Can Music Enhance Therapy Outcomes for Patients Living with Dementia and Memory Loss?

-Written by Shraddha Majcher

Sitting in the waiting room, your mind races with tasks - until a ’90s hit plays, and suddenly, you’re humming, foot tapping, and transported to more carefree days in your friend’s Firebird. You smile as those familiar notes deliver you back to that distant moment... Music is more than just a background noise to our lives. It is deeply intertwined with our memories, emotions, and experiences. Whether it’s a childhood lullaby, a wedding song, or the music that marked a pivotal moment in one’s life, music can elicit powerful memories. This connection is especially profound when it comes to individuals living with neurological decline such as dementia or Alzheimer's disease.

Take Tony Bennett for example. According to an article in Brain & Life Magazine by Gina Shaw, despite often being distant or disengaged due to dementia, Tony Bennett would come alive when he was in front of a piano. Whether performing on stage or rehearsing at home, singing or even hearing the piano music of others would restore his voice, and legendary charisma - momentarily masking the effects of dementia.

Most people aren’t as connected to music as Tony Bennett, but nearly everyone has songs that hold special meaning. As we age, many of our cognitive abilities, including memory, can begin to decline. But one area of the brain seems to remain resilient to the devastation of dementia - the part responsible for musical memory. Studies and personal stories alike have shown that music can reengage the mind in a way that few other stimuli can, providing discernible cognitive benefits, as well as emotional and social ones.

The Science Behind Music and Memory

Over the past two decades, research has shown that music activates multiple regions of the brain, including those involved in emotion, memory, and even movement. Concetta Tomaino, DA, Executive Director for the Institute for Music and Neurologic Function, explains that "songs of personal meaning stimulate memories, even for people who have trouble accessing their memories." Why?... because music taps the deep neural networks involved in information recall. Brain imaging studies have shown that the medial prefrontal cortex, a region crucial for memory storage and retrieval, lights up when people listen to music that holds personal significance.

In Alzheimer’s Disease, music is particularly effective.? So much so, that s a scientific term has been coined to describe it… called Music Evoking Autobiographical Memories or “MEAMs”. These memories, often associated with strong emotions, may remain more intact than other types of memory in the face of neurodegenerative disease. Even in the advanced stages of Alzheimer's, patients can still recognize familiar songs and sometimes sing along, offering a remarkable opportunity for connection between patients, loved ones, and caregivers.

Another example of music's power to reconnect people with their memories comes from Dr. Daniel Potts, a neurologist who recalls how his father, in the final days of his life after losing his ability to speak, began to sing with his family. “We just sat around his bedside and sang… and he sang right along with us,” shared Dr. Potts. "We'll never forget that."

Studies on Music's Impact on Alzheimer's Disease

Research supports these anecdotal experiences. A 2015 study published in Brain found that areas of the brain responsible for musical memory remain relatively undamaged in people with Alzheimer's disease. Similarly, a 2019 study by researchers at the University of Utah showed that listening to personally meaningful music could stimulate various regions of the brain, improving mood and enhancing connections to the environment. Functional MRI scans revealed that areas related to attention, visual processing, and executive functions lit up when patients with Alzheimer's listened to their favorite songs.

Even more impressive are the results seen from music-based interventions. Music & Memory, a nonprofit organization based in Mineola, NY, has implemented music therapy programs that help nursing homes and caregivers create personalized playlists for individuals with dementia. A study published in the Journal of the American Medical Directors Association in 2020 showed that these music interventions led to a significant reduction in the need for medications, including anti-anxiety drugs and antidepressants. Additionally, there were marked declines in aggressive behavior, depressive symptoms, and even pain levels.

The Emotional and Social Benefits of Music

Beyond its cognitive benefits, music can provide emotional relief and help foster social connections. For caregivers, music offers a way to reduce anxiety and stress, both for themselves and the person they are caring for. Singing or listening to music together can also help create meaningful moments of connection, even when verbal communication becomes difficult.

Music’s role in dementia care may not just be about preserving cognitive function, it’s about nurturing emotional well-being and providing a person’s sense of identity and connection to the world around them. The ability to experience joy and to relive cherished memories through music is a gift not to be overlooked in memory care.

