Music and Dementia
Dementia is a group of brain disorders that can cause memory loss, confusion, and mood changes. Alzheimer's is the most common type of dementia, and it happens when nerve cells in the brain are damaged, making it harder for the brain to communicate. However, studies show that music can have a positive impact on the symptoms of dementia. Live or pre-recorded music can help with agitation, anxiety, and depression while also improving language. Personalised playlists can also help reduce symptoms. Music stimulates movement and releases chemicals that promote positive emotions. Brain regions such as the frontal lobe, temporal lobe, and amygdala are activated during music processing. However, the effects of music can vary depending on the individual's disease stage and personal experiences. People with hearing loss are more susceptible to Alzheimer's, which suggests a connection between hearing and cognitive health.
Standardising music therapy protocols is a challenge because there are different types and stages of dementia. Empirical approaches to music therapy, guided by clinical observation and research on musical cognition, can help improve cognitive function and emotional well-being. Neurological Music Therapy (NMT) is a scientific approach where qualified therapists use musical elements such as rhythm and melody to engage patients. Combining scientific knowledge with musical expression is crucial to creating music that meets patients' needs. NMT is an excellent example of this approach, combining science and music to improve dementia care.
The Effectiveness of Original Music Composed for Dementia Care
This research project aims to investigate the effectiveness of original music in alleviating specific symptoms of dementia. There needs to be more scientific literature regarding the need to study the effects of original music composition further. While some studies have examined the impact of unfamiliar melodies on dementia patients by analysing their responses to musical elements such as rhythmic interruptions, initial research has shown promising results when testing original compositions in nursing homes. Engaging patients in songwriting, facilitated by music therapists, is a common practice that promotes cognitive stimulation and creativity. Clinical investigations have explored the impact of new songs on memory. However, there are still limitations in addressing different types of dementia. This project emphasises creating original music based on scientific principles to contribute to advancing scientific knowledge and redefining dementia care practices.
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The Therapeutic Power of Relaxing Music
Numerous scientific studies have highlighted the potential of relaxing music in alleviating agitation among individuals with dementia. Research conducted in nursing homes has shown that playing music during meals in senior facilities can calm residents with cognitive impairments. Research has found that music with a slow tempo between 80 and 100 beats per minute can help reduce agitated behaviours. Tempo is the most critical factor in relaxing patients, followed by melody and rhythm. Moreover, specific instruments like the piano and strings are more relaxing compared to percussion or brass instruments.
Meanwhile, vocals evoke memories and emotional responses. Personalised playlists have also demonstrated positive effects on dementia symptoms, such as reduced agitation and improved mood, suggesting a potential alternative without the presence of a music therapist. However, further research is needed to understand the diverse responses of patients, especially regarding different types of dementia.
The Influence of Familiarity in Dementia Care Music Therapy
The research explores the effects of familiar and unfamiliar music on dementia patients. Unfamiliar music may reduce attention and avoid negative memories, while familiar music stimulates the brain and enhances self-awareness. Some experts argue that rhythm is more important than familiarity. Studies show that familiar music activates the brain's frontal lobe.In contrast, unfamiliar music reduces activation in the frontal cortex. Familiar music can evoke both positive and negative memories. Creating original music may stimulate specific brain regions, promoting patient relaxation. Salvatore Petrone suggests that creating original music, perceived as unfamiliar, stimulates particular brain areas and induces less reactivity in patients, fostering relaxation.
The Influence of Musical Instruments in Dementia Care
Various musical instruments are crucial in enhancing dementia care through music therapy. Research indicates how specific instruments positively impact patients' well-being. Professionals in dementia care most frequently use specific musical instruments. The piano and strings, when played smoothly, offer a calming influence. The harp, known for its soothing tones, positively influences patients' blood pressure and pain levels. Ancient instruments like the lyre continue to find use in relaxation-focused therapy. A survey of musicians highlights associations between instruments and emotional qualities. For example, the harp is linked to beautiful, calm tones, while the flute evokes light sounds. Rhythm, primarily through percussion instruments, has positively impacted attention and patient responses. Salvatore Petrone's project selects instruments such as the piano, harp, flute, lyre, and strings to create relaxing music. Salvatore excluded percussion instruments that may stimulate movement to ensure a calm and tranquil experience for our patients.
