Home' Australian Ageing Agenda : AAA Nov-Dec 2016 Contents The fact is that this is not well understood by scientists at
Current theory suggest that since music activates so many
different parts of the brain at once it is perhaps able to activate
neural pathways to memories that are not damaged by dementia
pathologies. Alzheimer's dementia, for example, has a large
impact on the temporal lobes.
But much processing of music takes place in the prefrontal
cortex of the brain, which is among one of the last regions of the
brain to atrophy in people with Alzheimer's.
Music also activates brain structures in the limbic system
associated with emotions and therefore seems able to
awaken memories that are deeply connected with music via
In fact, music has even been used to help rehabilitate people
with other neurological conditions, helping them to regain
memory and verbal functioning.
However, while I have been moved by many cases of the 'Henry-
effect', I have also seen a number of situations in which people
have become distressed by the memories activated by music.
This is particularly a concern for people with dementia who
may have a history of depression.
Research indicates that people with depression respond
differently to music compared to other people. Most
individuals, for example, can listen to sad music and it either
doesn't make them feel sad, or they are able to use the sadness
elicited by the music to process and resolve negative emotions
relating to life events.
However, people with depression -- who are often strongly
attracted to sad, melancholy songs -- can find that listening to
such music merely deepens patterns of negativity and prolongs
their depression. People with depression are also more likely to
remember events negatively, and find it more difficult to disengage
from negative thoughts and stimuli.
Just how this works with people with dementia and
depression, we don't entirely know. What we do know is that
there is a well established although poorly understood connection
between depression and dementia. People with a history of
depression are more likely to develop dementia later in life, and
when an individual has dementia, depression can accelerate the
Individuals with depression also often lack awareness of the
effects of the music they listen to, much as they lack insight into the
damaging effects of other maladaptive behaviours. So the dangers
in playing 'favourite' music to people with dementia who are also
depressed is that their favourite music may well be the kind that
could bring up all kinds of distressing feelings and memories, even if
the individual is not able to articulate what they are experiencing.
A further issue to consider in using music in people with
dementia is the effect upon symptoms such as agitation.
In a recent study I conducted with my colleagues at the
MARCS Institute for Brain, Behaviour and Development at
Western Sydney University, we measured the arousal levels of
people with dementia when listening to a variety of different
music. Arousal refers to how alert and awake people are feeling,
"I have also seen a
number of situations
in which people have
by the memories
activated by music."
and it can be assessed based on various psychometric measures
such as the skin conductance measures we used in our study.
What we found is that arousal levels tend to increase for most
people no matter what music you play to them. Of course, for an
individual who is feeling lethargic and low in energy, an increase in
arousal can be quite a good thing as long as it is not accompanied
by distressing emotions.
However, for an individual who is already agitated or
anxious, an increase in arousal could mean an increase in
We have not yet been able to determine based on the results
of our small sample whether or not the increase in arousal
experienced by our participants was pleasant or unpleasant,
helpful or unhelpful.
These issues highlight the fact that music is a wonderful
resource for helping people with dementia to feel alive and re-
connected with themselves and their history.
But it should be approached with caution particularly in people
with a history of depression or other mental illness.
While our ongoing research has yet to demonstrate
conclusively how to deal with these issues, what is apparent
is that music for such individuals should be selected carefully
and with appropriate support systems in place to deal with any
Situations in which individuals are given headphones and then
left to themselves could actually result in discomfort or distress
What we know for sure is that music is powerful. It can
be used to enhance quality of life, but the effects are not
universally positive. For those reasons, it is worth introducing
a note of caution into the discussion of the use of music with
people with dementia. n
Dr Sandra Garrido is a dementia research development fellow
at the MARCS Institute for Brain, Behaviour & Development at
Western Sydney University.
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