Is music a useful non-pharmacological approach for dementia patients ?

I have found music to be my rock. My constant companion. It has gotten me through the worst and best days of my life. Maybe music really can heal! In a world that focuses heavily on approaching problems from an exclusively pharmacological approach, maybe we are discounting the potential benefits of non-pharmacological approaches such as music? Research has found that music can reduce stress and pain in patients, and other research has found that non-pharmacological approaches can be a helpful additional to the pharmacological approach in treating cancer patients. If music can benefit the masses, and non-pharmacological approaches have been shown to benefit cancer patients, can there be a crossover? Is it possible that music can be a non-pharmacological approach for diseases like dementia, which have no known cure?

I was particularly interested in exploring the benefits of non-pharmacological treatments in dementia because of the fact that over 50 million people worldwide are living with it. The Alzheimer’s Association defines dementia as a disease that causes one to experience a “decline in memory, reasoning or other thinking skills.” It is important to note that dementia and Alzheimer’s are not synonyms; Alzheimer’s is simply the most common type of dementia. With dementia affecting more than 50 million people researchers are not just exploring new drug treatments, but also new non-pharmacological treatments in helping to alleviate the progression and quality of life of those living with the disease.

Researchers in France sought to explore how and if music, something that all people are exposed to in some capacity throughout their life, could be a beneficial non-pharmacological treatment approach for dementia patients. Unlike previous similar studies, this study utilized randomized control trials i.e. that participants were randomly placed into the different conditions.

In order to explore the efficacy of music, the researchers wanted to explore if cooking, an activity that is similar to music, and is also “multisensory and pleasurable,” would elicit similar results. The study looked at 14 individuals who were assigned to either engage in a two hour music or cooking lessons twice a week for a month. In order to assess the emotional state of participants “discourse content, emotional facial expressions, and mood,” were assessed a total of six times. Participants were tested twice before the experiment began, once after the fourth session, once after the last session, once two weeks post study, and once four weeks post study.

To analyze discourse context and emotional facial expressions, a psychologist who oversaw the musical intervention had been assigned to conduct short semi-structured interviews. Mood was assessed by participants’ caregivers, using an adaption of the State–Trait Anxiety Inventory for Adults. The researchers found that music had short-term positive effects across all three measures and long-term effects for discourse valence and mood. However, apart from a short term increase of mood, cooking did not have a significant impact on a participants emotional states.

However, the researchers were aware that this study had a significant number of limitations, particularly the bias present since the interviewer and caregivers were aware of which group participants were assigned to. Therefore, they ran a similar study using completely new participants. Several differences were made overall. They ran the study with 48 participants, and the participants had 1 hour sessions, as opposed to the previous 2 hour sessions, twice a week over the course of a month. Additionally, one individual ran both the music and cooking group to allow for more control. Lastly, all biases were accounted for by ensuring caregivers and interviewers were blinded to which group the participants were placed in. The results from the second study saw that music and cooking has near similar effects on emotional state, unlike in study 1.

The researchers wrote this paper to showcase the improvements they made between individual studies. This paper helps bring light to an important area of research, replication, which is unfortunately not done often enough in academia. When researchers repeat previous studies, in a manner that takes into account the limitations of the previous study, it allows for what we hope to be a more accurate guide for future replications of the study. Not only does it shape future studies, but it allows for accurate discoveries and conclusions to be made about the area of study. Unfortunately, the majority of studies are not replicated because journals almost never publish replicated studies, and researchers are faced with publish or perish dilemma, the idea that to survive in academia you must be continuously publishing, thus resulting in a serious lack of publication.

Here, even when the researchers successfully replicated the study there are still many unanswered questions. One of the suggestions for future research, which the researchers themselves suggest, is adding a control group for comparison. Additionally, further researchers may consider exploring other pleasurable activities such as painting, which may have similar effects to music and cooking. Furthermore, questionnaires given to patients’ family members could also be helpful in gaining more accurate results. This would allow researchers to have a better understanding of the participants’ past, as if former musicians and chefs are amongst the sample studied the results could be unknowingly skewed. This replicated study answered many questions, but it also created new questions. Unfortunately, these new questions are likely to go unanswered under the current climate of publish or perish.

Maybe music is not the only answer to a non-pharmacological approach, but it definitely is an answer. Our hope for discovering the best non-pharmacological approach lies within the hands of researchers. Hopefully, some will risk publication for the sake of the greater good of science.

What other non-pharmacological approaches do you think should be explored ?

The above blog post is based on research findings from:Samson, S., Clément, S., Narme, P., Schiaratura, L., & Ehrlé, N. (2015). Efficacy of musical interventions in dementia: methodological requirements of nonpharmacological trials. Annals of the New York Academy of Sciences, 1337(1), 249–55.old.