Music for Dementia: Melody and Pitch at the Center of Composition
The perception of melody and note pitch, known as pitch, is crucial in music therapy for dementia. Variations in melody perception can be affected by note pitch, which may pose a challenge, especially for older adults or those with dementia. At the same time, the same melody can evoke different emotions. Research emphasises the importance of pitch, indicating that a linear structure with minimal note jumps is ideal for a relaxing melody. Researchers also highlight that metric structure and rhythmic accents are crucial in melody processing and memorisation. Syncopations in rhythm can introduce tension. Melodies can convey happiness, sadness, anger, and fear. Ascending melodies generate happiness, while the choice of song key is not as crucial for patient relaxation. In the early stages of Alzheimer's, patients often retain the ability to recognise familiar melodies, but memorising new melodies is challenging. This project aims to create new relaxing melodies with a narrow interval between notes and ascending notes to evoke positive moods in dementia patients.
The Influence of Timbre on Music Therapy for Dementia Care
Timbre is an essential element of sound that distinguishes different instruments and plays a critical role in music therapy for dementia care. The processing of timbre occurs in specific brain regions, which affects recognition and emotional responses. Although the connection between timbre and emotions is not fully understood, any changes made to it can have an impact on emotional reactions.
The timbre of an instrument influences the perception of tension or relaxation in music. Additionally, it has a significant impact on the pleasantness of the music. More complex timbres, where overtones overlap, can challenge our auditory system. Studies have also shown that complex spectral analysis of the sound of some musical instruments can evoke negative feelings.
Critiques of timbre studies have highlighted a need for more interdisciplinary research and limited participant diversity. Additionally, certain types of dementia, such as SD or PNFA, can hinder instrument recognition due to decreased brain regions.
Based on this research, the project's author chose softer timbres, such as the piano or harp (when played correctly), to create pleasant and accessible music for dementia patients.
Consonance and Dissonance in Music Therapy
The concept of consonance and dissonance in music is closely related to the overlapping of frequencies, known as "overtones" in English and "armonici" in Italian. Overtones refer to frequencies that complement the fundamental frequency of a note. For instance, overtones overlap when two or more adjacent notes are played simultaneously on the piano. In dissonant chords, this overlapping of complementary frequencies makes it challenging for the ear to identify the harmonics that appear close together, as the cochlear cells perceive.
PET scan studies reveal that the brain processes major and minor consonant chords differently. Major consonant chords induce a sense of happiness, while minor chords evoke sadness and intense emotions. Emotional responses to minor chords involve different brain regions than responses to major chords. People generally perceive consonant intervals and chords as pleasant, while dissonant ones are unpleasant. Recent research indicates that exposure to Western musical culture may influence this perception of consonance and dissonance and that it is less tied to a structural factor in our brains.
Insights from Expert
This section discusses the insights gathered from interviews with experts in music therapy for people with dementia. The conversations centred around creating new, relaxing music that can help alleviate symptoms, improve well-being, and address various dementia-related challenges.
Dan Cohen, the founder of the Music and Memory project, stresses the importance of personalised music in dementia treatment. Although he recognises the potential of original music, he also highlights the significance of a comprehensive approach. He encourages conducting research and raising awareness about how dementia affects musical perception in a complex way.
Dan Cohen is a prominent figure in the award-winning documentary 'Alive Inside', which won at the 2014 Sundance Film Festival. The film was aired on Netflix, Amazon Prime, and Vimeo Festival. Cohen's work involves using music as a form of therapy in nursing homes for the elderly, which has had a significant impact. The documentary showcases his dedication to music therapy for the elderly.
Concetta Tomaino is a pioneer in the field of music therapy. She believes that the quality of sound and the use of delicate instruments, such as the piano, are crucial in this therapy. Tomaino recommends avoiding harsh sounds and stresses the importance of slow rhythms. She also suggests carefully observing patients' reactions. Tomaino's contribution has significantly impacted the decision to prevent percussion rhythms, which can trigger epileptic seizures.
