Music and its Influence on the Cognitive Abilities of Alzheimer’s Patients

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Alzheimer’s is a degenerative disease, in which there is a gradual decrease in memory function, intellectual abilities and a change in personality occurs (APA, n.d.).  In the early stages of the disease, patients often lose the ability to remember and retain new information. In later stages they lose the ability to think, speak and do basic tasks such as brushing ones teeth (APA, n.d.). Alzheimer’s has also become the most common and prevalent form of dementia, in adults over the age of 65 (Passer, Smith, Atkinson, Mitchell and Muir, 2011). Currently there are half a million Canadians with the disease, and it is expected to increase to 1.1 million people by 2035 (Passer et. al., 2011). A wide variety of research is currently being conducted on the disease to find a cure, because of the increasing risk the disease poses on individuals psychological, social and physical well being continues to increase. Recent studies have suggested Alzheimer’s patients having a stronger likelihood to remember new information when it is provided in the context of music. These studies support the idea that the memory of Alzheimer’s patients is affected by music, regardless of familiarity and distortion.

Ashley Vanstone and Lola Cuddy examined the notion of whether the brains of patients with Alzheimer’s are able to preserve memories through music. Using 12 patients with Alzheimer’s ranging from moderate to severe, as well as 12 healthy control participants, Vanstone and Cuddy were able to examine the memory of all 24 participants. Throughout the experiment, participants were exposed to familiar songs, and were asked to identify any distortions in the melodies, and were asked to sing along to the familiar songs. In this study, a Familiarity Decision Test (FDT) was designed containing 10 familiar melodies and 10 novel melodies, participants were asked to determine whether the song was familiar or not. All participants were prompted to sing the melodies of four familiar tunes using the first phrase of the four songs. The rendition of the melody was deemed correct when the rhythm and general melodic contour was deemed recognizable. Thus, the basic goal of the task was to determine whether the participant could produce the tune in an accurate manner during the experiment.  The second category, the novel songs, was created using distorted melodies. This was created through reversal of the sequence of pitches making them unrecognizable. The second method of testing involved the use of a “distorted tunes test”, which required participants to assess and identify incorrect pitches of 26 short familiar melodies (Vanstone and Cuddy, 2009). This portion of the experiment was measured on whether the participant deemed the melody correct or incorrect and whether or not the melody was familiar to create a distorted tunes test recognition score (DTTREC). Another method used in the experiment, involved the use of an Unfamiliar Distorted Tunes Test (UDDT), which Vanstone formed as an analogue to the DDT test (Vanstone and Cuddy, 2009). This method involved using unfamiliar tunes prompting the participant to specify whether or not the melody was distorted. Twenty brief novel melodies were created, 10, which followed Western stylistic norms while the other 10 songs, contained pitch distortions. Through this experiment, the participant was given a starting pitch as a reference point, as well as two trials to give an example of what a distorted novel song sounded like. The entire experiment was presented in the form of the FDT test, the lyrics prompt test, the DDT test and the UDTT test (Vanstone and Cuddy, 2009).

Nicholas Simmons-Stern, Andrew Budson and Brandon Ally focused their study on trying to enhance the memory of Alzheimer’s patients to learn new information. The experimental design included testing their memories using lyrics of children’s songs with repetitive melodies. The study also included the use of lyrics placed on computer screens, as well as using 13 patients with Alzheimer’s and 14 healthy control participants with no familial history for comparison. During the study, participants were tested using two mechanisms: having the lyrics read to them and having the lyrics sung with musical accompaniment. . The stimuli used in the study consisted of using four line excerpts from a group of 80 children’s songs from children’s music databases. All songs selected for the study were subjected to a prescreening test to insure all songs were simple, had repetitive melodies and were unfamiliar to participating patients. However, the four lines from the excerpted song also had to include a “perfect tail rhyme scheme” (Simmons- Stern, Budson and Ally, 2010). The stimuli were further broken down into sung and spoken versions of each song, both of which had the same vocal speeds for the corresponding songs. For more concise examination the songs were broken down into four categories, which consisted of: total words, sung recording length, spoken recording length and expected years of education necessary for text comprehension. Each participant was presented with 40 song excerpts, and the four line lyrics were present on a laptop for the entire session. The session was then further broken down into 20 songs presented with musical accompaniments and the other 20 being spoken version of the songs. Each song used during the sessions was repeated twice in consecutive order. The results of the study were then used to evaluate the differences in memory performance during the sung and spoken conditions when comparing the control group and Alzheimer’s group (Simmons-Stern, et. al., 2010).

