FEATURE:
Unlocking the Music Box:
IMAGE CREDIT: Denise Cole
Music’s Role in the Fight Against Alzheimer’s
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THIS is not the first time I have explored…
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music and memory in the past couple of weeks. Last week, in fact, I looked at the connection between music and memory; how certain songs bring back fond recollections and put us in a safer space. I argued, when looking at my musical tastes, how I always pine for the teenage years. The years before then, I’d say, was the last time I was truly content and happy. Remembering the music from that time brings those times flooding back – all the adventures and happenings from around that time. I wonder whether there is a part of the brain where we store certain songs: connect them to memories from the past so they do not get lost with all the trivial nonsense we filter on a daily basis. There is a lot to be said on the subject and more exploration to do. In my mind, music is the most powerful form of communication we, as humans, have. It is harrowing when one reads the statistic around Alzheimer’s. Before going on; the statistics on Alzheimer’s – from Alzheimer’s Society:
What is dementia
Dementia describes different brain disorders that trigger a loss of brain function. These conditions are all usually progressive and eventually severe.
Alzheimer's disease is the most common type of dementia, affecting 62 per cent of those diagnosed.
Other types of dementia include; vascular dementia affecting 17 per cent of those diagnosed, mixed dementia affecting 10 per cent of those diagnosed.
Symptoms of dementia include memory loss, confusion and problems with speech and understanding. Dementia is a terminal condition.
Who is affected?
There are 850,000 people with dementia in the UK, with numbers set to rise to over 1 million by 2025. This will soar to 2 million by 2051.
225,000 will develop dementia this year, that’s one every three minutes.
1 in 6 people over the age of 80 have dementia.
70 per cent of people in care homes have dementia or severe memory problems.
There are over 40,000 people under 65 with dementia in the UK.
More than 25,000 people from black, Asian and minority ethnic groups in the UK are affected.
How much does it cost?
Two thirds of the cost of dementia is paid by people with dementia and their families.
Unpaid carers supporting someone with dementia save the economy £11 billion a year.
Dementia is one of the main causes of disability later in life, ahead of cancer, cardiovascular disease and stroke. As a country we spend much less on dementia than on these other conditions.
How does the UK compare to other countries?
There are an estimated 46.8 million people living with dementia and the numbers affected will double every 20 years, rising to 115.4 million in 2050.
Another 7.7 million people will develop dementia around the world every year.
What about treatments and research?
There is no cure for Alzheimer's disease or any other type of dementia. Delaying the onset of dementia by five years would halve the number of deaths from the condition, saving 30,000 lives a year.
Dementia research is desperately underfunded. For every person living with dementia, the annual cost to the UK economy is over £30,000 and yet only £90 is spent on dementia research each year.
There are not enough researchers and clinicians joining the fight against dementia. Five times fewer researchers choose to work on dementia than on cancer.
Alzheimer's Society is committed to spending at least £150 million over the next decade on dementia research to improve care for people today and find a cure for tomorrow. This includes £50 million to develop the UK’s first dedicated Dementia Research Institute
Those are shocking statistics and the fact so many of will be vulnerable to the disease should compel the government to generate more investment into finding a cure. I am sure there will be a cure one day but, until then, it is sad seeing how the disease takes hold. Alzheimer’s is no longer a disease that affects the elderly: more middle-aged and younger people are being affected by it. Alzheimer’s leads to nerve cell death and tissue loss throughout the brain. It leads to, over time, a shrinking of the brain and a complete attack of all its functions.
Admiration goes to those who care for those with Alzheimer’s as it is tough dealing with someone who has the disease. It is hard to know what to say and one needs patience and compassion in that situation. If it is difficult for those charged with caring for Alzheimer’s: the toll it takes on their loved ones is staggering. Watching someone you love succumb to the disease and lose a lot of who they are is too emotional to put into words. Many – who see relatives go through it – feel helpless and unsure how to talk to the person. Alzheimer’s is not a binary disease and takes on many different forms. Everyone’s case is unique so it can be hard formulating a cover-all therapy and treatment for people who suffer from it. I wanted to look at Alzheimer’s because, as we are aware, new studies are coming to light...
