Therapeutic factors and mechanisms of change in music therapy for people with late-life depression: A scoping review

Due to the growing aging population, the number of people with late-life depression (LLD) is estimated to increase significantly. LLD presents symptoms such as persistent low mood, decreased interest and pleasure, and feelings of worthlessness. Music therapy has demonstrated efficacy in alleviating depressive symptoms in this population. However, understanding of its therapeutic factors and mechanisms of change remain limited. This scoping review aims to elucidate the therapeutic factors, mechanisms of change and their related outcomes involved in music therapy for people with LLD. Databases including Medline, Cinahl, Psycinfo, Cochrane, Embase, Web of Science, and Google Scholar were systematically searched. Selection criteria included elderly individuals (above 60), late-life depression, music therapy, therapeutic factors and mechanisms of change. Of 1249 screened studies, 31 were included, identifying 5 domains of presumed therapeutic factors, presumed mechanisms of change and related presumed outcomes. The domains are emotion, social, cognition, arousal and behavior & motivation. The emotion domain, which encompasses presumed therapeutic factors and presumed mechanisms of change for emotion regulation emerged as the most prominent. Both music listening and interactive music making facilitate emotion regulation by evoking and expressing difficult feelings in people with LLD. Insights gained on therapeutic factors and mechanisms of change involved in music therapy for people with LLD can inform strategy development, enhance clinical care, and guide future research efforts.