Michael Hunter, MD on Medika Life

Music Therapy and Dementia — Surprising Findings

MUSIC THERAPY MAY IMPROVE SOCIAL INTERACTIONS between people with dementia and their caregivers.

Dementia is a broad spectrum of disorders that impact an individual’s ability to think, remember, make decisions, and communicate with others.

The condition is often progressive, rendering it challenging for those with dementia to interact and communicate with those around them; social engagement can be remarkably challenging. This problem can strain relationships between individuals and those who care for and about them.

Today we briefly explore how music therapy can reduce caregiver distress by improving social interactions for those with dementia.

Dementia and music therapy

While music-based psychosocial interventions may represent effective management tools for behavioral symptoms among those with dementia, there are not many studies looking at music therapy and social engagement.

recently published study shows that music therapy interventions may improve social interactions between people with dementia and their caregivers.

The new research is a proof-of-concept study evaluating the effectiveness of the so-called Musical Bridges to Memory (MBM) intervention on persons with dementia’s behavioral symptoms, social engagement, and associated caregiver distress.

The researchers recruited individuals with dementia from two memory care facilities. The interventions included active engagement from caregivers.

Researchers used a 12-week intervention called musical bridges to memory (MBM). The intervention included an assessment of musical preferences among the clients and baseline assessments of social behaviors and dementia severity.

Caregivers had training, and participants enjoyed live 45-minute concerts (with breakout sessions after the events). Music therapists encouraged interactions during the concerts and led the breakout sessions.

Researchers performed follow-up assessments, including behavior evaluation, obtaining caregiver feedback, and a neuropsychiatric symptoms questionnaire.

Photo by Jefferson Santos on Unsplash

Here are the results:

Among the intervention group, clients exhibited better forms of nonverbal social behaviors (compared to the control group). For example, participants with dementia demonstrated more eye contact with caregivers, interest, focus, and calmness.

Caregivers volunteered that they had lower stress levels regarding symptom management of their loved ones. The caregivers also reported that the program helped them to better connect with their loved ones, improving relationship quality.

This preliminary study needs validation but suggests that music therapy can facilitate social engagement between a person with dementia and their loved ones. The music therapy intervention appears to diminish stress levels in care partners.

I am glad that the researchers included a control group. The study spanned only 12 weeks, so we don’t know the long-term value of the music therapy intervention.

In addition, the study size is relatively small. Finally, the study authors volunteer that the included subjects with dementia did not have high levels of unsociable behaviors such as aggression at baseline. Finally, their study did not assess the success of the intervention based on the cause of the participants’ dementia.

Dementia basics

Among those 65 or older, five million have dementia in the United States. Over 15 million may have the condition by 2060. Alzheimer’s disease is the most common form of dementia.

Dementia is not a specific disease; rather, it is a general term for conditions with impaired thinking, memory, and decision-making. One has challenges with the activities of daily living.

Is dementia a normal part of aging?

recent survey showed that nearly half of adults aged 40 and older believe they will likely develop dementia, such as Alzheimer’s disease.

While dementia primarily affects older adults, it is not a part of the normal aging process. The United States Centers for Disease Control and Prevention (CDC) explains that many older adults live their lives without developing dementia.

Photo by Jeremy Bishop on Unsplash

Normal aging may include blood vessel stiffening, weakening bones and muscles, and some age-related memory declines. The last may include:

  • Word-finding struggles (but remembering the word later)
  • Misplacing the car keys on occasion
  • Forgetting the name of an acquaintance
  • Forgetting some recent events

However, we typically retain old memories, language, knowledge, and experiences built over the years.

Dementia risk factors

Dementia symptoms

The Mayo Clinic (USA) provides guidance about symptoms that may point to dementia.

