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Music is a complex composition of melody, harmony, rhythm, timbre, tempo, dynamics, form, texture, and words or lyrics. These elements, when put together, have a profound effect on the listener’s emotions, behaviour, and memory. When used appropriately, music can be a useful and effective tool to optimise the quality of life for persons living with dementia.
With these unique qualities, music has been widely used as a potentially beneficial intervention to improve moods, cognitive function, memory, and communication. This is commonly known as music therapy. Music therapy can also provide opportunities for socialisation and connection between individuals with dementia and people around them in both personal sphere and group setting.
In this article, we explore the use of music therapy as a non-pharmacological intervention to improve cognitive and behavioural symptoms in persons living with dementia, the possible effects and benefits of music therapy, and how music therapy is used in Singapore to better or enhance the quality of life of those living with dementia.
Benefits of Music Therapy for Persons Living with Dementia
Non-pharmacological approaches like music-based interventions are regarded as low-risk, accessible and inclusive as an approach to managing behavioural psychological symptoms of dementia or BPSDs, compared to pharmacological interventions.
Based on recent studies, music therapy has gained worldwide popularity in managing symptoms of dementia over the years. It is found that musical training can help mitigate effects of cognitive impairments and increase the capacity of persons to remember music.
In a study on persons living with Alzheimer’s Disease (AD), researchers found that persons with AD showed improvement in word fluency, biographical memory, and memory of the lyrics after participating in music therapy sessions.
Here are some of the benefits music therapy can have on persons living with dementia, as supported by several studies:
| Potential Benefits of Music Therapy for Persons Living with Dementia | |
1. | Improves mood and reduces agitation | Music can evoke positive emotions and memories. This can help alleviate depressive symptoms and other negative emotions such as anxiety and agitation which are common behavioural and psychological symptoms of dementia. |
2. | Enhances cognitive function | Music can improve certain cognitive and executive functions such as verbal fluency, recollection of lyrics/memories, and assists in Activities of Daily Living (ADLs). |
3. | Enhances communication | Music can serve as a non-verbal communication tool that helps persons living with dementia to express their thoughts. |
4. | Improves socialisation and connection with people | Group music activities can eliminate isolation and loneliness. |
5. | Improves quality of life | All the benefits can lead to improved quality of life. It is especially beneficial to those who are battling with emotional symptoms, such as anxiety. |
Supported Evidence of Music Therapy
The use of customised music playlist in medical setting has been proven effective in combating (disinhibited) behavioural symptoms of people living with dementia. Studies reported a rise in positive results in recent years.
Here are some evidence-based statistics that support the effectiveness of music therapy in managing BPSDs or behavioural and psychological symptoms of dementia, including agitation, aggression depression, anxiety and apathy, particularly in moderate stage of dementia:
- A meta-analysis of 17 randomised controlled trials (RCTs) by Zhang et al. (2017) found out that music therapy significantly reduced disruptive behaviours of persons living with dementia.
- An RCT conducted by Raglio et. al. (2010) revealed that individualised music therapy had a 30 per cent reduction in disruptive behaviours compared to control group.
- A Cochrane review (2018) that analysed 22 trials with over 1,097 participants saw music-based intervention resulted in significant reduction in depressive symptoms.
“Music Therapy is a person-centered, non-pharmacological approach that supports emotional well-being, cognitive function, and social interaction. It also provides opportunities for caregiver participation, strengthening emotional bonds and offering shared joyful experiences. The structured yet flexible format makes it accessible and highly beneficial for persons with dementia, including those in moderate stages. It is also listed as a recommended intervention for BPSD as part of the clinical guidelines for dementia by Singapore’s Ministry of Health.”
Music has the power to evoke emotions and help persons living with dementia recall and share their life stories with their caregivers and vice versa. Furthermore, music therapy activities can easily and effectively be incorporated into other forms of therapy such as reminiscence therapy and art therapy.
Here are some practical, meaningful, and evidenced-based activities (and their benefits) you can incorporate into the lives of persons living with dementia:
- Create a personalised playlist that includes your loved one’s favourite songs from his youth/era or culture. This can trigger fond memories and facilitate conversation.
- Encourage your loved ones to sway along or clap to the rhythm and tempo of the music. This can improve movements and functional abilities.
- Play soothing and familiar music to help your loved one manage emotions, moods, and relieve anxiety and pain.
- Encourage your loved one with dementia to sing along to his favourite songs. This will improve speech articulation and fluency over time.
- Combine music with visual art such as painting to encourage self-expression and enhance creativity.
Conclusion
As research continues to validate the effectiveness and benefits of music therapy, integrating music therapy into dementia care not only honours the personhood of persons living with dementia, but it is also an accessible and meaningful way to connect them with their loved ones. In the gentle rhythm of familiar melodies, many find joy, comfort and more importantly a renewed sense of identity and dignity that enhance their quality of life.
- Bleibel, M., El Cheikh, A., Sadier, N.S. et al. The effect of music therapy on cognitive functions in patients with Alzheimer’s disease: a systematic review of randomized controlled trials. Alz Res Therapy 15, 65 (2023). https://doi.org/10.1186/s13195-023-01214-9
- Shirsat A, Jha RK, Verma P. Music Therapy in the Treatment of Dementia: A Review Article. Cureus. 2023 Mar 31;15(3):e36954. doi: 10.7759/cureus.36954. PMID: 37139292; PMCID: PMC10151115.
- Zhang, Y., Cai, J., An, L., Hui, F., Ren, T., Ma, H., Zhao, Q. (2017). Does music therapy enhance behavioural and cognitive function in elderly dementia patients? A systematic review and meta-analysis. Ageing Research Reviews, 35, 1–11. DOI: 10.1016/j.arr.2016.12.003
- Van der Steen, J. T., Smaling, H. J. A., van der Wouden, J. C., Bruinsma, M. S., Scholten, R. J. P. M., & Vink, A. C. (2018). Music-based therapeutic interventions for people with dementia. Cochrane Database of Systematic Reviews, 2018(7), CD003477. DOI: 10.1002/14651858.CD003477.pub4
- Raglio, A., Bellelli, G., Traficante, D., Gianotti, M., Ubezio, M. C., Gentile, S., Villani, D., & Trabucchi, M. (2010). Efficacy of music therapy treatment based on cycles of sessions: A randomised controlled trial. Ageing & Mental Health, 14(8), 900–904.
