The effect of receptive music therapy plus usual nursing care on cognitive performance and quality of life in elderly patients with type 2 diabetes mellitus and cognitive impairment

Objectives To evaluate the effects of receptive music therapy (RMT) combined with usual nursing care on cognitive performance, quality of life (QoL), mood, and metabolic stability among elderly patients with type 2 diabetes mellitus (T2DM) and cognitive impairment. Methods A randomized controlled trial enrolled 80 participants (aged 65–80 years) with T2DM and mild cognitive impairment. They were randomly assigned (1:1) to an intervention group (RMT + usual nursing care, n = 40) or control group (usual nursing care only, n = 40) for 8 weeks. Primary outcomes were changes in Montreal Cognitive Assessment (MoCA), World Health Organization Quality of Life–BREF (WHOQOL-BREF), and Geriatric Depression Scale-15 (GDS-15) scores. Secondary outcomes included glycated hemoglobin (HbA1c) and fasting glucose. Paired and independent t-tests with ANCOVA adjustment for baseline values were used. Results Seventy-five participants completed the study (retention = 93.7%). Compared with the control group, the intervention group showed a significant improvement in MoCA scores (Cohen’s d = 0.78; 22.5 ± 2.0 → 26.1 ± 1.8, F = 9.84, p = 0.003). Total WHOQOL-BREF scores increased from 52.5 ± 5.6 to 61.4 ± 5.1 ( F = 8.73, p = 0.005), with notable gains in the psychological (+16.5%) and social (+14.2%) domains. GDS-15 scores declined markedly from 6.9 ± 1.5 to 4.1 ± 1.3 ( F = 10.46, p = 0.002), indicating a ≈ 40% reduction in depressive symptoms and a positive correlation with cognitive improvement ( r = 0.42, p < 0.05). Glycemic parameters remained stable (HbA1c 7.8 ± 0.9 → 7.5 ± 0.8%; p = 0.11; fasting glucose 8.4 ± 1.2 → 8.1 ± 1.0 mmol/L; p = 0.14), with no adverse events. Adherence exceeded 95%, and satisfaction was > 90%. Conclusion RMT integrated with standard nursing care significantly improved cognition, mood, and QoL in elderly patients with T2DM and cognitive impairment without affecting metabolic stability. These results support RMT as a safe, inexpensive, and feasible adjunct to conventional geriatric diabetes management, offering a holistic nursing approach to enhance mental and emotional well-being.