Dementia and Music: Understanding Pros and Cons of Music Therapy

September 22, 2024 - Reading time: 10 minutes

Dementia is a significant global health issue, affecting over 55 million people worldwide, according to WHO. This number is expected to rise to 78 million by 2030, with an ageing global population. Dementia encompasses various disorders, with Alzheimer’s accounting for 60-70% of cases. Other forms include vascular dementia, Lewy body dementia, and frontotemporal dementia. These conditions lead to cognitive decline, memory loss, and difficulty managing daily activities. By 2050, dementia cases may triple, highlighting the need for effective care strategies.

Music therapy is emerging as a beneficial non-drug treatment for improving dementia care. Nearly 90% of individuals with dementia experience symptoms like agitation, anxiety, and depression. Music therapy has shown the potential to ease these symptoms. This blog explores the connection between dementia and music therapy, focusing on its benefits and potential in enhancing home care.

The Science Behind Music and the Brain

Music's ability to engage multiple brain areas makes it a powerful tool for cognitive and emotional engagement. Studies show that music stimulates the auditory cortex, connects with the limbic system, and involves the hippocampus, essential for memory. This is particularly relevant for dementia patients, as research indicates that while up to 40% experience higher memory loss, their response to music often remains intact.

A 2018 Brain study suggests that music activates neural networks more resilient to neurodegenerative diseases like Alzheimer’s. Even as language and memory decline, the ability to enjoy and react to music persists. Musical memory and enjoyment are processed in the basal ganglia and prefrontal cortex, areas less affected by dementia.

This resilience offers promising therapy potential. A 2020 Frontiers in Psychology study found personalized music therapy improved mood and reduced anxiety in 67% of dementia patients, compared to 39% with standard care. Music therapy stands out for its emotional and cognitive engagement, complementing conventional treatments.

As dementia progresses, communication and interaction with the environment decline, leading to social withdrawal. Music therapy provides a non-verbal communication channel, activating the brain's emotional and memory centres. Research from the Journal of Alzheimer’s Disease found music therapy reduced restlessness by 30% and increased interaction by 50%, enhancing home care outcomes for dementia patients.

These findings highlight the therapeutic potential of music in dementia care, offering a scientifically backed, non-pharmacological option to improve the quality of life for those affected by the condition.

Pros of Music Therapy for Dementia Patients

1. Emotional Benefits

One of the leading significant advantages of music therapy is its ability to evoke emotions and memories. The experience of listening to a familiar song from the past can take a person with dementia back to another time and place, eliciting positive emotions and diminishing feelings of anxiety, depression, and restlessness.

Mood Regulation: Music can help control mood, reduce irritability, and even combat the symptoms of depression. A beloved song has the power to elevate one's mood and offer a comforting sense of the familiar.
Stress Reduction: Research indicates that soothing music can lower cortisol levels, the hormone linked to stress, thereby fostering relaxation and diminishing restlessness among individuals with dementia.

2. Improved Communication and Social Interaction

Dementia often impairs a person's ability to communicate verbally, noticeably leading to frustration and isolation. Music offers an alternative form of expression that transcends the limitations of language.

Non-verbal Communication: Singing, humming, or tapping in rhythm can serve as a form of expression for dementia patients when verbal communication becomes challenging.
Social Engagement: Participating in group activities like music therapy sessions or sing-alongs can cultivate a feeling of unity and connection. It promotes social engagement and helps alleviate the sense of being alone or isolated.

3. Cognitive Stimulation and Memory Recall

Although music therapy isn't a cure for cognitive decline, it can stimulate the mind and help in retrieving long-term memories.

Memory Triggering: Well-known songs have the power to unlock specific autobiographical memories (Refers to the memories of personal events.). A tune from someone's childhood or a melody played at their wedding can bring back clear memories, helping individuals to re-engage with their own life story.
Attention and Focus: Interacting with music demands a specific degree of concentration and attention, which can aid in stimulating cognitive functions and maintaining an active mind.

