SING FOR YOUR LIFE 2005 -

Silver Song Clubs Delivered by Sing For Your Life on a model developed by the Sidney De Haan Centre Groups of older people meet in community venues to sing and make music - including those with dementia and their carers Led by experienced facilitators supported by volunteers Currently about 40 groups across S.E. & Northern England, Italy, Finland, Western Canada 2

RCT 2010 Change in demographics of the UK More older people living with chronic long term health conditions and in social isolation Limited research into benefits of singing for older people Only 2 previous trials Formative evaluation of SSCs by SDH Centre Cohen (2006). Allocated 166 healthy older adults to chorale or usual activities and assessed at baseline & 12 months. Intervention was over 30 weeks & group reported higher overall rating of physical health , mental health & greater sense of control than comparison 3

Trial Design Programme devised by SFYL and led by experienced facilitators April-July 2010 Outcome measures - standardized health questionnaires Primary measure York SF-12 Secondary measures HADS, EQ-5D, Service Use Questionnaire Measured at baseline, post-intervention and 6 month follow-up Participant comments invited All self-report measures SF 12 a widely used health related QoL measure with 12 questions and 2 scales (MCS & PCS). York version validated for older people HADS widely used and validated for other settings EQ5D 5 dimensional with 3 alternative responses. A measure of health utility. Can identify 243 possible health states and each is given a value. Over 80% wrote written comments on 2nd Q 4

Findings from Questionnaire Analysis (1) At 3 months sig. greater improvement in mental health related quality of life in intervention group (p<0.01) At 6 months, sig. greater improvement in mental health related QOL in intervention group (p=0.05) SF12 score ranges 0-100, where 0= lowest level of health and 100 = highest. Scores weighted when computed. Scores vary over lifetime, with PCS decreasing and MCS increasing with age. UK national norms (all age) are 52.1 (MCS) & 50.9 (PCS) (Gandeck et al 1998, cited in Warren et al 2011 paper presented to Policy Association conference). Baseline measures in Greaves & Farbus study of older people in UK were 47.0 (MCS) and 35.3 (PCS) Therefore baseline scores for sample in SSC show they are generally fit and healthy. On physical scores, lower scores and still greater improvement in intervention group but non-significant. 5

Findings from Questionnaire Analysis (2) HADS anxiety score 0-7 considered normal range. UK norm for anxiety scale = 6.14 (Crawford et al 2001) Both groups healthy at baseline and improved over course of project (intervention more so). At 6 months difference between groups not significant. At 3 months lower anxiety scores in intervention group(p<0.01) 6

Findings from Questionnaire Analysis (3) Cost-effectiveness Combines costs of interventions with QALY changes Singing group cost more but also greater QALY gain. Singing groups cost effective if willing to pay >£14,000 per QALY NICE estimates QALY value £20,000-£30,000 Probability of cost-effectiveness favours singing groups Cost-effectiveness depends on commissioners’ valuation of QALY i.e. How much willing to pay per QALY If QALY valued at £0 then control favoured in 81% cases. As QALY value increases, likelihood of intervention being more cost-effective 7

Participant feedback “I started my participation in this project just after I retired from work and feeling a little anxious about future life. This project has been instrumental in showing me there is life after ‘work’”

Conclusion Singing groups for older people appear to have a benefit in terms of mental health. Singing groups may be a cost-effective health promotion strategy for this population

SING FOR YOUR LIFE A new focus…

The Prime Minister’s Challenge On Dementia - the call Delivering major improvements in Dementia care and research by 2015. Improve care in the community to support independent living.

A SONG A DAY KEEPS THE DOCTOR AWAY! Our response… A SONG A DAY KEEPS THE DOCTOR AWAY!

Group participatory singing can… Provide Cognitive Stimulation Therapy (CST) Help reduce social isolation Be delivered whether living in: Community Assisted Living Centres Residential Care Homes

Our challenge is… How can we all help?

Silver Song Music Box System Participatory Singing Programmes available on demand Easy to operate - Plug in and play! No formal musical training required Themed and personalised programmes Improved behaviour - reduced need for use of antipsychotic drugs

SING FOR YOUR LIFE power of music n