What is Dementia?

Dementia is the loss of cognitive function which is manifested in memory problems; behavioral, psychological and personality changes; motor difficulties; and difficulties in caring for oneself. There are many causes of dementia, including strokes, infectious disease such as HIV, thyroid and other metabolic disorders, and degenerative diseases such as Parkinson’s and Alzheimer’s.

How many people have dementia and what therapies are used as part of their treatments?

Estimates place the prevalence of Alzheimer’s disease to over 1% of adults age 65-69 and over 20% of adults over 85. Alzheimer admissions to nursing homes account for 40% of admissions. (1) There have been many studies that evaluate whether or not music can play a role in treating dementia-related social and cognitive problems. Modalities that have been researched include listening to music, singing, dancing and movement, and playing musical instruments. (2)

What studies have been conducted using music to help the patient with dementia?

One study (3) published in 1980 evaluated music therapy as part of reality orientation, a technique to help confused patients. Traditional reality orientation uses a reality board with clocks, calendars, weather conditions, pictures of the seasons, and other cues to help patients with dementia. Both the experimental and control groups used the reality board as well as activities in reading, writing, spelling and poetry. The experimental group added rhythm instruments and recordings of several musical pieces, involving both listening and actively participating in making music. Outcome measures included the patients’ ability to identify themselves and others by name, remember date, time, and season, and to recall information presented during the sessions. The experimental group showed significant improvement, suggesting that music is a helpful part of reality orientation.

Social behavior and music participation was investigated in 1992 (4). Since Alzheimer’s disease can lead to social withdrawal and isolation, the investigators used music to promote social interaction. The subjects in this study had individualized sessions with a music therapist in at least one music activity, and the subjects’ pre- and post- therapy social interactions was monitored. The group had a 24% increase in social behavior.

Getting anxious?

Alzheimer’s disease often leads to anxiety and agitation. A study in 1996 (5) examined the effects of music therapy on agitation. Agitation measures included hyperactivity, restlessness, subjective distress, and need for medication. Subjects participated in small group music therapy, and pre-therapy behavior was compared with post-therapy behavior. Subjects were much more agitated before therapy sessions than during or after, indicating a positive effect of music therapy.

Forgetting things?

Using music therapy to improve memory was the focus of a 1991 study (6). The subjects of this study participated in music therapy sessions where both familiar and unfamiliar songs were presented. The subjects were told to sing along as soon as they recognized the music, to listen to a phrase and then repeat it, and then to learn a new song and verse. The patients’ recall of the therapist’s name, their names, and important dates was also measured. The patients were able to recall songs better than spoken verse. Singing also appeared to be pleasurable. Singing appeared to be a useful way to help with memory as well as provide an enjoyable activity.

E.R.’s bottom line:

Alzheimer’s disease is a growing problem as the population ages. Because of loss of cognitive function and ensuing isolation, quality of life can decline. Music therapy offers a promising modality for helping with many aspects of Alzheimer’s disease.

We at E.R. Music are grateful to readers who inform us about new research being published involving music and the treatment of dementia. We will review the studies and incorporate them into this chapter. Please join our mailing list if you would like to be informed of the latest developments.

Copyright 2007, E.R. Music, LLC

References

1. cdc.gov

2. Brotons, M., Koger, S., and Pickett-Cooper, P., “Music and Dementias: A Review of the Literature,” J Music Therapy, XXXIV (4), 1997,204-45.

3. Riegler, J., “Comparison of a Reality Orientation Program for Geriatric Patients with and without Music,” J Music Therapy, XVII(1), 1980, 26-33.

4. Pollack, N., and Namazi, Kevan, “The Effect of Music Paricipation on the Social Behavior of Alzheimer’s Disease Patients,” J Music Therapy, XXIX, 1992, 54-67.

5. Brotons, M., and Pickett-Cooper, P., “The Effects of Music Therapy on Agitation Behaviors of Alzheimer’s Disease Patients,” J Music Therapy, 33(1), 1996, 2-18.

6. Prickett, C., and Moore, R., “The Use of Music to Aid Memory of Alzheimer’s Patients,” J Music Therapy, XXVIII(2), 1991, 101-10.