stroke, COPD and cancer, the studies report reduced stress and improved wellbeing across a range of outcomes.

There is initial evidence that participation in individual personalised music listening sessions can reduce anxiety and/or depression in nursing home residents with dementia and that listening to music may enhance overall wellbeing for adults with dementia.

The highest quality evidence supports the promotion of group singing and music programmes for healthy adults.

It should be noted that people respond differently to different singing and music interventions, so these need to be carefully designed and targeted in order to maximise wellbeing outcomes for people with identified conditions.

Addressing issues of context, social diversity and wellbeing inequalities represents an important focus point for policy and practice agendas on music singing and wellbeing. As is ensuring that interventions reflect both active and passive forms of engagement. 

A key challenge for establishing evidence in this field is the breadth and diversity of projects and research approaches adopted. More research is needed to understand the relationship between music activity and wellbeing over time.

There is also scope for additional well-designed evaluations and robust research studies which examine music and singing interventions other than group singing, playing and listening.

The review raises complex questions about the measurement of subjective wellbeing in people with dementia.