Dementia effects approximately 50 million people world-wide with almost 10 million new cases every year. It is a syndrome which is the deterioration of cognitive functions that is not considered normal deterioration that comes with age. It effects calculation, learning, language, memory, thinking, judgement, and comprehension among other things (World Health Organisation. 2019). The difference between dementia and normal aging is that it is significant enough to interfere with independent daily functioning (Seth A. Gale, MD, Diler Acar, MD, Kirk R. Daffner, MD. 2018). There are many studies conducted to reduce the number of people effected and delay the deterioration of cognitive functions using music. Research has been achieved to see if emotional connections to music can trigger memories and reactivate parts of the brain to improve memory recall in dementia patients. This research is considered important as this could be a temporary cure for this syndrome and reduce the number of people affected.
There are many theories surrounding the use of music to delay the effects of dementia, some of these include the ability to remember old songs as patients tend to sing and dance to them for longer than other songs and they seem to remember and respond to information better. Retaining music is considered a complex skill as it requires being connected to the individuals’ culture and it is easily accessible making it an easy therapy to be part of. Another theory is disassociation between different types of memory for music, however this is mainly for musicians. The final theory mentioned in the research is the processes related to music and how it is believed to be the last to deteriorate and how music has been suggested to enhance autobiographical memory recall for people with dementia, as music triggers motor activity and memory recall (Spiro, N. 2010). The most common research question use for this topic is can music delay or decrease the effects of dementia. All of the research conducted have similar hypotheses that singing familiar songs can trigger memories, creating the feeling of connectedness to past events and emotions, resulting in improved memory recall (Osman S,E, Tischler, V, Schneider, J. 2014). This hypothesis can be and has been tested with dementia patients, where the patients were interviewed before and after the experiment to prove the hypothesis true. For the topic of music and dementia there are many research areas that are being studied in relation to the use of music in memory recall, some of these include the use of listening to music to see if they trigger anything, in this case patients are listening to music from their past to see if this helps increase memory recall. Another set of research conducted was having groups of dementia patients sing and actively engage with the music to see if it can trigger memories or increase total memory recall.
There have not been many experiments conducted to prove or disprove that the use of music in whatever form can delay the effects of dementia or improve memory recall. Research conducted by Osman discovered that there are three main symptoms of dementia which have been proven to be positively influenced by music is, language recollection, memory and mood which includes aggression, depression, and agitation. They also revealed that music does have a positive effect on cognitive functions like communication and memory in this syndrome. It has also been discovered that neurobiological effects of music suggest that audio stimulus conjures past emotions resulting in temporarily enhanced cognitive functions (Pauwels, E,K,J, Volterrani, D, Mariani, G, Kostkiewics, M. 2014). Another research experiment using 104 participants, who were randomly sorted into a control and experimental group, only 100 completing the experiment. While the control group continued with normal care, the experimental group completed 12 sessions of group music therapy. After 6 sessions there was as slight improvement in cognitive function, and after the final session there was an increase in short term memory recall this lasted for about 1 month after, concluding that the use of group music therapy delays the deterioration of cognitive functions (Chu, H, Yang, C,Y, Lin, Y, Ou, K,L, Lee,T,Y, O’Brian, A,P, Chou, K, R. 2013).
Another experiment conducted to determine how efficient music intervention is when used in everyday care, was conducted using 90 participants, this experiment improved episodic memory, cognition among other things. Episodic memory is memories of past events that have an emotional connection, which music seems to trigger in that specific part of the brain. Research suggested that people suffering from dementia tended to keep the ability to perceive and recognise music that is familiar to them even in the advanced stages of this syndrome (Mahendran, R, Rawtaer, I, Fam, J, Wong, J, Kumar, A,P, Gandhi, M, Jing, X,K, Feng, L, Kua, E, H. 2017). Additional studies that have been conducted that support these previously mentioned experiments proved that music is important for dementia patients achieving goals in the psychological, social and cognitive fields (Raglio, A., Filippi, S., Bellandi, D., & Stramba-Badiale, M. 2014). Research now focuses on the delay or prevention of mental decline as it has recently been decided that it would be more beneficial to the population as it is rapidly aging, with a majority of seniors suffering from this cognitive decline. The main outcome of music therapy that resulted in this discovery was the rational changes and possible reversal of cognitive impairment or prevent further deterioration.
