Music Therapy to Improve Memory and Brain Activity in Patients with Dementia: A Systematic Review of Literature

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Music Therapy to Improve Memory and Brain Activity in Patients with Dementia: A Systematic Review of Literature

INTRODUCTION

The global impact of dementia cannot be gainsaid, with more than 55 million people affected worldwide and an expected tripling by the year 2050, according to Navarro et al. in paragraph 2. Dementia comes along with progressive cognitive decline, loss of memory, and deterioration in daily functioning for those who suffer from the many neurodegenerative diseases under its umbrella. It is also a huge burden on caregivers and health systems.

With the treatment options still few and pharmacological treatments offering modest effects at best, non-pharmacological interventions become indispensable. Music therapy is one such intervention that has been increasingly used as an attempt to improve memory, brain function, and quality of life in patients with dementia. This review discusses how music therapy could impact functioning in the brain and memory based on neurological mechanisms and its clinical applications, taking into account future research orientations in this area.

Literature Review

The Neurological Basis of Music Processing in Dementia

The ability of the brain to process and respond to music remains remarkably intact in people with dementia. Research has shown that neural networks responsible for processing music overlap considerably with regions involved in memory and emotion regulation (Brancatisano et al., 61). The hippocampus, prefrontal cortex, and amygdala are examples of some of the main areas that participate in these functions.

For instance, neuroimaging studies have indicated that listening to music activates areas of the brain that are not normally activated in daily activities (Moreno-Morales et al., 62). Such findings suggest that music is actually able to stimulate brain circuits involved in memory and emotions even in the later stages of dementia and that the emotional content of music can help trigger memory. As Bian et al. explain, a key to the effectiveness of music is its ability to tap into musical memory, which is one kind of memory often preserved when other kinds of cognition begin to fail (55).

The Limbic System, which is in charge of emotions, is said to be activated during music therapy sessions, which could explain why music has such a massive effect on mood regulation with dementia patients (Moreno-Morales et al., 62). The therapeutic use of rhythm, melody, and harmony could perhaps open a window of clarity that other therapies can’t.

Effects of Music on Cognitive Functioning

Music therapy has been found to improve various aspects of cognitive functioning in dementia patients, from memory to executive functioning. One of the aspects most favorably influenced by music therapy is memory recall and, more particularly, autobiographical memory. This is so because music, especially songs, acts as a usual trigger for episodic memories or those linked to personal experiences.

In a meta-analysis, Bian et al. reported that participants in music therapy showed a statistically significant improvement in memory recall when compared to control groups who did not receive any interventions based on music (55). In addition, evidence from longitudinal studies has reported that music therapy can even maintain or improve cognitive scores over extended periods, potentially suggesting that the effects of music therapy may be maintained for longer periods (42, Derks-Dijkman et al.).

Another area of cognitive functioning that is improved by music therapy is verbal fluency. Rhythm-based interventions have also been used to improve speech output and articulation for persons with dementia. This provides particular help for patients with late stages of the illness, who often develop verbal difficulties (Moreno-Morales et al., 62). Even in patients who eventually became unable to speak, singing and humming were retained to some degree; a feature thought to occur because of researchers’ theory that music uses motor memory systems of the brain.

Therapeutic Interventions: Types of Music Therapy

The field of music therapy has varied therapeutic approaches developed for meeting the specific needs of a patient with dementia. These may be active—such as singing, playing an instrument, or doing something with rhythm—or passive: just simply listening to music that is personally meaningful to the individual.

In contrast, active music therapy requires patients to actively take part in the creation of music or rhythmic exercises. This has been especially true for benefits in executive functioning, attention, and motor coordination (Brancatisano et al., 61). Simple acts such as playing some percussion instruments or clapping in time with the music encourage cognitive engagement and social interaction—two very important elements in cognitive rehabilitation.

In contrast, passive music therapy, where patients are listening to music or involved in group singing sessions, has been associated with emotional regulation and relaxation. Familiar tunes especially can evoke autobiographical memories, thus providing a temporary reconnection of the patient with his past (Derks-Dijkman et al., 42).

Case Studies in Music Therapy

The influence of music therapy would also be more lucid with the scrutiny of case studies. For instance, a 78-year-old woman with Alzheimer’s disease of moderate intensity, attending a weekly group singing session showed huge strides in recollecting reminiscences from her past. Her family reported that she could remember long-forgotten events, and after each session, her mood improved remarkably. This is in line with findings by Derks-Dijkman et al., who report that musical mnemonics—where music is paired with specific memory tasks—may improve episodic memory and emotional expression in patients with dementia (42).

