By Ivana Premasinghe
(Photo by Spencer Imbrock on Unsplash)
Alzheimer’s is a life-altering experience for both patients and their loved ones. As the disease progresses, many patients experience movement difficulties, memory issues, and social isolation. Music therapy is a promising treatment technique that has been shown to alleviate these symptoms. In this article, Ivana Premasinghe discusses her experiences giving musical performances for Alzheimer’s patients. She explores the effects of music on the human brain and the need for a personal approach to treating neurodegenerative disorders.
Alzheimer’s is a life-altering experience for both patients and their loved ones. As the disease progresses, many patients develop memory issues that inhibit them from performing daily tasks and remembering family members (“Memory Loss and Confusion”). On a neurological level, their brains abound with amyloid plaques and neurofibrillary tangles. These abnormalities spread through the brain over six stages, starting in the transentorhinal cortex and ultimately reaching the neocortical association areas (Brion, 1998).
Another neural symptom of Alzheimer’s is the loss of connections between neurons in the brain (“Alzheimer’s Disease Fact Sheet”). The National Institute of Aging explains that neurons “transmit messages between different parts of the brain, and from the brain to muscles and organs in the body” (“Alzheimer’s Disease Fact Sheet”). Therefore, Alzheimer’s patients with broken neural networks experience various physical symptoms, such as difficulty with movement. Studies have pinpointed multiple brain regions as hubs for motor control. Specifically, Area 46 in the frontal lobes is likely involved in motor dysfunction, the dorsolateral prefrontal cortex in spatial working memory, and the parietal cortex in movement execution (Ghilardi, 1999).
Connections between neurons are also vital for interpersonal interaction. As such, any disruptions can create communication barriers between patients and their loved ones, potentially leading to social isolation. Social isolation often generates negative physical and emotional responses, such as ailing health, antisocial behavior, and despondent moods (Ontario, 2008).
While the search for a cure is still underway, researchers are studying how to better care for Alzheimer’s patients in spite of communicative and cognitive barriers. For instance, Gina Salazar, an activity director for elderly populations, states that loved ones can help increase patients’ comfort and happiness levels by taking them on walks, cooking with them, and playing ball toss games (2015). However, one activity has been proven especially effective through both literature and my personal experience: music.
As a volunteer at a senior assisted living facility, I held weekly singing and piano performances for patients with Alzheimer’s and other types of dementia. I also conducted sing-along events involving their favorite songs. Although my performances were not formal therapy sessions, the music evoked remarkable physical, social, and emotional changes in the patients.
From a neuroscientific standpoint, music exerts a profound influence on the human brain. A 2007 Stanford study used fMRI imaging to examine the effects of music on brain activity. The researchers found that “music engages the areas of the brain involved with paying attention, making predictions and updating the event in memory” (Baker). These discoveries underscore the importance of music as a multifaceted approach to helping Alzheimer’s patients.
In musical therapy sessions, a trained professional uses music to evoke a response from patients. Possible responses include focusing on the performer, mouthing song lyrics, and moving to the beat. Such responses can significantly alleviate symptoms of Alzheimer’s (“What Is Music Therapy”).
Take, for instance, motor control. I have personally witnessed Alzheimer’s patients struggle to look forward or to throw a ball correctly. However, multiple theories suggest that motor control issues can be mitigated by dancing. Swaying along to music is a simple way for Alzheimer’s patients to exercise without having to overexert themselves. According to neurologist Joe Verghese, dancing “takes advantage of our brains’ neuroplasticity” (Siegfried). He notes that the “cerebral cortex and hippocampus, which are critical to these activities, are remarkably plastic, and they rewire themselves based upon their use” (Siegfried). Based on this theory, the more often a patient dances, the more neural pathways will be generated and the less likely the patient will be to lose those movement capabilities.
Singing also has a positive neurological impact because it stimulates several parts of the brain simultaneously. A 2011 study by Brion et al. showed that the various elements of singing – including rhythm, controlling pitch, and reading musical notation – all activate different parts of the brain. In most cases, rhythm stimulates the left hemisphere, controlling pitch activates the right hemisphere, and reading musical notation innervates the temporal-occipital regions of the brain. Because singing stimulates multiple parts of the brain, as opposed to only one region, it creates flexibility for new learning (Thaut, 2005).
Music can also affect patients emotionally. The Alzheimer’s Foundation of America describes music’s remarkable ability to “shift mood, manage stress-induced agitation, [and] stimulate positive interactions” because even patients who have lost most of their cognitive functions can still sing (Sauer). Many of the patients who attended my music sessions arrived tired and disgruntled. However, upon hearing their favorite songs, they began swaying from side to side and even ended the session with a standing ovation.
Music appears to affect various aspects of patients’ behavior, helping them become more responsive, alert, or talkative. Throughout my volunteering experiences, I have observed significant mood and behavioral shifts in patients from the beginning to the end of each session. During my performance, many patients began mouthing the lyrics to my songs, moving their hands, focusing on my face, and swaying along to the music.
More critically, music can help reinforce patients’ identities and their relationships with others. Music can provide insight into patients’ lives, illuminating their unique character and experiences. Take, for instance, former musical prodigies who can no longer perform independently because they have lost the necessary cognitive functions. When such patients watch a performer sing, the music can trigger memories of their own talents and interests. These experiences can foster a closer relationship between the patient and the performer. According to the Alzheimer’s Foundation, people tend to relate music to important events and emotions (“Alzheimer’s Disease and Music Therapy”). Many patients, therefore, automatically associate certain songs, rhythms, and tunes with past memories.
Through my performances, I have discovered various details about patients’ past experiences. For example, I realized that some patients who sang along to Broadway songs were former drama teachers and musical theater performers. I also learned that many patients who moved their hands in synchronization with the music used to be music conductors. Finally, I witnessed patients call out for loved ones after hearing a song that reminded them of their families. These examples demonstrate how music can reveal patients’ interests and memories, which otherwise may be difficult for them to communicate.
Music can yield various physical, mental, and emotional benefits for Alzheimer’s patients. Simply watching a music performance can improve patients’ moods, evoke forgotten memories, and stimulate motor movements. Additionally, insights from music therapy sessions can help volunteers and healthcare professionals better understand and care for these patients – despite communicative and cognitive barriers. In the words of Dr. Jane Flinn from George Mason University, “The message is: do not give up on these men and women.”
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