According to a study that looked at translational neurodegeneration - there are scientists and medical professionals expounding the therapeutic and augmentative powers of music. I will quote from an article written early in the year – one that talks about musical therapy and results seen when used on patients:
“Increasing articles have demonstrated that MT can improve multiple domains of cognitions in AD patients, including attention, psychomotor speed, memory, orientation and executive functions [10, 23, 25, 26]. Bruer RA and other scientists found that listening to the music could increase the global cognition of AD [25, 34]. And Ozdemir L pointed out the effect of MT for AD could last for at least 3 weeks after intervention [26]. After 6-week intervention, Gómez Gallego M et al. found that listening to the music which patients like could significantly improve the memory and orientation of AD. At the same time, improvements were observed in depression and anxiety in AD patients. In addition, anxiety was reduced in mild ones, and delirium, hallucinations, agitation, irritability, and language disorders were reduced in moderate AD ones [22]. Kim HJ et al. demonstrated that multi-domain cognitive stimulation including music therapy could improve the word-list recognition and recall test scores”.
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Maybe the results and transformative powers of music are not going to change the course of Alzheimer’s and cure the disease. Every brain is different but we do know people who do not suffer from the disease lock special music memories away. When we hear that piece of music; it brings images to mind and a lock that no other stimulus is capable of doing. It is profound watching how a mind can be opened and lit up when listening to music. I theorised how we unconsciously store music we love to a special part of the brain – attached with that is a collection of unique memories and times associated with that piece. Alzheimer’s is not something we are afflicted with from birth - so every patient would have accrued a bank of special music memories and kept them tight. It is hard to say how Alzheimer’s changes music perception and remembrance but it is clear those who suffer Alzheimer’s will not completely forget music and those sounds they connect with past times. I will continue but, when thinking about music and memory in Alzheimer’s patients; an article by Live Science spiked my thoughts:
“Music's ability to tap into procedural memory and pull on our emotional heartstrings may mean it can do more than simply allow dementia sufferers to access pristine memories from the past. In 2010, the researchers discovered that Alzheimer's patients had a much easier time recalling song lyrics after the words had been sung to them than they could after the words had been spoken. "It suggested that music might enhance new memory formation in patients," said Nicholas Simmons-Stern, also at Boston University and lead author of the study.
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Since then, the researchers have been investigating whether patients can learn vital information, such as when to take their medication, through song. According to Simmons-Stern, as-yet unpublished results lend hope to the idea, suggesting music will be a powerful tool for the treatment and care of dementia patients in the future. However, to have the intended effect, the music must ring true: "The lyrics need to fit the music in a way that's natural and enhancing, and the process of fitting is extremely important," he said. Repetition of the lyrics is also crucial.
Despite this progress, the scientists still aren't sure whether music aids in patients' ability to form new memories by harnessing procedural memory, strengthening new knowledge by tying it emotions, or doing some combination of the two. It may not be surprising that they are only now getting a handle on music's influence on the minds of elderly people; they have barely studied its effects on the rest of us. "I think that music as a scientific area of study has not been thought to be legitimate or mainstream until very recently," Budson said.
Even in the firm hands of science, music is slippery: Like love, it is such a complex neural stimulus that scientists struggle to determine the interplay between lyrics and tune, sound and meaning. Simmons-Stern said what they know is this: "Every patient, and pretty much anyone, could benefit from having more music in their lives."
This research shows that, not only can Alzheimer’s patients remember stored musical memories and find comfort through it – music, in itself, can act as a diary and alarm clock; it helps with daily routines and can be a helpful pneumonic device. The battle as to whether music can help form new memories in Alzheimer’s suffers is raging on. With medication and traditional therapy; music therapy is an experimental tool that we are learning more about. The benefits have been shown and it is clear, through the years, more research is being carried out. The articles I have already source chart the years between 2012 and 2016. This year, new studies are coming to light. Bodies like Alzheimer’s Association are continuing to probe and bring new evidence to light. Alzheimer’s robs the sufferer of the ability to retain information short-term: that frustration that comes where the person repeats themselves and forgets the person in front of them. It is cruel and indiscriminate but it is the long-term memories that could be unlocked through music therapy. If a patient can recall a selection of long-term memories (some people who have the disease can) then can that ability, help improve short-term memory? Music is brilliant when it comes to unearthing those oft-forgotten times – potent enough to connect us to very specific locales and scenarios. So, then…are there other benefits when it comes to music aiding those with Alzheimer’s?!
