{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T21:18:52Z","timestamp":1792876732740,"version":"4.5.0"},"reference-count":55,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>An estimated 70% to 80% of older adults develop delirium in the intensive care unit (ICU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine if a slow-tempo music (60-80 beats\/min) listening intervention decreases delirium duration, delirium severity, pain, or anxiety in older adults undergoing mechanical ventilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This multicenter randomized clinical trial with concealed outcomes assessments was conducted in older adults undergoing mechanical ventilation from February 2020 to December 2023. Patients were enrolled from the ICUs of 2 hospitals affiliated with the Indiana University School of Medicine and from the Mayo Clinic in Rochester, Minnesota.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>A music intervention comprising classical and contemporary tracks, delivered twice daily through noise-canceling headphones and tablets for up to 7 days, was compared to active control listening to a silence track delivered under identical conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary outcome was delirium\/coma-free days during the 7-day intervention period assessed by the Confusion Assessment Method for the ICU (CAM-ICU) and the Richmond Agitation-Sedation Scale. The secondary outcomes were delirium severity assessed by the CAM-ICU-7, pain assessed by the Critical Care Pain Observation Tool, and anxiety assessed by the visual analog scale for anxiety (VAS-A).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 158 patients were randomized (mean [SD] age, 68 (9.2) years; 72 [45.5%] female and 86 [54.4%] male). In an intention-to-treat analysis, no differences were found in the number of delirium\/coma-free days in the music intervention group compared with control (median [IQR] days, 2.5 [0-5] vs 3 [0-5];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.66). There were also no statistically significant differences in the mean CAM-ICU-7 scores, mean pain scores, or mean VAS-A scores over the 7-day intervention period. By end of the 7-day period, both music intervention and control groups had similar mean (SD) CAM-ICU-7 scores (2.72 [2.80] vs 2.56 [2.72]), Critical Care Pain Observation Tool scores (0.20 [0.55] vs 0.61 [1.29]), and VAS-A scores (43.6 [24.7] vs 28.8 [38.4]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this randomized clinical trial among older adults undergoing mechanical ventilation, a slow-tempo music intervention did not demonstrate a statistically significant decrease in delirium duration, delirium severity, pain, or anxiety symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov Identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT04182334\">NCT04182334<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamainternmed.2025.5263","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T15:01:25Z","timestamp":1760367685000},"page":"1442","source":"Crossref","is-referenced-by-count":10,"title":["Slow-Tempo Music and Delirium\/Coma-Free Days Among Older Adults Undergoing Mechanical Ventilation"],"prefix":"10.1001","volume":"185","author":[{"given":"Babar A.","family":"Khan","sequence":"first","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis"},{"name":"Indiana University Center for Aging Research, Indianapolis"},{"name":"Regenstrief Institute, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sikandar H.","family":"Khan","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis"},{"name":"Indiana University Center for Aging Research, Indianapolis"},{"name":"Regenstrief Institute, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Perkins","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Heiderscheit","sequence":"additional","affiliation":[{"name":"Anglia Ruskin University, Cambridge, England, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick W.","family":"Unverzagt","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Indiana University School of Medicine, Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Indiana University School of Medicine, Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"J. 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