Author: Katie Kavanagh
Artist: Qiwen Liu
Editor: Rachel Grosberg
Music is a part of everyone’s life, playing a versatile role and affecting each person uniquely. It is a pastime, a career, a mood regulator. But could it be more than just the background character in our memories? Could it have the ability to slow the loss of these memories, even for someone with a memory disorder? Could it prevent the development of these memory disorders altogether?
Alzheimer’s Disease (AD) is the most common form of dementia (memory disorder) in the world, affecting approximately 55 million people worldwide. Despite the high number of people suffering from Alzheimer’s disease worldwide, treatments are limited and there is a desperate need for new advancements. Approximately £17.3 million is spent in the UK on Alzheimer’s research annually. Despite this significant funding, only 10% of pharmacological treatments currently reach their desired effects, often causing unwanted physical side effects, and increasing distress and confusion for patients.
AD is caused by nervous system degeneration, largely due to abnormal accumulation of misfolded proteins β-amyloid and tau within specific regions of the brain. This build-up of proteins causes plaques and tangles to form within the hippocampal formation which decreases neurotransmitter numbers, in particular acetylcholine, inducing memory and cognitive impairments.
However, the pathological effects of AD are not uniform or equal across different brain regions.
The brain areas involved in music cognition are theorised to deteriorate more slowly than their non-musical counterparts. This has led to the exploration of music as a therapeutic agent to delay symptom progression in those already living with AD, but also to prevent disease onset.
Memory loss is the main symptom associated with AD, however, patients also suffer from physical symptoms such as difficulty swallowing. Known as dysphagia, difficulty swallowing is experienced by 13-57% of Alzheimer’s patients, making mealtimes stressful and reducing food intake, which can lead to malnutrition. Accompanying dysphagia is aspiration which is the intake of food, liquid, or saliva into the lungs, and can lead to pneumonia–the most common cause of death for those with Alzheimer’s. A study carried out by Columbia Healthcare Centre featured Alzheimer’s patients who received personalised playlists with songs from their childhood that hold significant meaning to them. They listened to these playlists for 30 minutes before dinner and their food intake was recorded with and without intervention. The average food intake increased from 41.4% to 71.4% with this music intervention, the 30% increase indicating a decrease of dysphagia, aspiration, and distress. This simple addition to patients’ daily routine is an amazing alternative to Percutaneous Endoscopic Gastrostomy (PEG), known as tube feeding, which removes independence and normality from patients’ lives.
While listening to music can decrease AD symptomatology, it has also been shown that playing a musical instrument can decrease the chance of it developing. A survey to explore the possibility of prevention was carried out by Loyola University Chicago. It consisted of 23 orchestral musicians who were aged 65 years and upwards, the age at which 10% of the population are expected to develop Alzheimer’s. Their musical background, family history and health were all taken into account and they were screened for Alzheimer’s. Results showed that none of the musicians had developed Alzheimer’s despite familial and age-related prevalence.
In several cases it has been demonstrated that patients in the moderate to severe stages of Alzheimer’s, experiencing severe cognitive impairments, still possess the ability to learn and play songs, demonstrating intact musical procedural memory. Playing a musical instrument has been shown to increase cognitive ability through enhanced neuronal communication between the left and right hemispheres of the brain, which causes positive effects on learning, memory, fine motor skills, verbal reasoning, and non-verbal reasoning. It is theorised that playing an instrument over a long period of time can lead to plastic changes such as the rapid unmasking of existing connections between neurons and even the establishment of new connections. The functional and structural changes in response to music have been observed through neuroimaging techniques such as fMRI.
Despite such evidence, the effect of music on memory disorders is not yet well-established, and requires significantly more research and funding to solidify music’s role in the treatment and prevention of AD. Music could potentially be the affordable, easy-to-use, and remarkably versatile remedy we’ve been searching for, offering a refreshing alternative to traditional pharmaceutical treatments for those navigating the challenges of dementia.
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