Sara Santini, the Sound Project leader, has emphasised music's positive effects on dementia symptoms. She highlights the emotional impact of music and its potential to stimulate reactions in individuals with dementia. According to Santini, electronic sounds may be challenging for older adults more familiar with classical music.
Conclusion: The expert interviews have shed light on the complex world of music therapy for dementia patients. They have highlighted the importance of a personalised and comprehensive approach focusing on sound quality, instrument selection, and emotional engagement to create effective interventions.
Analysis of Spotify Playlists
Salvatore examined 40 music tracks marketed as suitable for individuals with dementia. The tracks were selected from different playlists on Spotify, with the aim of gathering ideas and insights for composing new songs that can enhance the quality of life for people with dementia.
A detailed methodology was used to collect information from the selected music tracks and organise them into tables. This approach allowed for a thorough understanding of the music, guiding the creation of new songs in the project.
Surprisingly, the research revealed that many of the examined music tracks exhibited features contrary to those suggested by scientific research for people with dementia. The tracks were rough and not very calming, highlighting the need for more careful criteria in selecting music for this audience. To protect privacy, we cannot disclose the names of these music tracks.
Conclusion: The analysis of 40 music tracks for relaxation in individuals with dementia yielded significant findings. While some tracks did not achieve the expected level of relaxation, this study motivated the author to compose new music that is better suited for individuals with dementia. It highlights the significance of selecting appropriate music for people with dementia to aid them in feeling peaceful and relaxed.
Exploring Sound Quality with Spectral Analysis in Cubase 12
Salvatore used spectral analysis in Cubase 12 to investigate how musical instruments create sound. The overlapping of overtones is crucial in shaping the perception of sound, resulting in the development of a timbre known as "rough." Our auditory system's cochlea struggles to differentiate between frequencies that are very close together. The graph illustrates that rough sounds produce a less distinct and more dense spectrogram than soft-toned sounds.
Furthermore, the following figure demonstrates a possible approach for developing music for individuals with various forms of dementia.
Music Creation Strategy for Dementia
Salvatore intends to utilize different strategies to create music for various types of dementia, as suggested by the scientific literature. Personalized music tailored to the specific type of dementia can result in positive effects.
Music Experiment with Individuals Affected by Dementia
Salvatore carried out a study to examine the potential impact of original musical pieces on individuals with dementia. The study had some limitations due to the absence of standard protocols, limited resources, and the need for a control group. The research involved patients with various types of dementia, all in the early or intermediate stages of the disease. Five patients participated in two music sessions held in the same week. Cognitive and psychological responses, such as memory, mood, and vital parameters like blood pressure and oxygenation, were observed before and after each session. During the sessions, patients wore headphones in a quiet room to avoid distractions.
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Data Analysis
The analysis of the study's data has shown that the patients had positive outcomes. Approximately 60% of the patients showed improvement in their mood and communication skills. During the sessions, the patients displayed non-violent and non-aggressive behaviours, which is a positive sign. The observations were interesting from a physiological perspective as well, as there was an increase in blood oxygenation and body temperature, which aligns with the relaxing effects of music. However, there was an unexpected slight increase in systolic and diastolic blood pressure, contrary to the expected decrease in blood pressure caused by relaxing music. Recent research has highlighted that listening to music can result in a temporary increase in blood pressure due to the pleasure it brings.
Objective Evaluation of Results
Salvatore Petrone shared that working on this project has been an invaluable experience, despite the challenges presented due to limited research on music and therapy. As a musician and researcher, he had to balance creativity with adherence to guidelines, resulting in enjoyable music even for those unaffected by dementia. However, the study had some limitations, including a lack of differentiation between types of dementia and the use of non-standard protocols. Nevertheless, creating these relaxing musical pieces represents a significant development in composing music for individuals affected by dementia. This scientific approach aligns with the principles of Neurologic Music Therapy, which uses music to stimulate the brain and enhance the patient's well-being.
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