Music and Dementia
Dementia is a collection of brain disorders, with Alzheimer's being the most prominent among them, which disrupt brain function, leading to memory loss, confusion, and mood changes. Emerging scientific research demonstrates the positive impact of music in alleviating specific symptoms of dementia. Alzheimer's disease, the most prevalent form of dementia, results from nerve cell damage that impairs brain communication. Studies reveal that live or pre-recorded music can effectively address symptoms such as agitation, anxiety, and depression while improving speech. Tailored playlists designed for dementia patients also promise to reduce some disease symptoms. Music triggers movement and releases chemicals like dopamine and endorphins, fostering positive emotions. Research highlights the activation of brain regions, including the Frontal Lobe, Temporal Lobe, and Amygdala, during music processing. However, the subjectivity of dementia, the disease stage, and personal experiences influence the varying effects of music on patients. Individuals with hearing loss are more susceptible to Alzheimer's, indicating an intriguing connection between hearing and cognitive health.
Standardizing music therapy protocols remains challenging, especially considering the various types and stages of dementia. Empirical music therapy approaches, guided by clinical observation and research on music cognition, offer potential benefits in improving patients' cognitive function and emotional well-being. The emergence of Neurologic Music Therapy (NMT) introduces a scientific dimension, where qualified therapists use brain stimulation techniques using musical elements such as rhythm and melody to engage patients. The fusion of scientific research and musical composition is crucial in creating music that addresses patients' physiological and psychological needs. NMT is an exemplary model, merging scientific knowledge with musical expression to enrich dementia care.
Unlocking the Potential of Composed Music for Dementia Care
This research project explores the creation of original music aimed at alleviating some symptoms of dementia. A noteworthy gap in existing scientific literature highlights the need to examine further the creation of researched composed music.
Studies have examined the effects of unfamiliar melodies on dementia patients by analyzing their responses to rhythm breaks and other musical elements. Furthermore, an initial study attempted to test original compositions in nursing homes, resulting in promising outcomes.
Patient engagement in song composition, guided by music therapists, has emerged as a common practice, fostering cognitive stimulation and creativity. Clinical investigations have also explored the impact of novel songs on memory, albeit with certain limitations in addressing varying dementia types.
Given the current gap in research on this topic, this project underscores the significance of creating original music based on scientific principles. Such an approach not only contributes to advancing scientific knowledge but also holds the potential to reshape dementia care practices.
The Therapeutic Power of Relaxing Music
Numerous scientific studies highlight the potential of relaxing music to alleviate agitation among individuals with dementia. Research carried out in nursing homes shows that music played during meals in nursing facilities can have a calming effect on residents with cognitive impairment. Music with a slow tempo of 80-100 beats per minute can reduce agitated behaviour. The tempo is the most critical factor in relaxing patients, followed by melody and rhythm.
Additionally, specific instruments such as piano and strings are more calming than percussion or brass, while the voice evokes memories and emotional responses. Personalized music playlists have also demonstrated positive effects on dementia symptoms, such as reducing agitation and improving mood, suggesting a potential alternative without a music therapist. However, further research is needed to understand different patient responses, particularly regarding different types of dementia. Although some studies report conflicting results, relaxing music has demonstrated effectiveness in nursing homes.
The Influence of Familiarity in Dementia Care Music Therapy
Research delves into the effects of familiar and unfamiliar music on dementia patients. Unfamiliar music can reduce attention and avoid negative memories. Familiar music stimulates the brain and improves self-awareness. However, some experts argue that pace is more crucial than familiarity. Functional MRI studies show that familiar music activates the frontal lobe, while unfamiliar music reduces activation in the frontal cortex. Familiar music can evoke both positive and negative memories. Creating original music could stimulate specific brain regions, promoting patient relaxation.
Salvatore Petrone believes that creating original music, perceived as unfamiliar music, has advantages in stimulating specific brain areas and inducing less reactivity in patients, promoting relaxation.
The Influence of Musical Instruments in Dementia Care
Diverse musical instruments are crucial in enriching dementia care through music therapy. Research sheds light on how different instruments can positively impact patients' well-being.
Studies indicate that drums can have a beneficial effect on individuals with dementia, promoting movement and activity. Exposure to various musical instruments, including percussion like djembe, claves, paddle drum, and maraca, yields varied reactions among Alzheimer's patients. Music therapists often favour instruments such as the voice, piano, woodwinds, and strings.
In dementia care, professionals more frequently utilize specific musical instruments. The piano and strings, when played legato, offer a calming influence. The harp, known for its soothing tones, has been found to affect patients' blood pressure and pain levels positively. Ancient instruments like the Lyre continue to find use in relaxation-focused therapy.
Surveying musicians highlights associations between instruments and emotional qualities. For instance, the harp is linked to beautiful, calm tones, while the flute evokes airy sounds. Rhythm, mainly through percussion instruments, has positively affected patients' attention and responses.
The project's approach selects instruments such as the piano, harp, flute, Lyre, and strings for crafting relaxing music. Percussion instruments, which might trigger movement, are purposefully excluded to ensure a tranquil experience for patients.