The two journals studied the common area of determining what the extent music plays in enhancing memories in patients with Alzheimer’s disease. Vanstone and Cuddy’s experiment saw a range of musical memory across the spectrum of Alzheimer’s the participants. Some participants with the moderate or severe form of the disease showed normal abilities with their musical abilities, others showed partial ability to acknowledge familiar tunes and perform some tasks.   In some cases, the participant did not meet the normal levels despite engaging in the tasks. Overall, the data collected showed that the Alzheimer’s participants performed significantly lower in comparison to the control group. However, when the researchers examined individual cases of the participants, it became evident that there was a high degree of variability in musical memory functioning.  Lastly, the researchers acknowledge that due to the small sample size, the study was not able to determine the degree of preserved musical ability in patients with Alzheimer’s disease. The results only conformed to the notion that this phenomenon is most likely not uncommon in the general population. Both journals used similar approaches in terms of engaging the participant with music and examining the melodies of each song. However, major difference stem in the notion that one study allowed for familiar tunes and analyzing distorted melodies, while the second study focused on unfamiliar melodies. The second study also added another variable, using spoken and musical accompaniment as the two manipulated variables for the experiment in testing the same area of interest in Alzheimer’s patient. Overall, Simmons- Stern and his peers focused on whether music could be used to enhance memory, and the extent to which it plays in recognition of verbal information in both groups of patients. However, unlike the first journal, the Simmons- Stern and his colleagues were able to confirm their hypothesis that patient with Alzheimer’s disease performed better on a task using background music in comparison to spoken lyrics without music (2010).  The findings suggest that music involves more diversified encoding that requires use from many different parts of the brain, such as the cerebellum, hypothalamus, and nucleus accumbens, creating a complex and diversified neural network (Simmons- Stern et. al., 2010).  Therefore “music and sung recordings may create a more robust association at encoding than do stimuli accompanied by only a spoken recording” in patients diagnosed with Alzheimer’s disease (Simmons- Stern et. al., 2010).  Many of the areas associated in encoding and retrieving information from music are also affected at a slower rate in comparison to areas of the brain normally associated with memory, notably “the cortical areas such as the medial prefrontal cortex and orbitofrontal cortex” (Simmons- Stern et. al., 2010).   They also noted that in the healthy control group, no benefit occurred when music was used suggesting that the encoding and retrieval processes for musical and non- musical processes differ in healthy adults in comparison with Alzheimer’s patients. Overall, in comparison to the first journal, Simmons- Stern and his colleagues gave a stronger insight into the role that music has in patients with Alzheimer’s and why this phenomenon may occur.
Thus, experiments with music and Alzheimer’s patients may lead to further studies to examine how memories may be preserved or retrieved and providing a diagnostic progression for the disease. In conclusion, further studies will need to be conducted in order to formulate a more conclusive relationship between music and memory in Alzheimer’s patients. There is not enough data to thoroughly conclude that the memory of Alzheimer’s patients is consistent when music is added into the equation. However based on the data researched from the two journals, there does seem to potentially be a link between the two variables with the second journal being more supportive of music playing a role in the memory of Alzheimer’s patients. In conclusion, the two journals have given insight into how patients with Alzheimer’s disease can potentially be taught novel information using music to present everyday information and in developing more effective therapy treatments.

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Works Cited

Alzheimer’s Disease  . (n.d.). American Psychological Association (APA) .  Retrieved November
23, 2011, from
http://www.apa.org/topics/alzheimers/index.aspx

Passer, M. W., Smith, R. E., Atkinson, M. L., Mitchell, J. B., & Muir, D. W. (2011).  Memory.
Psychology: frontiers and applications (Fourth Canadian Edition ed., p.  300). United States
of America: McGraw- Hill Ryerson.

Simmons-Stern, N. R., Budson, A. E., & Ally, B. A. (2010). Music as a memory enhancer in
patients with Alzheimer’s disease. Neuropsychologia, 48(10), 3164-3167 . Retrieved
November  24, 2011,
from DOI:10.1016/j.neuropsychologia.2010.04.033
Vanstone, A. D., & Cuddy, L. L. (2009). Musical memory in Alzheimer disease. Aging,
Neuropsychology, and Cognition
, 17(1), 108-128. Retrieved November 22, 2011, from
DOI:10.1080/13825580903042676