Music Makers and Dreamers of Dreams




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Modern medicine struggles with understanding and treating dementia and many other ailments of the mind. Mounting evidence now suggests that music may be the key to unlocking the mysteries and memories of the mind.

Recently, a randomized controlled trial of musical interventions in dementia reported that music improved the emotional state and decreased the severity of behavioral disorders in patients with moderate to severe dementia, including Alzheimer’s disease. The study included 48 patients and involved two one-hour music sessions each week for four weeks. Although no changes in cognitive function was observed, the improvements in quality of life lasted for up to four weeks after the music sessions ended, and the benefits extended to caregivers, as well, as evidenced by reduced stress levels.

In 2012, a similar study evaluated the effects of music interventions on patients with cognitive dysfunction and dementia. Two separate populations were evaluated: residents of an assisted living facility with moderate dementia and patients with more severe dementia who lived in a secure ward. Each group of patients was divided in half; during three weekly therapy sessions, one half of the patients sang songs, which included themes from well-known and popular musicals such as The Sound of Music, Oklahoma, The Wizard of Oz, and Pinocchio, and the rest just listened to the tunes.

After four months, patients who participated in the music sessions experienced improvements in cognitive and drawing tests, and their own self-reports of quality of life improved. Additionally, patients who actually did the singing, as opposed to just listening, showed greater improvement in overall function.

Musical interventions are not new in mental health, and many studies have demonstrated benefits in cognition, anxiety, mood, attention, and overall well-being of patients with dementia. While most reports of the benefits of music are qualitative, one study showed that music increased the secretion of two hormones (estradiol and testosterone) that are believed to be preventive for Alzheimer’s disease. Thus, music has actually been proposed as a replacement to hormone therapy, though the clinical usefulness of this approach has not yet been established.

In the course of dementia, autobiographical memories are often lost. But, musical memories are preserved and often trigger autobiographical recollections. And, musical abilities are often retained by people with dementia, despite significant losses of verbal memory and linguistic functions. Music is clearly tied to emotion, but exactly how is not yet clear.

Music expresses the inexpressible and speaks when words fail. For those of us who are blessed with a healthy mind, hearing a song may remind us of a fun time, a romantic moment, or a sad ending. But, someday, that soundtrack may be all that is left of a life well lived.

The authors of many of these studies suggest that sing-alongs are inexpensive, easy and entertaining therapy for patients with dementia. Structured protocols for music-based interventions are currently being developed and validated. With virtually no downside, patients should be encouraged to sing and sing often.

References

Basaglia-Pappas S, Laterza M, Borg C, Richard-Mornas A, Favre E, & Thomas-Antérion C (2013). Exploration of verbal and non-verbal semantic knowledge and autobiographical memories starting from popular songs in Alzheimer’s disease. International psychogeriatrics / IPA, 25 (5), 785-95 PMID: 23388499

Ceccato E, Vigato G, Bonetto C, Bevilacqua A, Pizziolo P, Crociani S, Zanfretta E, Pollini L, Caneva PA, Baldin L, Frongillo C, Signorini A, Demoro S, & Barchi E (2012). STAM protocol in dementia: a multicenter, single-blind, randomized, and controlled trial. American journal of Alzheimer’s disease and other dementias, 27 (5), 301-10 PMID: 22815078

El Haj M, Fasotti L, & Allain P (2012). The involuntary nature of music-evoked autobiographical memories in Alzheimer’s disease. Consciousness and cognition, 21 (1), 238-46 PMID: 22265372

Fukui H, Arai A, & Toyoshima K (2012). Efficacy of music therapy in treatment for the patients with Alzheimer’s disease. International journal of Alzheimer’s disease, 2012 PMID: 23056992

Groussard M, Mauger C, & Platel H (2013). Musical long-term memory throughout the progression of Alzheimer disease. Geriatrie et psychologie neuropsychiatrie du vieillissement, 11 (1), 99-109 PMID: 23508326

Hsieh S, Hornberger M, Piguet O, & Hodges JR (2012). Brain correlates of musical and facial emotion recognition: evidence from the dementias. Neuropsychologia, 50 (8), 1814-22 PMID: 22579645

Lancioni GE, O’Reilly MF, Singh NN, Sigafoos J, Grumo G, Pinto K, Stasolla F, Signorino M, & Groeneweg J (2013). Assessing the impact and social perception of self-regulated music stimulation with patients with Alzheimer’s disease. Research in developmental disabilities, 34 (1), 139-46 PMID: 22944256

Narme P, Clément S, Ehrlé N, Schiaratura L, Vachez S, Courtaigne B, Munsch F, & Samson S (2014). Efficacy of musical interventions in dementia: evidence from a randomized controlled trial. Journal of Alzheimer’s disease : JAD, 38 (2), 359-69 PMID: 23969994

Simmons-Stern NR, Deason RG, Brandler BJ, Frustace BS, O’Connor MK, Ally BA, & Budson AE (2012). Music-based memory enhancement in Alzheimer’s disease: promise and limitations. Neuropsychologia, 50 (14), 3295-303 PMID: 23000133

Image via Stocky Images / Shutterstock.

  • Music Therapy

    I work in a long-term mental health clinic, and I’ve always been a little dismissive of music therapy and music interventions. But I’ve had to backtrack after seeing how some patients react to sessions where music is played, especially in terms of quality of life. Definitely going to have to do a little research!

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  • Elizabeth Van Rijn

    Thoughts of the day
    The Science of Music
    I was at home singing to songs on Pandora radio. It was one of those moments when you know no one is listening and you hope the neighbors are tone deff. Then I remembered a technique my friend Seyoung taught me. When you focus on the music in your mind, not on your voice, you hit appealing notes. I closed my eyes and focused on the music. Instantly my voice improved. Almost shockingly! “Why is this?” I thought. I was discovering the language of emotion, otherwise known as music.
    When I believed in what I was saying/singing/communicating, true emotion was realesed. As though a primal instinct naturally produced, felt, and responded to the emotion emitted vocally and instrumentaly. I continued to focus on the music and how it effected me and it seemed as though I was discovering more to this mystery. What were the actual affects of auditory stimulation?
    We are all born scientists. Discovering and learning through experiments. An infant constantly looks, grabs, smells, and tastes everything. It continues on to adulthood. What does it taste like? What does it sound like? What does it feel like? What does it look like? But the ultimate question is how does it make you feel? Emotion, a primal instinct we are not able to control.
    In any language you can describe how you feel to someone. You can taste what they taste, see what they see, hear what they hear, but can you feel what they feel?
    Some of the common physical aspects of emotion are crying, lauphing, screaming ext. all which are involuntary vocal reactions to intense feelings. These same sounds are projected through prelingguistic fragments in our everyday flow of speech. These fragments are known as interjections. An unconscious presense communicating to other’s our true feelings regardless of what we are saying. The part of speech provoked by pure emotion. By focusing on your feelings, not the sound of your voice, you use primal instincts to naturally emit the language of emotion. This vocally prolongs Interjections and intensifies them through focus, there for provoking primal emotion in others. I found the science of music is the unconscious voice created by concentration on pure emotion, there for projecting and provoking one’s emotions in others.
    Next time you listen to your favorite song maybe you should try to focus on how it makes you feel and why it makes you feel that way. What is it communicating to you? What are you learning about yourself??

Jennifer Gibson, PharmD

Jennifer Gibson, PharmD, is a practicing clinical pharmacist and medical writer/editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. She is the owner of Excalibur Scientific, LLC.
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