Dear Doctors: We got an email from a medical center looking for adults with cognitive problems to be in a study about music. What would be the connection? My father-in-law has mild cognitive impairment and may be progressing to dementia. He is very interested in applying.
Dear Reader: Cognitive impairment refers to a decline in the ability to think, remember, reason, make decisions and learn and retain new information. It is sometimes a precursor to other forms of dementia. Memory loss is perhaps the best-known symptom, but the effects are more far-reaching. People with this diagnosis struggle to concentrate, find it difficult to complete tasks, can be unable to follow instructions and lose the ability to solve problems. The condition can also erode the ability to recognize and express emotions, which adds another layer of separation from the wider world.
The use of music as a therapeutic tool to bridge those mental and emotional barriers has gained support in recent years. Research has found that for some people, music can improve mood, ease anxiety, elicit memories, sharpen cognitive function and encourage participation in daily life. Studies have linked the addition of music to the lives of people living with mild cognitive impairment with an improved ability to learn, retain and recall new information.
Similar studies have been conducted with patients living with Alzheimer's disease. The addition of music was found to be helpful in easing the agitation that often occurs in dementia. It also helped increase alertness and orientation, and sometimes eased symptoms of depression, which led to a decrease in the amount of medication needed.
Exactly how or why music works in these ways is not yet fully understood. However, there is a growing body of evidence showing that, even when other neural pathways are disrupted, those that are associated with listening to music remain intact. The result is that music can engage and activate parts of the brain that, due to disease progression, have otherwise become inaccessible.
Researchers have found that even when patients have progressed to the later stages of Alzheimer’s and other forms of dementia, some were able to recognize and respond to music. They could tap out a beat, showed clear enjoyment as they listened and could sometimes accurately remember the lyrics to songs.
Music therapy is increasingly available as part of the management of cognitive impairment and dementia. Therapists use music to get the patient's attention, as background sound to ease anxiety and agitation, as a cue for transitioning between activities and physical spaces and as a shared experience to create an emotional connection. When access to professional help in someone's area is either limited or unavailable, families can add music to their caregiving duties.
Not surprisingly, this is most effective when the songs and melodies are already familiar to the patient. The music of someone's youth has been found to elicit a strong response. It is important to understand that music therapy has not been found to reverse the loss of cognitive function. However, it may preserve or amplify existing function, and it can improve quality of life for patients and caregivers alike.
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