4. Behavioral Benefits

Music therapy has been recognised for its ability to mitigate challenging behaviours associated with dementia, such as aggression, restlessness, and aimless wandering.

Reduction in Agitation: Calming music can have a soothing effect on patients, minimising the events of agitation and aggression, especially during the evening hours, known as "sundowning."
Improved Sleep Patterns: Listening to calming music before bedtime can enhance relaxation and improve sleep quality, which is often disrupted in dementia patients.

Cons and Challenges of Music Therapy

1. Variability in Response

Not all patients with dementia respond to music therapy in the same way. Factors such as personal preferences, cultural background, and the stage of dementia can influence the effectiveness of music as a therapeutic tool.

Personal Preferences: What calms one patient may annoy another. Choosing the appropriate music involves a thorough knowledge of the patient's background and tastes.
Overstimulation: Sometimes, music can have an overstimulating effect, causing more agitation instead of relaxation. Loud or fast-paced tunes might intensify feelings of restlessness and confusion, particularly in those who are sensitive to such stimuli.

2. Temporary Effects

While music therapy has immediate positive effects, these benefits often diminish quickly after the session ends. To sustain positive outcomes, regular and ongoing sessions are necessary.

Short-term Relief: While music can provide immediate relief from symptoms like anxiety and agitation, these effects are typically temporary and need to be reinforced regularly.
No Cure for Cognitive Decline: Music therapy does not slow down the progression of dementia or improve cognitive function in the long term. It is primarily a tool for enhancing quality of life rather than a treatment for the disease itself.

3. Implementation Challenges

Effective music therapy necessitates meticulous planning and expert supervision. Merely having music play in the background is unlikely to produce the intended therapeutic effects.

Need for Expertise: Trained music therapists are needed to tailor interventions to the specific needs of the patient. Unstructured use of music can sometimes do more harm than good.
Resource Limitations: Not all care facilities have access to trained music therapists or the resources to provide individualized music therapy sessions, limiting the reach and effectiveness of this intervention.

Does Music Help Improve Memory in Dementia Patients?

The concept that music can aid memory in those with dementia is multifaceted. Music has the power to evoke particular memories and boost emotional health, yet it cannot restore lost memories or stop dementia's advancement. Rather, music serves as a mnemonic aid, enabling patients to reach into their long-term memory for recollections that may be hard to access otherwise.

Autobiographical Memory Recall: Familiar music can evoke specific personal memories, providing a sense of continuity and identity for patients who may struggle with memory loss.
Emotional Connection: Even when specific details of memory fade, the emotional resonance of the music remains, allowing one to re-experience the associated feelings, offering solace and happiness.

Practical Tips for Using Music in Dementia Care

Personalise the Playlist: Arrange the music selection (playlist) to the patient’s preferences and history. Use songs that hold personal significance to evoke positive memories and emotions.
Create a Calm Environment: Use calming music during stressful times, such as bedtimes or between personal care routines, to reduce anxiety and agitation.
Engage in Music-making: Encourage participation in singing or playing simple instruments like drums or tambourines. Active involvement can enhance the therapeutic benefits of music.
Monitor Responses: Pay attention to the patient’s reaction to different types of music. If a particular song or genre seems to cause distress, discontinue its use and try something different.

Final Thoughts: Balancing the Positives and Negatives

While music therapy is not a cure-all for dementia, it serves as a unique, non-drug approach to improving the lives of those with the condition. The emotional, social, and behavioural advantages of music are extensively recognised, offering patients moments of happiness and connection. Nonetheless, it's crucial to acknowledge music therapy's limitations, such as its transient impact and the variability of individual reactions.

For caregivers and family members, integrating music into the daily care routine can be an invaluable strategy for aiding a relative with dementia. Playing cherished tunes, participating in sing-alongs, or utilizing music to foster a tranquil environment can all provide solace, delight, and a feeling of togetherness during the demanding path of dementia caregiving.