Aging is a shared experience that humans expect and recognize. People may anticipate retirement life, envision life with grandchildren, or perhaps begin to ponder what themes and relationships contribute to create their life story. However, data from the Canadian Study on Health and Aging shows that by 2031, 937,000 individuals will be living with dementia, with more than 65 percent of those being women. Dementia is defined as the progressive impairment of cognitive functions such as memory, resulting in difficulty with day-to-day tasks, disorientation, changes in mood or personality, and many more signs and symptoms (Chambers, 2016). Researchers are exploring the use of different medications to “cure” dementia-causing diseases like Alzheimer’s disease; however, it should be noted that no medication has been ascertained as a definite cure. In the meantime, it is important to offer treatments which lessen the symptoms of dementia.
Over the last few decades, appreciation has developed for the powerful music therapy intervention strategy in which music therapists build strong relationships with patients diagnosed with some form of dementia and use music to meet the cognitive, physical, and emotional needs of their patient (CAMT, 2020). Music therapy has proven effectiveness at reducing behavioural, psychological, and physiological signs and symptoms as well as increasing the necessary skills to maintain social relationships (McDermott, 2013). Regarding dementia treatment, there are two commonly used methods – interactive and passive. With the interactive method, the patient is actively involved in creating music whereas with the passive method, the patient will listen to music, often delivered by the music therapist who is playing the music in real time.
Why is music therapy so effective? Music, in general, is a dynamic communication tool that can be used when a patient’s language is diminished (Samson, 2015). Patients with dementia have the same need to express their emotions and connect to people around them, and music is an important medium to make this possible. Music can also stimulate interactions between various cognitive systems, more so when movements in response to music are elicited (Zatorre, 2007). Many researchers have hypothesized that music therapy may help with neurodegenerative symptoms because music, language processing, and the symptoms share cognitive structures. They have also recognized that sound and rhythm have a role in the complex interplay between these three factors. Music therapy is non-invasive, non-pharmacological, and has no confirmed adverse effects, which is why these is a growing need to evaluate the power of this intervention (Zhang, 2017). Moreover, therapists can account for the patient’s background and patterns of behaviour to provide therapy that connects with the patient and increases their engagement.
Results of eleven distinct trials have shown that music therapy significantly reduced anxiety scores in disruptive behaviour (Zhang, 2017). Additionally, depression symptoms have also reduced in nursing home residents with dementia, following music therapy for 2 weeks. In this specific study, the Cornell Scale for Depression was used to assess depression symptoms, and researchers reviewed over 200 hours of video of participants to measure well-being. Specifically, the level of enjoyment, mood, and engagement of the nursing home residents during music therapy was analyzed. The residents later participated in music activities for an additional two weeks, at which point their depression score had stabilized, however, improvements in participant well-being were still noted, especially for those that engaged in music with movement (Ray, 2017). Another study also reported a significant reduction in symptoms of depression, as well as agitation. This study’s participants consisted of 132 nursing home residents with moderate to severe dementia. Both studies highlight the benefits of providing music therapy for nursing home residents to alleviate symptoms and provide comfort to individual with dementia.
Music therapy, in addition to reducing negative symptoms, can also increase positive emotions and states of being. Sixsmith et al. (2007) noted that music therapy led to positive self-esteem and greater feelings of competence and independence, which were accompanied with less feelings of isolation. These results were greater when the patient’s musical preference was taken into consideration, and familiar songs were used to encourage the patient to reminisce about family and childhood memories (Sixsmith, 2007). Significant improvements in mood and behaviour were observed in another study with supporting results. Participants who took part in 2 weekly sessions for 12 weeks were happier, more focused on their environment, and better able to relate to people. An analysis of objective measures of outcome in the same group of participants showed decreased heart rates and oxygen saturation levels after music therapy sessions (Maseda, 2018).
The aforementioned studies are just a few which emphasize the power of music and music therapy to improve the quality of life of individuals with dementia. In general, music therapy is a unique intervention to allow people with dementia to address their emotional, physical, and social needs, thus enriching the lives of these individuals. Although we may all have specific dreams of what our life will look like as we age, a common thread between our hopes is likely peace and happiness. Music therapy may make it possible for individuals with dementia to embrace these feelings as well.
Contributed by: Riya Trivedi
Chambers, L. W., Bancej, C., McDowell I. (2016). Prevalence and monetary costs of dementia in Canada. The Alzheimer Society of Canada. https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-36-no-10-2016/report-summary-prevalence-monetary-costs-dementia-canada-2016-report-alzheimer-society-canada.html
(2020, September). About music therapy. CAMT. https://www.musictherapy.ca/about-camt-music-therapy/about-music-therapy/.
Maseda, A., Cibeira, N., Lorenzo-López, L., González-Abraldes, I., Buján, A., de Labra, C., & Millán-Calenti, J. C. (2018). Multisensory stimulation and individualized music sessions on older adults with severe dementia: effects on mood, behavior, and biomedical parameters. Journal of Alzheimer's Disease, 63(4), 1415-1425. https://doi.org/10.3233/JAD-180109
McDermott, O., Crellin, N., Ridder, H. M., & Orrell, M. (2013). Music therapy in dementia: a narrative synthesis systematic review. International journal of geriatric psychiatry, 28(8), 781-794. https://doi.org/10.1002/gps.3895
Ray, K. D., & Mittelman, M. S. (2017). Music therapy: A nonpharmacological approach to the care of agitation and depressive symptoms for nursing home residents with dementia. Dementia, 16(6), 689-710. https://doi.org/10.1177/147130121561377
Samson, S., Clément, S., Narme, P., Schiaratura, L., & Ehrlé, N. (2015). Efficacy of musical interventions in dementia: methodological requirements of nonpharmacological trials. Annals of the New York Academy of Sciences, 1337(1), 249-255. https://doi.org/10.1111/nyas.12621
Sixsmith, A., & Gibson, G. (2007). Music and the wellbeing of people with dementia. Ageing and Society, 27, 127. https://doi.org/1017/S0144686X06005228
Zatorre, R. J., Chen, J. L., & Penhune, V. B. (2007). When the brain plays music: auditory–motor interactions in music perception and production. Nature reviews neuroscience, 8(7), 547-558. https://doi.org/10.1038/nrn2152
Zhang, Y., Cai, J., An, L., Hui, F., Ren, T., Ma, H., & Zhao, Q. (2017). Does music therapy enhance behavioral and cognitive function in elderly dementia patients? A systematic review and meta-analysis. Ageing research reviews, 35, 1-11. https://doi.org/10.1016/j.arr.2016.12.003