This study between February 2020 and December 2023, involved 158 older patients (average age 68) from the ICUs of 2 hospitals affiliated with the Indiana University School of Medicine and the Mayo Clinic in Rochester, Minnesota. The participants were randomly assigned to either a music intervention group that listened to slow-tempo music at 60–80 beats per minute, or a control group that listened to silence under identical conditions.
The intervention involved twice-daily listening sessions of classical and contemporary slow-tempo tracks using tablets and noise-canceling headphones, lasting up to 7 days. This research hypothesized that such sessions might reduce the duration or severity of delirium which affects up to 70% to 80% of older ICU patients. Delirium is characterized by confusion, agitation, and disorientation and is associated with worse clinical outcomes, including prolonged hospital stays and increased mortality risk.
Using the Confusion Assessment Method for the ICU (CAM-ICU) and the Richmond Agitation-Sedation Scale, this research measured the primary outcome and found no significant difference between the music and control groups. The patients in the music group had a median of 2.5 delirium/coma-free days, when compared with 3 days in the control group (P = .66).
Secondary outcomes, which included delirium severity, pain, and anxiety, showed no meaningful improvement. The mean CAM-ICU-7 score for delirium severity was 2.72 in the music group versus 2.56 in the control group. Pain, assessed by the Critical Care Pain Observation Tool, showed mean scores of 0.20 for the music group and 0.61 for controls. Also, anxiety measured through the Visual Analog Scale for Anxiety (VAS-A) yielded average scores of 43.6 versus 28.8, which suggested no consistent calming effect.
The findings challenge the assumption that music therapy provides measurable clinical benefits for delirium management in mechanically ventilated older adults. While music remains valued for emotional comfort and patient engagement, its ability to influence neurological or physiological outcomes in critical care remains uncertain.
The findings of this study suggest that slow-tempo music alone may not be sufficient to reduce delirium duration, severity, or associated distress in the ICU setting. Further studies may explore whether combining music therapy with other sensory or pharmacologic interventions could produce more significant results.
Reference:
Khan, B. A., Khan, S. H., Perkins, A. J., Heiderscheit, A., Unverzagt, F. W., Wang, S., Downs, J. H., 3rd, Gao, S., & Chlan, L. L. (2025). Slow-tempo music and delirium/coma-free days among older adults undergoing mechanical ventilation: A randomized clinical trial: A randomized clinical trial. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2025.5263
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