Always on my mind: Understanding the role of music in dementia

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Music is an undeniably significant part of being human. It spans different genres, cultures and eras, and it promotes bonding, communication and wellbeing. From listening to music in the car, to playing in an orchestra, discussing the charts, to joking about each other’s ‘bad’ music tastes: music is a crucial part of daily life.

Research also suggests that our connection to music stays with us throughout our lives, even whilst living with dementia. This powerful notion underpins the creation of a new Commission on Dementia and Music, being coordinated by the International Longevity Centre – UK (ILC-UK) and funded by the Utley Foundation.

In 2015, researchers from the Max Planck Institute put forward an explanation as to why musical memory can be preserved in advanced Alzheimer’s disease[1]. The study observed brain responses to music, then used this data to demonstrate an overlap of brain regions key to musical memory with areas that are relatively spared in Alzheimer’s disease.

Alongside scientific evidence to demonstrate the primacy of music in dementia, there is a growing body of evidence demonstrating beneficial outcomes associated with music for people living with dementia.

Areas of study include minimising the impact of behavioural and psychological symptoms of dementia (BPSD) such as wandering, agitation, and physically aggressive behaviour, reduction in anxiety and depression, improved retention of speech and language, and improvements in wellbeing and quality of life. Academic studies are enhanced and supported by a wealth of anecdotal evidence, quotations and video footage of the genuine difference that music can make.

Interestingly, some studies into music and dementia have demonstrated a reduction in the use of antipsychotic medication for study participants. This is crucially important given the recent concerted effort to review and reduce the usage of antipsychotic medication for individuals living with dementia. This follows Professor Sube Banerjee’s[2] warning that antipsychotic medication for people with dementia has a limited positive effect and frequently results in serious side-effects.

Studies also discuss the potential positive effects for caregivers, such as reduced stress and, for those employed in caring, increased capacity for other tasks. For example, if day-to-day tasks can be made less stressful for the resident through the use of therapeutic music (for example getting dressed), the care worker can have more time to dedicate to other residents and activities.

But what do we mean by ‘music’? Studies have, to date, looked at varying forms of musical activity to try and understand the potential for impact. The Commission will embrace this range, from listening to the radio, to joining a choir, taking up an instrument in older age, to receiving tailored music therapy from a qualified practitioner. It is true that more can be done to produce robust research studies demonstrating the respective value of varied forms of intervention. However, it is clear that different types of musical activity can play an important role for different individuals and at different times.

That is part of the beauty of music; it can be incredibly flexible and tailored to the individual, be that by adapting music selections to a person’s cultural background or ethnic heritage, or by encouraging the individual to engage in activities which they enjoy the most, such as singing or moving to the music.

We are all aware of our ageing population and the increasing pressure which dementia will place on our health and social care systems, not to mention individuals and their families, over the years to come. ILC-UK and the Commission on Dementia and Music are enthusiastic about pursuing and promoting musical projects which we believe can make a genuine difference to the lives of individuals, and which, in turn, can help society to understand more about our minds.

Sally Bowell
Research Fellow

ILC-UK will be launching a report to summarise the Commission’s work, findings and recommendations in December. To request further information, please contact dementia@ilcuk.org.uk.

[1] Jörn-Henrik Jacobsen, Johannes Stelzer, Thomas Hans Fritz, Gael Chételat, Renaud La Joie, Robert Turner; “Why musical memory can be preserved in advanced Alzheimer’s disease”, Brain, Volume 138, Issue 8, 1 August 2015, Pages 2438–2450, https://doi.org/10.1093/brain/awv135

[2] Department of Health The use of antipsychotic medication for people with dementia: time for action. A report for the Minister of State for Care Services, Professor Sube Banerjee, 2009

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