Written By Zeran Zhang, Co-VP for Music For Dementia
I was reading about the controversial approval of the Alzheimer’s drug Aducanumab by FDA before stumbling across an article published in the Advances in Alzheimer’s Disease Journal in 2021 about a study conducted in Greece examining the effectiveness of music therapy on Alzheimer’s patients and their caregivers as an alternative therapeutic approach. Although there have been numerous studies with findings that music therapy has a positive effect on patients with Alzheimer’s by reducing levels of anxiety and depression(Guétin et al., 2009), reducing levels of agitation(Brotons & Pickett-Cooper, 1996), increasing serum melatonin levels (Kumar, 1999), and possibly heightening arousal allowing better attention and improved memory (Simmons-Stern et al., 2010), this study in Greece stood out to me because its duration is longer than many studies published, and it examines the effect of music therapy sessions on the caregiver themselves and whether interpersonal relationships between patient and caregiver improved, demonstrated by emotionally strengthened daily interactions. A total of 31 caregivers participated in music therapy sessions with their patients and were given structured interviews to determine the potential benefits of music therapy. From the interview results, the researchers believe that the music therapy sessions indirectly benefited the caregivers by reducing their stress and strengthening their emotional ties with the patients(Eftychios et al., 2021).
As a caregiver currently assisting patients with different stages of Alzheimer’s with bedridden patient care or activities such as bathing/dressing, toileting, meal preparation and/or feeding, communication with family, healthcare professionals, and social workers, I have direct observation of AD patients’ behaviors and moods. In addition, while volunteering with Music For Dementia at Brookdale Senior Living and while caregiving, I have performed live personalized and non-personalized music either online through zoom due to COVID-19 safety precautions or in person with the resident 1:1. From my personal experience, the sessions where I was able to interact with the resident in person by singing/playing to them and engaging with them were the most effective, evidenced by the positive change in resident’s mood from agitation to cheerfulness not only demonstrated through facial expressions but also through verbal affirmation. I would also feel refreshed afterwards, and when other residents joined in to comment, the whole atmosphere would be lightened up.
The article about the study in Greece discusses an interesting point. It differentiates between music therapy, music-based intervention, and music listening. It says that music therapy is done by a professional music therapist using an empirical healing model. Music listening involves listening to and creating a personalized playlist. Music-based interventions are more general, do not need a certified professional, and include passively listening to music (Eftychios et al., 2021). Most studies are done using music therapy, and whether playing music in the background makes a significant difference is debatable. Reflecting back on Music For Dementia’s involvement and efforts, we were in person before COVID-19, actively performing and interacting with residents through conversation, sing-alongs, and story reading. Once COVID-19 hit, with the increasing number of hospitalizations for elderly patients with dementia and increasing social isolation in the AD community, Music For Dementia decided to host online sessions through zoom to continue personalized playlist building and music-based interventions. To be honest, it is quite difficult to know whether the residents understand why we are on a screen playing music and talking to them. Some wave happily to us while others seem confused. After seeking some guidance from a healthcare professional in the field, we were able to create some surveys which are planned to be given out to the participant to help us reflect on the quality of the music sessions and make improvements. It would be interesting for researchers to examine the effectiveness of music therapy or music-based intervention in virtual settings, since there has been increasing demand due to the pandemic. But I am hopeful to return with other volunteers in person and follow the methods presented in studies that have shown beneficial results to ensure impactful music sessions and bring joy and creativity to the room.
Eftychios, A. , Nektarios, S. and Nikoleta, G. (2021) Alzheimer Disease and Music-Therapy: An Interesting Therapeutic Challenge and Proposal. Advances in Alzheimer's Disease, 10, 1-18. doi: 10.4236/aad.2021.101001.
Guétin S, Portet F, Picot M, C, Pommié C, Messaoudi M, Djabelkir L, Olsen A, L, Cano M, M, Lecourt E, Touchon J: Effect of Music Therapy on Anxiety and Depression in Patients with Alzheimer’s Type Dementia: Randomised, Controlled Study. Dement Geriatr Cogn Disord 2009;28:36-46. doi: 10.1159/000229024
Kumar, A. M., Tims, F., Cruess, D. G., Mintzer, M. J., & al, e. (1999). Music therapy increases serum melatonin levels in patients with alzheimer's disease. Alternative Therapies in Health and Medicine, 5(6), 49-57. Retrieved from https://proxy.lib.umich.edu/login?url=https://www.proquest.com/scholarly-journals/music-therapy-increases-serum-melatonin-levels/docview/204815060/se-2?accountid=14667
Melissa Brotons, Ph.D., RMT-BC, Patricia K. Pickett-Cooper, RMT-BC, The Effects of Music Therapy Intervention on Agitation Behaviors of Alzheimer's Disease Patients, Journal of Music Therapy, Volume 33, Issue 1, Spring 1996, Pages 2–18, https://doi.org/10.1093/jmt/33.1.2
Simmons-Stern, N. R., Budson, A. E., & Ally, B. A. (2010). Music as a memory enhancer in patients with Alzheimer's disease. Neuropsychologia, 48(10), 3164–3167. https://doi.org/10.1016/j.neuropsychologia.2010.04.033