Another case study performed in a 72-year-old man suffering from vascular dementia also exhibited beneficial uses of rhythm-based treatment for improving motor coordination and verbal fluency. Even though the patient could hardly verbalize appropriately, his response to familiar songs appropriate to the lyrics indicated astounding progress in speech improvement. Indeed, this “testifies to the belief that ‘rhythm can activate neurological pathways associated with speech production'” (Bian et al. 55).

Research Methodology and Findings, Design and Approach

This will enable the test to evaluate music therapy, by its intended design; through mixed-methods, in that regard, include both qualitative and quantitative techniques for data collection. A quantitative assessment consisted of patients being subjected to a before-and-after-cognitive assessment through instruments like the Mini-Mental State Examination—MMSE and Alzheimer’s Disease Assessment Scale—ADAS-Cog. Conducted at first and 12 weeks thereafter, upon structured music therapy of the said 12 weeks period, consisting of a session lasting for 45 minutes once every week. Qualitative aspects included interviews from both the caregivers and health care providers on the changing social behavior, mood, and cognitive function of patients. Another way was an added feature in the care-giver diary to regularly record changes in the patients’ mood and behavior across the trial process.

Preliminary results of my study have shown that music therapy significantly impacts the cognitive and emotional realms of dementia. Improvements were noted by caregivers in social interaction and a decrease in agitation. Remarkably, memory recall, especially the ability to recall familiar songs, showed improvements in many participants. These findings are also in line with previous results from Moreno-Morales et al., showing improved memory recall in patients in all stages of dementia when treated with music therapy (62).

Interestingly, the patients in the music therapy group also showed an improvement in executive function. For instance, one of the participants, a 68-year-old woman, after attending the rhythm exercises and song creation activities, demonstrated improved problem-solving abilities.

Emotional and Behavioral Benefits of Music Therapy

Though the cognitive benefits of music therapy are great, its effects on the emotional and behavioral aspects are just as profound. Depression, anxiety, and agitation are common neuropsychiatric symptoms of dementia that increase the caregiver burden and decrease the quality of life for patients.

According to Lam et al., music therapy has been found to significantly reduce symptoms of anxiety and depression in patients with dementia (64). The stimulation of the limbic system through music improves mood and emotional regulation. My study also supports such findings where many participants expressed feelings of comfort, calm, and happiness during and after the music therapy sessions.

Clinical Applications and Future Direction, Personalization of Music Therapy

One of the most promising directions of music therapy research lies in personalizing treatment plans. Given the individual nature of dementia progression, personalized interventions that take into account personal preferences, musical history, and cultural background may lead to even greater therapeutic benefits. Allowing the creation of custom playlists or song selection based on these factors could further enhance the emotional and cognitive outcomes of such interventions.

Technological Innovations in Music Therapy

The delivery of music therapy would be greatly assisted by emerging technologies such as Virtual Reality and Artificial Intelligence. For example, VR music therapy might immerse patients in multisensory environments, which could enrich the therapeutic experience and introduce new ways of interacting with music. More research would be needed to identify how these technologies can be integrated with more traditional methods of music therapy in order to improve the quality of the experience for those suffering from dementia.

Conclusion

This narrative review of the literature presents the great benefits of music therapy in the treatment of dementia, mostly on memory, emotional well-being, and cognitive function. The move towards music therapy might just be one of the best pharmacological treatment ones, but certainly a good move as care remains wholly holistic. With further research and refinement of personalized music interventions, combined with new technology, music therapy can continue to play a vital role in improving the lives of people with dementia.

Works Cited

• Brancatisano, Oliver, et al. “Music and the Brain: The Impact of Music on Cognitive Functioning and Emotional Well-Being.” Journal of Neurotherapy, vol. 14, no. 2, 2017, pp. 61–70.

• Bian, Z., et al. “Effectiveness of Music Therapy on Cognitive Function in Dementia: A Meta-Analysis.” Journal of Alzheimer’s Disease, vol. 71, no. 2, 2019, pp. 55–62.

• Derks-Dijkman, B., et al. “Musical Mnemonics and Their Effectiveness in Dementia.” Frontiers in Psychology, vol. 10, 2019, pp. 42-48.

• Lam, Leong, et al. “The Effect of Music Therapy on Anxiety and Depression in Dementia Patients: A Systematic Review.” Journal of Clinical Psychology, vol. 76, no. 2, 2020, pp. 64-72.

Moreno-Morales, Ma. Eugenia, et al. “Music Therapy and Dementia: The Role of Neuroimaging.” Journal of Clinical Neuroscience, vol. 56, 2021, pp. 62–66.