Music therapy

An estimated 5.8 million people in the United States are living with Alzheimer’s dementia in 2019, according to the Alzheimer’s Association. This includes an estimated 5.6 million people age 65 and older and 200,000 people younger than 65 who have younger-onset Alzheimer’s. One in 10 people age 65 and older (10 percent) has Alzheimer’s dementia. It’s a disease that Amy Losak of Teaneck, New Jersey, knows all too well.

Losak says her father, Sam, had dementia more than 20 years ago, and she and her mother, Sydell Rosenberg, discovered that music was a helpful tool for him.

“Years ago, I remember that my mom ... engaged a music therapist for my dad,” Losak says. “He had dementia — I don’t think it was diagnosed as actual Alzheimer’s. He had studied violin and classical music as a youngster, and he still retained memories and a love for music.

“She hired a woman named Alicia, who played guitar. I regret that I never got to meet her or observe a session in my parents’ apartment in Queens, New York. I don’t know how mom found Alicia — perhaps it was through the NYC chapter of the Alzheimer’s Association, which was very helpful to us at the time.”

After her mother died suddenly in 1996, Losak’s father had to go into a local nursing home.

“He apparently enjoyed the volunteer musician who visited regularly and entertained the residents,” she says. “I called him Banjo Man because that’s the instrument he played. He wore suspenders and a straw bowler-type hat. When Dad died in 2003, I called Banjo Man to thank him for the joy he had given my dad. Banjo Man told me that my dad sang the loudest on his floor. Apparently, Dad remembered the lyrics to popular old songs Banjo Man played.”

Losak says she met Banjo Man “a few times,” and her personal life has intertwined with her professional, coming full circle, so to speak.

“I now do public relations for the Alzheimer’s Drug Discovery Foundation in New York,” she says.

Countless studies have shown the plethora of positive ways music engages people with Alzheimer’s and dementia. With the month of June being Alzheimer’s & Brain Awareness Month, learn how music can play a significant role in treatment; what kinds are most beneficial; and like Losak’s dad Sam, how music can lead to better memory retention and cognition — and even bring a little joy.

Music as a medicine

Music is a useful tool for people with Alzheimer’s and dementia because it’s something everyone can relate to, says Tracey Esser, a music therapist at the Ivey in Charlotte, North Carolina, a nonprofit wellness day center for people living with memory loss from Alzheimer’s, mild cognitive impairment and other dementias.

“Music is a nonthreatening means for communication, socialization and stimulation,” she says. “Music can also be used to calm agitated behaviors. All levels of dementia can benefit from music therapy.”

Dr. Timothy Thoits, chief of neurology at Spectrum Health in Grand Rapids, Michigan, adds that some Alzheimer’s patients may also have separation anxiety when the caregiver leaves their sight.

“Music therapy can help to calm them,” he says. “Depression is also common in Alzheimer’s patients, and listening to music has been shown to improve the mood.”

Music therapy may reduce stress and cognitive decline, for both short- and long-term memory in Alzheimer’s patients, says Yuko Hara, director of aging and Alzheimer’s prevention at the Alzheimer’s Drug Discovery Foundation in New York City.

“Observational studies also suggest that older adults without Alzheimer’s who have practiced music throughout life had better cognitive functions compared to those who didn’t,” Hara says. “One recent study in mild Alzheimer’s patients reported that a music therapy session lasting just one hour was enough to decrease levels of a stress hormone called cortisol.”

When playing a piece of music that is familiar, it can evoke memories, Hara adds. That’s because Alzheimer’s patients listening to familiar or preferred music can specifically activate a region of the brain associated with musical memory that’s typically spared in early Alzheimer’s disease, she says.

And many studies have tested the effects of listening to music, and a few have also tested the effects of singing, Hara says.

“These studies reported that listening to music improved autobiographical memory, reduced depression and anxiety, or slowed the decline in cognitive functions,” she says. “In one study, singing improved short-term memory, episodic memory, mood and orientation. Some studies also showed that music reduced caregiver distress.”

Sounds of success

Usually when assessing a patient, a music therapist will learn favorite songs and songs that were popular during their early adult years, according to Esser.

“This music appears to stay in their memory,” she says. “Music is beneficial as it offers opportunities for reminiscing, engagement, creativity and can also have a calming effect. Patients are engaged in the moment during singing or playing instruments.”

All kinds of music therapy can be beneficial to Alzheimer’s and dementia patients, Esser says.

“Listening can create a calming environment,” she says. “Singing offers socialization and engagement; as well as physical benefits. It exercises lungs, increases oxygen, stimulates overall circulation and reduces stress. Playing instruments can improve fine and gross motor skills, reduce stress and increase socialization. Writing music provides creativity and allows for self- expression.”

And better results are seen if a patient participates in music therapy two to three times per week for 45-minute sessions, Esser says.

“Repeating songs or musical activities within a session can also be helpful. Music therapy can last for weeks or months, depending on the patient’s needs.  Some results are immediate, such as engagement and socialization,” she says.

It is easy to incorporate music into a patient’s life, Hara says. “It is low cost and may improve the quality of life for both the patient and the caregiver,” she says. “As it is not a drug therapy, it can be used safely in combination with prescribed medications.”

Although some experts say a major drawback to music therapy is that there simply aren’t enough therapists and resources to serve the many who would benefit, Hara cautions that another downside could be that it may cause overstimulation and confusion.

“When playing music, it is a good idea to pick the type of music that the patient enjoys, adjust the volume in line with the patient’s hearing ability, and make sure that there are no competing noises or sounds that are distracting,” Hara says.