A Powerful Therapy Tool to Enhance Connection and Outcomes?

The research is clear: music can have a profound impact on individuals with dementia. How can care teams in long-term care, assisted living, and home health use music to enhance function and quality of life for patients with cognitive decline? Experts offer several strategies where music can be used to support memory, cognition, and emotional well-being. Here are just a few:

1. Facilitating Neuroplasticity and Recovery Why it works: Music can stimulate the brain’s neural pathways, aiding in recovery after injuries or neurological decline following stroke, Parkinson’s Disease, and Alzheimer’s disease.

How to apply it:

• Use rhythmic cues to recondition motor pathways and enhance limb control. For example, playing a steady drumbeat or metronome while a patient practices walking can help synchronize their steps, to improve gait and balance. Similarly, clapping or tapping to a rhythmic pattern can aid in relearning hand movements during fine motor exercises.
• Play lively music to boost energy or soothing tunes to promote calm during stressful moments.

2. Supporting Cognitive and Linguistic Skills?

Why it works: The key to music’s success in dementia care is personalization. Dr. Potts suggests focusing on the songs that hold personal significance for the individual. Music from the “reminiscence bump,” typically occurring between the ages of 10 and 30, when emotions are heightened can be especially effective at triggering memories. Lyrics and melodies reinforce memory, sequencing, and comprehension.?

How to apply it:?

• Encourage patients to follow instructions embedded in songs (ex. “If You’re Happy and You Know It”)
• Create musical games where patients identify words or fill in the blanks.
• Use storytelling songs to teach sequencing by breaking them into parts for patients to put in chronological order.

3. Encourage Social Interaction?

Why it Works:?

Music is most beneficial when it’s experienced with others. Jonathan Graff-Radford, MD, of the Mayo Clinic, recommends engaging with the individual by singing along or keeping the beat. “See which songs trigger more engagement,” he advises. Singing, playing instruments or rhythmic movement engages multiple brain areas. Some people may tap their feet, clap, or even sing along when seeing others around them doing it.?

How to apply it:?

• Therapy staff or a certified music therapist can lead the sessions
• Organize weekly sing-alongs, drumming circles, or music-based games with themes tied to holidays or residents’ interests (ex. movies of their generation).? This type of approach can often be used along with Group Therapy.
• Incorporate movements such as hand gestures or gentle swaying for those with limited mobility,?
• Engage them in a social game of hot potato or musical chairs where they are interacting with each other?
• Simple standing dance moves (chair dancing counts) based on their mobility level and goals.
• Live music performances with local musicians or schools and encourage residents to request songs, join in with instruments or present the microphone during the chorus.?

4. Stimulate Memory Recall

Why it Works:?

Music can be used as a mnemonic device to help individuals with Alzheimer’s recall autobiographical memories. Whether they are listening to a song from their past or singing along, music can bring vivid memories to the forefront. Research has shown that even individuals with advanced Alzheimer’s may remember events and details from their lives when prompted by familiar music.

How to apply it:

• ?Ask families to provide personal histories of their loved one's favorite songs or genres. Different people have different musical preferences, and what works for one person might not resonate with another.?
• Pair the music with pictures or tactile items from that time period
• Pair music with their family pictures that marked special events such as their wedding song when presenting their wedding picture, happy birthday song, holiday music, etc.

Impact and Benefits

As the research on music’s impact on memory and cognition continues to evolve, there is still much to learn about its potential, especially concerning different types of dementia, such as frontotemporal dementia or Lewy body dementia. Studies are also exploring how musical training earlier in life can delay cognitive decline in older adults, suggesting that lifelong engagement with music may possibly offer protective benefits against dementia.

As we deepen our understanding of music’s role in the brain, we may discover even more ways to use music to enrich the lives of people living with neurological decline. Integrating music in dementia care doesn’t just enhance cognitive function, it brings joy, dignity, and connection to the lives of those affected. In the words of the late Tony Bennett, who continued to sing well into his later years, "I have always felt that music can communicate beyond what words can.”?

About Author:

Shraddha (like Prada) Majcher brings over 20 years of dedicated experience as a physical therapist and industry writer blending clinical insight with a knack for spotlighting progressive patient-centered care, provider empowerment, and operational excellence.