Liesk 2015

Methods	RCT (parallel). No information on data collection period reported.
Participants	Country: Germany. 5 nursing homes. 26 participants with dementia were randomized. 2 had no complete baseline data, and 24 (12 in each group) were included in analyses. Mean age: 83.6 years in music group (SD 5.1; range 72 to 89); and 84.3 in cognitive stimulation group (SD 5.4, range 70 to 90). Diagnosis of dementia: partly formally diagnosed with ICD 10 and partly not formally diagnosed. People with mild to moderate dementia were included. People with vision or hearing impairment or life‐threatening illness were excluded.
Interventions	1) Active group music intervention ‘Musikgeragogik’ which included singing folk songs and canons and instrumental performance, 12 sessions of 90 minutes in 6 weeks. 2) Cognitive stimulation intervention: adapted Cognitive training program from NEUROvitalis, 12 sessions of 90 minutes in 6 weeks.
Outcomes	Cognition was measured with the Mini‐Mental‐Status‐Test (MMST), DEmTect (and subscales), MTF/ROF (Modified Taylor Figure/Rey‐Osseterrieth Figure), Mac‐Q (Selbteinschatzung‐Gedachtnis), Trail Making Test A, FAS‐Test (Controlled‐Oral‐Word‐Association Test), BTA (brief test of attention). Quality of life was measured with a quality of life instrument (DEMQOL) and DEMQOL‐Proxy (no full name, developed by Smith and colleauges; Smith 2005). ADL was measured with the Barthel‐index, IADL and ADL (Aktivitaten des taglichen Lebens). Also the NOSGER (nurses' observation scale for geriatric patients) was measured, but it is unclear for which outcome. Outcomes were measured at baseline (before randomization) and 1 or 2 days after the last session.
Notes	No explanation about the instruments that were used. The instruments are only mentioned in the Table with results. Unknown for which outcome the NSOGER‐enschatzungen is used. Low fidelity in music intervention group (see 'Other bias' quote below). Bottom effect cognitive measure and more problems described (also in Discussion section of the article) which was part of the goal of the article. No information about funding reported.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: “Die randomisierte Zuteilung der Programme auf die Einrichtungen fand computergestutzt statt”. (Randomized computer‐assisted allocation of the programs [at the level of individuals with dementia] was performed at the facilities)
Allocation concealment (selection bias)	Unclear risk	No description about allocation concealment.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not possible to blind the convener and participants.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Unclear who administered the instruments and whether these persons were blinded for the intervention type.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Few participants missed outcome data and this was clearly reported.
Selective reporting (reporting bias)	Unclear risk	No research protocol available.
Other bias	High risk	Participants in the control group frequently developed an acute illness resulting in missing sessions. Quote: "Während keiner der 12 Teilnehmer des MP akut erkrankte, fielen 5 der 12 Teil­nehmer des KS zwischen zwei und vier Sitzungen aus." (While none of the 12 participants in the music intervention group became acutely ill, 5 of the 12 participants in the cognitive stimulation group missed between two and four sessions). People who attended fewer than 8 of 12 sessions were excluded from the analyses, so these people still contributed to outcome data. Therefore, adherence or fidelity may be a problem even though they already preselected people who were probably interested in music therapy.