The influence of soundscape on neuropsychiatric symptoms in nursing home patients with dementia.

Interventions to improve the auditory environment of institutions for people with dementia are scarce. We developed the
intervention MoSART+. It combines the use of the smartphone application MoSART and specially trained sound-ambassadors.
Nurse-assistants will use MoSART to register the actual soundscape at two to three random moments during their shift.
Subsequently, the ambassadors facilitate nurse-assistants to invent and implement micro-interventions to improve the quality of the auditory environment.
The aim of this project is to investigate the effect of MoSART+ on neuropsychiatric symptoms in dementia. We will perform a
stepped wedge cluster-randomised trial among 88 patients in 11 dementia specialist care units (clusters) of 5 nursing homes
participating in the academic network UNO-UMCG. Every three months, a randomly allocated nursing homes will switch from
usual care to the intervention. After 18 months, all nursing homes will have received the intervention. Assessments will take
place every 3 months from baseline until end of follow-up.

We expect that soundscape improvement leads to a decrease of neuropsychiatric symptoms (primary outcome), and subsequently to improved quality of life and decreased psychotropic drug use (secondary outcomes). In addition, job distress
among staff may decline and job satisfaction may increase. Informal caregivers might become more satisfied with the care
provided. We will also record the quality of the auditory environments before and after the intervention, and the number and
type of micro-interventions undertaken.

1. The increased awareness will lead to numerous small and immediate adaptations of the auditory environment (micro-interventions) and longer-term interventions (macro-interventions).



2. The interventions will improve the quality of the auditory environment;



3. The improved quality of the auditory environment leads to decreased NPS and increased quality of life in nursing home patients with dementia.



4. The improved quality of the auditory environment leads to a reduction in work distress and increased job satisfaction among nursing staff.

Measurement every three months.

Measurement after 13 weeks short term effects.

Measurement after 26 weeks more sustained changes.

A smartphone application called Mobile Soundscape Appraisal and Recording Technology (MoSART).