The Relationship Between Music and Alzheimer’s Disease

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November is Alzheimer's awareness month; therefore, I decided to write something optimistic and uplifting about dealing with this grim illness. It needs to be mentioned that Alzheimer's is the most common type of dementia, and there is currently no cure. According to the statistics, 6.9 million people 65 and older currently have dementia in our country.

Having many years of musical education and knowing perfectly well the therapeutic effects of music, I wondered how music can help patients with Alzheimer's maintain their cognitive abilities and/or slow down cognitive decline. Let's see what the research says.

There is quite a bit of research on this subject. In the 1993 study (Lord, T. & Garner, E.), the participants were 60 nursing home patients diagnosed with Alzheimer's Dementia (AD). At the beginning of the study, all participants were given mental status and mood tests. Next, the participants were randomly assigned to three groups. The subjects from the experimental group listened to the "Big Band" music from 1920 and 1930, played daily during their recreation time. The second group was working on puzzles during daily activity sessions. The third group was drawing and painting during the recreation activities. After six months, all participants were retested. The results indicate that the "music" group patricians were more alert, happier, and had higher recall of past personal history. The authors concluded that music has a therapeutic value in AD.

A more recent interesting study has come out of Greece (Efychios, A. et al. 2021). The researchers studied the effectiveness of music therapy in AD patients. The participants were 32 patients (17 women and 15 men, mean age 67.5) with mild, moderate, and severe AD. All patricians were administered the mental status test (MMSE), which was repeated every six months under the neurologist's supervision for up to 30 months of the study. The subjects attended individual and group sessions with the participation of the musical instruments (piano, maracas, scrapers, drums, and claps). At the end of the study, all participants benefited from musical therapy in terms of improvement in their mental status.

In a Canadian study (Byrns, A. et al. 2020), music therapy was designed with a virtual environment, and EEG was recorded. The participants (19 patients, mean age 72, 2) listened to eight 30-second classical and contemporary songs. At the beginning and end of the experiment, the participants completed the self-assessment of the emotions questionnaire (PANAS) and a questionnaire on cyber-sickness. All participants completed attention and memory exercises before and after music therapy sessions. The results showed a considerable increase in memory performance and a slight improvement in attention abilities. Participants also reported that musical therapy decreased their negative emotions and increased positive emotions and relaxation. Thus, positive emotions promoted better cognitive performance in AD patients.

An extensive review article on music therapy in AD patients (Matziorinis, A. & Koelsch, S. 2022) generally showed the beneficial effect of music therapy on AD patients. It improves mood, reduces depression and anxiety, and improves some aspects of cognitive functioning, such as autobiographical recall, memory, and verbal fluency. Despite severe memory problems, AD patients can still learn new songs and react emotionally to music. Some studies show the positive effect of music therapy on reducing agitation in AD patients, increasing social interactions, and providing a way for caregivers to connect with loved ones, which becomes quite challenging when the disease progresses. Also, an individualized music playlist and a focus on relaxation techniques are most beneficial for AD patients (Leggieri, M et al., 2019).

The question arises: How is it possible that music memory remains largely intact despite severe memory deficits in AD patients? Scientists believe musical neural networks differ from traditional temporal memory-related neuronal pathways. Music memory retrieval includes diffuse network areas inside and outside of the temporal, frontal, and parietal lobes.

So, suppose you are a caretaker for a person with AD. In that case, it may be a good idea to have a playlist with their favorite song and to play it during mealtimes and relaxation time. It may also be helpful during a morning routine to decrease agitation.

One of the most important applications of the above studies is that because science believes that musical activity may have a protective role in age-related cognitive decline, it is a good idea to start some musical activities no matter what age. It can be learning to play an instrument or joining a choir or a dancing club. It is never too late to start taking care of our brain.