Cognitive changes

  • Memory loss, typically noticed by someone else
  • Challenges communicating or finding words
  • Challenges with visual and spatial abilities (for example, getting lost while driving)
  • Difficulty reasoning or problem-solving
  • Challenges handling complex tasks
  • Difficulty with planning and organizing
  • Challenges with motor functions and coordination
  • Confusion and disorientation
Photo by Esther Ann on Unsplash

Psychological changes

  • Personality changes
  • Depression
  • Anxiety
  • Inappropriate behavior
  • Paranoia
  • Agitation
  • Hallucinations

Dementia risk factors

We may conveniently divide dementia risk factors into two categories: Non-modifiable versus potentially modifiable. Let’s take a quick look at both groups.

Non-modifiable risk factors

There are some dementia risk factors over which we have no control. For example, dementia risk rises with age. However, remember that dementia is not a normal part of aging (and can occur in younger folks).

Conditions associated with dementia include Huntington’s disease. This disease is secondary to a genetic mutation that causes cells in the brain and spinal cord to waste away. Symptoms include a severe decline in thinking skills, typically around age 30 or 40.

traumatic brain injury, for example, from repetitive head trauma, increases dementia risk. Soldiers, football players, or boxers may be at a higher risk.

Creutzfeldt-Jakob disease is a rare brain disorder without known risk factors. The condition may be secondary to deposits of infectious proteins known as prions. Symptoms of this fatal disease typically appear after age 60.

Those with Parkinson’s disease are at a higher risk of developing dementia, a condition known as Parkinson’s disease dementia.

family history of dementia can elevate your risk. Still, many with a family history never develop symptoms; the reverse is true, too: Many with dementia have no family history. Today, we have tests that can help to determine if you have certain genetic mutations that raise your risk.

Those with Down syndrome have a higher risk of dementia by middle age.

Modifiable risk factors

A recent US Centers for Disease Control (CDC) study examined how common eight risk factors were among adults 45 years and older. These risk factors included:

  • Sedentary behavior
  • High blood pressure (hypertension)
  • Obesity
  • Diabetes
  • Depression
  • Smoking
  • Hearing loss
  • Binge drinking

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Here are the disturbing findings of the CDC study looking at dementia risk factors:

  • Nearly half had hypertension (high blood pressure) or did not get recommended physical activity levels.
  • Adults with cognitive decline are more likely to report at least four factors (34 percent) than those without cognitive decline (13 percent).
  • One-third of adults who reported a cognitive decline — worsening confusion or memory loss in the previous year — had at least four risk factors compared with 13 percent of those without cognitive decline.
  • Nine percent of adults with no risk factors reported cognitive decline, while 25 percent with at least four risk factors reported a cognitive decline.
  • Several modifiable risk factors appeared more common among African American, Hispanic, and American Indian or Alaska Native populations than other races and ethnicities.

Dementia risk reduction — Action plan

The US Centers for Disease Control (CDC) reminds us of some potential risk-reducing maneuvers:

Now, the things we should dodge:

  • Binge DrinkingIf you drink, do so in moderation.
  • Avoid smokingQuitting smoking improves your health and reduces your risk of heart disease, cancer, lung disease, and other smoking-related illnesses.

The Mayo Clinic (USA) has some additions to our action plan:

  • Get adequate vitamin D. Some studies suggest that those with good vitamin D levels are more likely to experience dementia. We don’t have enough proof to advocate for supplementation with vitamin D (and vitamin K), but you should aim to get adequate amounts. The Mayo Clinic adds that taking a daily B-complex vitamin and vitamin C also might [emphasis added] help.
  • Manage cardiovascular risk factors. Manage high blood pressure (hypertension), high cholesterol, and diabetes. Lose weight if you’re overweight.
  • Treat health conditions. See your doctor for the management of depression or anxiety.
  • Maintain a healthy diet. A Mediterranean-type diet — rich in fruits, vegetables, whole grains, and omega-3 fatty acids, commonly found in certain fish and nuts — might [emphasis added] promote health and lower your risk of developing dementia. This diet also improves cardiovascular health, which may help lower dementia risk.
  • Get adequate sleep. Practice good sleep hygiene. Please talk to your healthcare provider if you snore loudly or have periods where you stop breathing or gasp during sleep.

Thank you for joining me today in this look at music therapy and dementia. Have you had any experience with music therapy?

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Michael Hunter, MD
I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

Michael Hunter, MD

I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

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