Although research is limited, current evidence proves the previous research, that these therapies strengthen attention and improve cognition in dementia patients (Mahendran, R, Rawtaer, I, et al. 2017). The final piece of research that supports all the aforementioned studies is that activities with music help maintain social, physical and cognitive abilities however, they have not explored in depth the long term effects of this therapy on dementia patients, but compared with usual care of patients in this situation, music therapy improves mental processes, mood, episodic memory and short term memory. For patients with mild and moderate dementia, the use of regular musical leisure can have long term cognitive benefits (Särkämö, T, Tervaniemi, M, Laitinen, S, LicPhil, Numminen, A, Kurki, M, Johnson, J,K, Rantanen, P. 2013).
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All of the research conducted supports the theories surrounding music and dementia as all of the experiments so far prove these theories and support the hypotheses. These state that the use of music as a therapy delays the deterioration of cognitive functions, so far all of the experiments prove the short-term benefits of dementia. The type of research that has been conducted so far has been interviews as it is easier to get reliable data that isn’t influenced by a self-moderated survey. All of the research has had qualitative data as the experimenters were measuring memory recall with an interview styled test. There were many controls that were implemented for each experiment, for Spiro’s the controls were based upon the type of participants involved in the experiment, there was an age bracket of above 65 years old, have dementia, and no significant hearing impairment. Participants were excluded if they were participating in other experiments, had language issues, and were unable to participate for whole 30 minutes of the therapy. These controls were in place to ensure that the tests were beneficial to the whole research task to get the best results possible so that it could benefit the whole community. For Mahendran’s experiment the criteria were similar, meaning there was an age group required, have the syndrome, are able to participate in the experiment for 6 weeks, and have the ability to function independently.
The design for these experiments could have been improved in both main experiments by including participants with varying stages of dementia to help understand the full potential of the music therapy on dementia patients. These experiments are reliable as this experiment is able to be repeated many times to ensure the results are sufficient enough to get averages and compare the data however, these measures are not mentioned in any of the experimental reports. The population of people used in the experiment is inappropriate as approximately 50 million people are affected by dementia, yet the largest experiment included 100 people, this sample size is too small to fully understand the potential of the experiment. The sample should be big enough to make the results generalisable however, these results although helpful are only useful for preliminary research and not a whole experiment.
The background research supports the results from the experiments conducted, the results concluded that music therapy used on dementia patients not only helped them socially but mentally as well, as on average the participants short term memory recall had improved as well as recognition. The data collected helps give insight to the cognitive processes impacted due to dementia and how music effects those parts of the brain while supporting the hypotheses and previous research. All of the research and data collected can be supported by other researchers, another experiment concluded that the use of music therapy and other forms of music help dementia patients with memory recall and language functioning (Brotons, M, Koger, S,M. 2000). Some of the controlled variables include the type of participants included and the types of music used, which was not specified. Other controls that should have been considered was having a range of patients with different severities of dementia so there is a wider range of results throughout the whole experiment, this should have been implemented in every set of research.
Some of the implications of the results include that music is useful when improving the speech and fluency of individuals with dementia (Spiro, N. 2010). It has also been implied that musical leisure activities may have long term cognitive effects in cases of mild and moderate dementia, therefore could be used in rehabilitation and dementia care (Särkämö, T, Tervaniemi, M, Laitinen, S, LicPhil, Numminen, A, Kurki, M, Johnson, J,K, Rantanen, P. 2013). Some limitations of the study conducted by Spiro include the insignificant evidence on the musical effects presented in controlled randomised trials, and as stated previously there is limited research in this area to base the accuracy of the findings on to ensure the data collected was not a coincidence (Spiro, N. 2010). Other limitation to these studies is that all of the experiments so far are short term, most researchers usually don’t complete a follow up exam to see how long these sorts of therapies last and the sample size is generally too small (Chu, H, Yang, C,Y, Lin, Y, et al. 2013). Särkämö agrees with Chu that these experiments for the most part only focus on the short-term effects, therefore reveals nothing about the long-term benefits, there is also no variety in the severity of dementia between the patients as most participants are diagnosed with mild – moderate dementia. Mahendran stated that these activities may not always improve the effects of dementia and that the studies are more to determine if these sorts of activities and therapies are beneficial for the patients.
These studies are an adequate starting point for the research problem with trying to improve the cognitive effects and delay the deterioration of mental processes in dementia patients through the use of music therapy and seeing if emotional connections help with music and memory recall. The research has advanced appropriately for the studies to take place as originally there was no connection between music and dementia, now a connection has been discovered and some studies include the idea that emotions are involved. Although there are many advancements in this field of study there are some areas that need to be studied further, including the effect on more severe forms of dementia and the long-term effects of music therapy. If the research had been looked into further there many have been a way to make the results of music therapy last longer and reduce the total amount of people suffering altogether.
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