A new study has found that personalized soundscapes have been found to improve resident well-being and behaviour while reducing care provider anxiety and stress.

Dr. Arezoo Talebzadeh, a researcher from Ghent University in Belgium presented the unexpectedly positive results of the randomized control trial, conducted in collaboration with Dr. Andrea Iaboni and other researchers at Toronto Rehabilitation Institute (UHN), during the recent AGE-WELL 10th Annual Conference in Toronto.

“Our goal is to empower caregivers and, eventually, residents themselves to shape their own soundscapes,” says Talebzadeh, an architect who designs for long-term care and senior housing projects.

The whole goal of this research for me is that it's helpful, something that makes life a little more joyful or less stressful for people living with dementia and for those that care for them.

-Dr. Arezoo Talebzadeh

About the trial

“Soundscapes” are familiar everyday sounds, like bird songs and rain falling, that can be purposefully employed to calm anxiety and help to stimulate a sense of place and time for people living with dementia.

Talebzadeh and her team worked with 32 individuals on the Specialized Dementia Unit at the UHN to evaluate the effect of soundscape interventions on anxiety, depression, and agitation as measured by the Neuropsychiatric Inventory (NPI).

During the year-long trial, the soundscape was delivered individually in participants' rooms, primarily during nighttime and morning routines. The nighttime soundscape featured gentle sounds such as rain and cicadas to aid sleep, while morning sessions included bird songs to facilitate wakefulness and activation. The intervention aimed to mask environmental noises, such as those from the corridor, with sound levels carefully measured to remain unobtrusive. The soundscape was played intermittently between 7 p.m. and 7 a.m., tailored to daily activities and the hospital's schedule.

Analysis of the collected data indicated improvements across all measured domains for participants who received the soundscape intervention. Notably, resistance to care during morning routines was significantly reduced. This finding was unexpected and highlighted the potential benefits of reduced anxiety and stress for care providers.

Cricket chirps over music and birds

In a parallel study conducted in a care home in Belgium, Talebzadeh explored personalization of the soundscape intervention. Participants could rate each sound based on preference, allowing the soundscape system, called Acusticare, to adapt and remove disliked sounds. The system allowed for cultural adaptation; for instance, church bells were included in Belgium due to their familiarity. Results provided some surprising insights into sound preferences among participants.

“We were surprised to find that crickets outperformed even familiar tunes and birdsong, which really challenged our assumptions.” says Talebzadeh. Contrary to expectations from existing literature, participants rated the sound of crickets the highest, surpassing both music and bird sounds.

Talebzadeh suggested this preference might be attributable to the crickets' masking effect, which may be more relaxing and effective in minimizing environmental distractions. Overall, psychoacoustic analysis revealed that sounds with higher sharpness were rated most favourably, possibly due to their perceptibility among individuals living with hearing loss associated with dementia.

Refining Soundscapes

Next steps for Talebzadeh and the interdisciplinary research team include refining sound selection according to type of dementia, minimizing confusing or overwhelming soundscapes, and potentially integrating artificial intelligence to assist caregivers in daily customization. Collaboration with organizations in Canada and Europe is ongoing, with the goal of expanding deployment beyond research settings to everyday environments.

Soundscapes are an important part of valuable tool to reduce anxiety and enhance quality of life and enabling longer independent living.

“People may not know, every three seconds someone in the world is diagnosed with dementia. I'm a designer, not a physician, so I think about how I can help through design” says Talebzadeh. “The whole goal of this research for me is that it's helpful, something that makes life a little more joyful or less stressful for people living with dementia and for those that care for them”.