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Power of Song: The Effects of Music Therapy on Dementia

In the US alone, there are more than 3 million cases of dementia per year. Worldwide, there are 50 million cases. Dementia is the culmination of cognitive functioning impairment that interferes with daily life; an overarching term that describes memory loss, difficulty with speech and comprehension, lack of judgment, impulsivity, etc. Dementia can range in severity, from the most mild stage of its beginning effects on an individual’s cognition, to a complete inability to function independently with even the most basic activities of living. Though around ⅓ of all people aged 85 and older have some form of dementia, it is not a normal part of aging, and the causes are still unknown (NIH). By 2040, the number of 65 year old adults with dementia is expected to skyrocket to over 14 million (CDC), and by 2050, the worldwide number of 50 million is expected to triple. The pathway from diagnosis to mortality in Alzheimer’s disease, the most common form of dementia, is approximately 8.3 years, and thus individuals at different stages of this trajectory have varying degrees of neurodegeneration (Erikson et al., 2022). Though there are steps that can be taken in attempts to prevent dementia such as Alzheimer’s, once it is onset, it is not curable. However, it can be treatable– to an extent. In fact, exposure to music may have positive effects on the cognitive function of those who struggle with dementia.

Alzheimer’s Disease, though it manifests differently in every individual that is afflicted, is often first noticed by the progressive difficulty with learning and retention of new information (Salthouse & Albert, 2008). This is what is referred to as episodic memory, and makes contextualizing and remembering previous memories and experiences much more difficult. Often, the earliest pathological changes of the disease are seen in medial temporal lobe regions essential for normal memory. Over time however, pathological abnormalities will impact more and more brain regions until they are seen throughout the temporal, parietal, and frontal lobes. To better understand the changes that occur and what can be done about them, I have analyzed Music Therapy in the Treatment of Dementia: A Systematic Review and Meta-Analysis.

So, what can be done in order to remedy the effects of Alzheimer’s Disease? In order to ameliorate the symptoms and struggles of dementia, both pharamalogical and non-pharmological options exist. Pharmacological approaches, such as acetylcholinesterase inhibitors aimed to treat cognitive symptoms (which is a fancy way of explaining a mechanism that attempts to stop the breaking down of neurotransmitters), often have little success. However, non-pharmacological options, such as psychosocial and educational therapies, seem to minimize negative behavioral occurrences, and have an overall positive outcome on quality of life. Specifically, music therapy, in daily clinical use with patients with dementia, has had significant positive impacts on emotion, behavior, and cognition. Those with dementia enjoy music, and sensations of pleasure and “welfare” can be stimulated through the activation of brain areas that suggest that music therapy has the capacity to enhance cerebral plasticity – the ability to modify the way the brain is structured. 

It is also clear that the ability to respond to music is preserved in individuals with dementia even when they are no longer able to communicate verbally. If you have ever had the experience of being in a public space, hearing a song that you haven’t heard in a while, and immediately being transported back to an event or experience highly connected to strong memories and emotion, you may understand just how powerful our responses to music can be. 

How Music Can Help People with Alzheimer’s and Dementia 

In this meta-analysis spanning data from Medline, PubMed Central, Embase, PsycInfo, and Cochrane,  individuals ranging from mild to severe dementia were assigned randomly to both intervention and control groups, respectively. These five independent sites sharing studies of the same subject found that the intervention type (which refers to those with Alzheimers who were exposed to some type of therapy) that was shown to have the greatest positive effect on cognitive function was music. This is possibly explained because listening to music involves attention to sound, lyrics, and rhythm, and thus requires attention to the environment. This suggests that the brain has several areas activated simultaneously in order to listen to music, and is linked to wide cortical activation. Music exposure also seems to be a powerful stimulus for neuroplastic changes, which could also decrease neuronal degeneration through enhancement of cerebral plasticity and creation of new brain connections.

The length of time that people with Alzheimer’s and dementia listen to music also seems to have a significant effect on positive cognition results as observed through the number of sessions per week and the intervention length of music therapy experienced by each individual. Shorter interventions, less than 20 weeks, had a larger effect on people living with dementia than longer ones. Though the number of sessions per week did not seem to affect the success of music therapy, a greater frequency of therapy sessions was important. What this means is that a high level of therapy sessions each week during a short intervention period is most effective in expressing cognitive benefits.

In terms of quality of life, there also seems to be a positive effect. This effect, however, may not remain after a continuous 6 months of music intervention. However, evaluation of depression in connection to music therapy suggests that people living with dementia show no improvement after treatment. But, if the depressive state was evaluated after 6 months of treatment, a shift in favor of music therapy was shown, suggesting that effects of music therapy are not immediate. Additionally, continuous and repeated music intervention is necessary in order to obtain noticeable results. This mainly means one thing: showing up each day is important! Treatment cannot work overnight, and can only work when it is a continous practice, day after day, week after week. Whether improvment continues long term is still up in the air, but it’s clear that there is significant improvement in quality of life within the first 6 months of regular music therapy.

The Power of Music Therapy for Dementia 

The main message is this: there is a positive trend supporting music therapy in improving cognitive function in those with dementia. Quality of life seems to be improved for those living with dementia, but this effect is not yet observed long-term. Additionally, there is a positive result for the treatment of long-term depression, though no effect for short term depression. This novel therapy, with further research, could prove to be a worthwhile treatment in lessening the symptoms of dementia through promotion of cognitive function, quality of life, and/or depressive state in people living with dementia. So, if you or a loved one may be suffering from dementia or Alzheimer’s Disease, what can be done? Ideally, join a music therapy program and group. This will help to support cognitive functioning through the benefits of music as well as regular socialization. However, learning to play an instrument, playing music in the house more regularly, turning on the radio in the car, or getting tickets to the symphony may be small steps to a brighter future for cognitive functioning.

For more information, my works cited are listed below, as well as a link to a similar blog post connecting Alzheimer’s disease and Music Therapy.

References:

Centers for Disease Control and Prevention. (2019, April 5). What is dementia? Centers for Disease Control and Prevention. Retrieved November 13, 2022, from https://www.cdc.gov/aging/dementia/index.html 

Erickson, K. I., Donofry, S. D., Sewell, K. R., Brown, B. M., & Stillman, C. M. (2022, September 5). Review of Cognitive Aging and the Promise of Physical Activity. Annual Reviews Clinical Psychology

Salthouse, T. A., & Albert, M. S. (2008). Neuropsychology of the development of Alzheimers Disease. In The Handbook of Aging and Cognition. essay, Psychology Press. 

Moreno-Morales, C., Calero, R., Moreno-Morales, P., & Pintado, C. (2020, May 19). Music therapy in the treatment of dementia: A systematic review and meta-analysis. Frontiers in medicine. Retrieved October 7, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7248378/#s1title 

U.S. Department of Health and Human Services. (n.d.). What is dementia? symptoms, types, and diagnosis. National Institute on Aging. Retrieved November 13, 2022, from https://www.nia.nih.gov/health/what-is-dementia  

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