How music can help battle dementia
Dementia sufferers, deprived of so many precious memories, are still able to remember the songs they love. Music can evoke emotions even in the most advanced Alzheimer’s patients. With emotions come associated memories. Music can make life worth living again.
When I joined the Max Jaffa Orchestra in 1977, one of the first things I noticed was there were a large number of elderly ladies in the audience, particularly at the morning concerts, held outdoors in the Spa Sun Court in beautiful Scarborough. The morning and evening concerts provided these nice old biddies with a structure to their lives and social contact with others of their own age and background.
They would often sing along to the melodies that were popular in their youth. The enjoyment they derived was not just from the music – their faces gave away the happy memories of their youth, their romances, and their own voyages of discovery. Songs from the war years and selections from Ivor Novello musicals were particularly popular. More interesting, they could remember all the words! All the members of the orchestra understood that for many of them, it was access to the type of music they loved that helped them to keep a grip on life.
When I hear any of the music I grew up with and still enjoy, a host of memories come flooding back. I can remember where I was, the time of year, what the weather was like, who I was with and what I was doing when I first heard it. Supertramp Live in Paris instantly reminds me of driving home from Newcastle in such a heavy snowstorm I worried if I would make it all the way. Memories from 40 years ago are clear, thanks to the music.
Listening to and enjoying music requires very little mental processing, although learning songs takes time and involves some repetition. But musical memories, particularly of songs learned in youth and music first encountered in early adolescence up to one’s late twenties, remain strong and robust and accessible. Most people can instantly recognize a song they know after hearing just a few notes. Importantly, this music can also be evocative.
Scientists from the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig, the University of Amsterdam and INSERM Caen, have recently succeeded in pinpointing the location of musical memory. They have found that ability to hold and remember a tune activates specific parts of the brain and that these memories reside in areas responsible for association and memory (the caudal anterior cingulate and the ventral pre-supplementary motor area.) These areas seem to be particularly resistant to the effects of dementia and remain largely intact – despite the effects of progressive degeneration.
So musical memory seems able to withstand the effects of neurodegenerative decline. Musical aptitude and appreciation are two of the last remaining abilities that remain almost unaffected in dementia sufferers, and it’s thought that music can restore memories when everything else fails.
The idea that people with dementia may benefit from singing and other musical activities has grown increasingly popular in recent years, with initiatives such as Singing for the Brain being offered by the Alzheimer’s Society.
Music has three advantages for the elderly, and particularly for those suffering dementia.
First, dancing to music helps coordinate motor movements in Parkinson’s sufferers as well as those with dementia. [ref: Dr. Peter Lovatt.]
Second, singing does not require the cognitive functionality absent in most dementia patients. Singing sessions activate the left side of the brain and listening to music sparks activity in the right side of the brain, while simply watching rehearsal activates the visual cortex. With so much of the brain being stimulated at once, patients exercise more mind power than usual, as well as enjoy themselves!
Third, by pairing music with everyday activities such as having lunch, the scientists hope to make life easier for patients. They can learn to associate songs and pieces of music with corresponding activities, thereby improving not only the memory of that activity but also the necessity of performing it. For example, one song could remind a patient that it’s time to make a cup of tea, whilst another could act as a reminder that it’s time to go for a walk.
There have been several detailed case studies that offer support for the idea that musical memory might be disproportionately preserved in dementia patients. One key finding is that music is a particularly good cue for autobiographical memories – the memories that reinforce our sense of identity and play a hugely significant role in how we connect socially and emotionally with those that are close to us.
Jaak Panksepp, author of Affective Neuroscience: The Foundations of Human and Animal Emotions has argued that music is a core ingredient of emotional communication, and so it is! Much of our interaction with pre-linguistic infants depends primarily on changes in voice tone. Most parents would agree that a lullaby is a very effective way of getting babies to sleep. Music is also an integral part of spoken language – without its melodic nuances, our words would sound robotic and devoid of feeling. Shouting, screaming, laughing, crying are all just distinctive changes in pitch, rhythm and volume.
The essential communicative qualities of music may be at least in part why singing gives us a way to connect with people with severe cognitive impairments like dementia.
Music is so much more than a collection of toe-tappin’ tunes – there is a wealth of evidence that it can significantly improve health and wellbeing. Apart from the obvious physical benefit of singing as cardiovascular activity, musical engagement also reduces levels of the stress hormone cortisol, increases immunity, lowers perception of pain and reduces symptoms of depression.
Music can improve mood, memory and overall quality of life in people with dementia. It certainly improved quality of life for the old dears in the audience in Scarborough.
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