Roger* was in his early sixties when he came to see me because of concerns about his memory. At his Geriatrics Clinic appointment, we talked about his world travels, his time as a student in university, his hobbies, and how he had been spending his time since he had retired. He was lively and engaging. But over the course of the visit, Roger struggled to answer questions.
He was getting lost while driving. He wasn’t keeping up with his finances the way he used to. And ultimately, he scored very poorly on a memory test.
We told Roger and his wife about Roger’s diagnosis of probable Alzheimer’s disease, and discussed some resources and support groups. We talked about seeing him again in Geriatrics Clinic in the future, and possibly starting him on a medication, like donepezil, that could slow down his decline, but wouldn’t be able to stop it. And they left. We had nothing else to offer them.
Although neuroscience has made great strides in the past 15 to 20 years, we are still only capable of delaying decline and, primarily, treating Alzheimer’s patients’ day-to-day symptoms. In this context, we focus on improving the quality of life for people with Alzheimer’s disease. One promising way to do that is through music therapy. It’s often delivered by accredited music therapists, who have completed a university degree or certificate in music therapy, followed by a clinical internship. And it’s offered in long-term care homes, hospitals, schools, and day treatment programs. Studies from France and Israel have shown that Alzheimer’s patients who had music therapy experienced excitement and enjoyment, felt a sense of belonging, and had decreased anxiety and depression. Those are common problems: a recent meta-analysis cited 42 percent of people with Alzheimer’s had depression, and 39 percent also had anxiety.
There’s also an informal type of music therapy that’s gaining popularity: It involves people with Alzheimer’s listening to music on an iPod. In Ontario, the Alzheimer’s Society of Canada runs an initiative called the Music Project, which provides people with dementia with a free iPod pre-loaded with music of the participant or participant’s loved ones’ choosing. Other cities in Canada are also working on implementing this initiative.
The effects of this type of therapy can be seen in the award-winning documentary “Alive Inside: A Story of Music and Memory”. It follows as a social worker brings iPod shuffles to residents in nursing homes across the United States containing music they used to listen to (and loved) earlier in their lives. They begin smiling and bobbing their heads to the music. Others shed tears of joy.
Research into the use of personalized music is promising. Listening to preferred music for 30 minutes per session, twice per week for six weeks significantly reduced anxiety in those with dementia in a nursing home in Taiwan. Another study in those with Alzheimer’s disease found that listening to individualized music reduced agitation more than listening to relaxing music. A review of eight articles demonstrated that preferred music can reduce agitation in those with dementia.
Overall, the use of iPods with preferred music in those with Alzheimer’s appears to be a positive intervention if carried out with attention and care. While we are actively searching for medications to cure this disease, we should also be promoting interventions that help them have better day-to-day lives right now. Music therapy and personalized music through iPods are one way to do that.
*Identifying characteristics have been changed to protect the patient’s privacy