A piece by The Arbor Company – who quote from the Alzheimer’s Association – talks about live music and how dancing (and exercising at these events) can provide further benefits:
“Researchers believe music stimulates many parts of the brain at the same time, such as those areas affecting language, mood and movement, along with the senses of hearing, sight, sound and touch. Research at the University of California at Davis pinpointed an area of the brain which stores memories by linking them to familiar songs and the emotions associated with those memories. The affect a song will have on someone can often be determined by a person’s past emotional experience with that song. If the song reminds someone of breaking up with an old boyfriend, their response could be less positive than a song associated with happier memories. Alzheimer’s patients might show distress in such a situation by acting agitated, tense or making grimacing facial expressions.
Music popular when a person was between the ages of 18 and 25 often promotes the most positive response. However, typical childhood songs or music that is unfamiliar may also be effective, often due to a lack of an emotional connection. Depending on the type of music, music therapy may help accomplish a variety of things. Stimulating music with a quick tempo and percussion songs can motivate patients to take action or stay awake. Sedating music might prove more soothing. This type of music works well with patients who feel agitated or overloaded by their environment. In later stages, the disease causes patients to stop showing affection to others, but through dance or swaying to the music they may move closer to others or make affectionate gestures.
Patients in early stages may benefit from going out dancing or to hear a concert. Respect their likes and dislikes, even about music they once liked. Brain changes may affect their perception of the music. Playing an instrument may be enjoyable for those who once played. Note and play favorite pieces, such as songs played at a wedding, which serve to spark happy memories. As the disease progresses, playing music may help improve balance while walking. Music can also be used boost the mood of a person suffering from Alzheimer’s, while more soothing music often helps with nighttime behavior issues. In later stages, the same favorite pieces might jog a person’s memory when discussing past events. Music often motivates advanced Alzheimer’s patients to participate in exercise. Relaxing music also soothes and provides comfort”.
We know music is invaluable to those going through anxiety disorders and depression. Not only can a variety of songs produce different emotions/reactions: a consistent and structured exposure to music – in a suitable environment – can help relax the sufferer and help with their recovery/treatment. Not only that but music is a sociable industry: getting out to gigs and picking up an instrument can be really helpful and pivotal when it comes to coping with mental illness. There is a lot more work to do but the rise of Alzheimer’s means action needs to be taken. There are great charities and bodies directly involving themselves with sufferers.
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Money is being spent and there is daily research carried out to help fight and cure the disease. Until the day comes everyone is free from it: what other forms of therapy and education are there?! Music’s role in the siege is growing and more is coming to light as to how it can not only help recover some memories – it has a physical component where the disease sufferer can, through attending gigs or listening to music, remain active and improve their mental health. The eradication of memories and the sense of self is one of the most disturbing and poignant sides to Alzheimer’s. Seeing some, who goes through Alzheimer’s, lose their nature and identity can take a lot away from loved ones and those who care for them. There are no easy answers and quick fixes but, year by year, we are learning more about Alzheimer’s. Medicine and therapy are developing and people are getting a better sense of what Alzheimer’s entails and its complexities. I feel music has a real place and importance to play. I have sourced articles where know what effect music has and how it is being utilised to help those who go through Alzheimer’s. I feel there is, even more, utility available from music: greater physical, emotional and cognitive benefits from the full spectrum of the art. I feel, with every breakthrough and discovery, those who have to live with the brutal reality of Alzheimer’s are being afforded…
IMAGE CREDIT: Denise Cole
A small, but crucial, ray of light.