Crafting Relaxing Melodies for Dementia Care
Perception of melody, pitch, and key are crucial in creating effective music therapy for dementia care. Variations in melody perception are influenced by pitch, with higher pitches posing more significant challenges for distinction. The same melody can evoke diverse moods and effects in individuals.
Research emphasises pitch's role in perception, suggesting a linear structure with minimal pitch jumps for a relaxing melody. However, researchers also emphasise meter structure and rhythmic accents for elaboration and memorisation. Syncopations in rhythm can introduce tension.
Melodies effectively convey emotions like happiness, sadness, anger, and fear. The proposal suggests that ascending melodies generate happiness, dismissing tonality as a crucial factor for relaxation.
Early-stage Alzheimer's patients often retain the capacity to recognise familiar and general melodies. However, novel melody memorisation proves challenging.
This research suggests crafting new relaxing melodies with minimal pitch intervals and ascending notes to evoke positive moods and aid pitch distinction for dementia patients.
Timbre's Influence on Dementia Care Music Therapy
Timbre, the distinct quality of sound that helps differentiate instruments, plays a vital role in music therapy for dementia care. Its processing occurs in specific brain regions, impacting recognition and emotional responses. Although we do not fully understand the link between timbre and emotions, making modifications through ADSR envelope alterations can affect emotional reactions.
An instrument's timbre contributes to the perception of tension or relaxation in music. It also influences music's pleasantness degree and can pose challenges for our auditory system when frequencies overlap. Studies comparing timbres' emotional impact show that complex spectral analysis can evoke negative feelings.
Critiques of studies on timbre highlight gaps in interdisciplinary research and limited participant diversity. Dementia types like SD or PNFA can hinder instrument recognition due to declining brain regions.
Given this research, the project's author opts for instruments with smoother timbre, like the piano or harp, to craft pleasant and accessible music for dementia patients.
Consonance and Dissonance in Music Therapy
The concept of consonance and dissonance in music arises when multiple notes are played, depending on whether there is an overlapping or lack of overlapping audio frequencies. For example, in the case of consonant chords, there is no overlapping of audio frequencies that would generate an overlap of frequencies that could be challenging to decipher by our ear and, more specifically, by the cochlear cells. PET scan studies reveal distinct brain processing for consonant major and minor chords. Consonant major chords evoke happiness, while minor chords elicit sadness and strong emotions.
Emotional responses to minor chords engage different brain regions than major chords. People generally find consonant intervals and chords pleasing, while they perceive dissonant ones as unpleasant.
Recent research suggests that exposure to Western musical culture may influence this perception rather than brain structure.
Considering this, the project uses non-dissonant major and minor chords to engage multiple brain areas in music therapy.
Insights from Expert
This part discusses insights gained from interviews with experts in music therapy for individuals with dementia. The interviews focused on creating new, relaxing music to alleviate symptoms and enhance well-being.
Dan Cohen's Perspective: Dan Cohen, founder of the Music and Memory project, emphasizes personalized music for dementia treatment. While he recognizes the potential of original music, he also highlights the importance of a holistic approach, encouraging research while acknowledging the complexity of dementia's impact on music perception.
Concetta Tomaino's Insights: Concetta Tomaino, a pioneering music therapist, stresses the significance of sound quality and gentle instruments like the piano. She advises against harsh sounds, emphasizes slow rhythms, and suggests careful observation of patient reactions. Tomaino's input influenced the decision to avoid percussion rhythms to prevent seizures.
Sara Santini's Expertise: Sara Santini, leading the Sound Project, underscores music's positive effects on dementia symptoms. She highlights the emotional impact of music and its potential as a trigger for reactions. Santini also believes electronic sounds are potentially challenging for an elderly generation more familiar with classical music.
Conclusion: These expert interviews provide valuable insights into the intricate world of music therapy for dementia. They highlight the need for a personalized, holistic approach, emphasizing the role of sound quality, instrument choice, and emotional engagement in creating effective interventions.
Learning from Calming Music for Dementia:
This study looked at 40 calming music tracks designed for people with dementia. The author carefully examined these tracks from different Spotify playlists. The goal was to get ideas and useful information for creating new songs to help people with dementia.
How the Study Was Done: The author collected information from the chosen music tracks and organized it into tables. This helped me understand the music better and guided the creation of new songs for the project
Surprising Discoveries: The research uncovered something unexpected. Some of the music tracks that were intended to be relaxing had characteristics that were not adequately suitable for individuals with dementia. They were rough and not soothing. For privacy reasons, we will not disclose the names of these pieces of music.
Conclusion: Examining 40 calming music tracks for dementia provided valuable insights. While some tracks did not deliver the expected level of relaxation, this research inspired the author to create new, more suitable music for individuals with dementia. It underscores the significance of choosing the right music for people with dementia to help them experience a sense of calm and peace.
Exploring Sound Quality with Spectral Analysis in Cubase 12
Spectral analysis in Cubase 12 examined how various musical instruments produce sound. Different audio frequencies blend and can make it difficult to discern, impacting sound quality. This critical bandwidth can result in rough sound.
In this project, we used spectrograms to investigate musical instruments. The objective was to identify instruments that produce smoother, less dissonant sounds. The analysis revealed that rough sounds exhibit overlapping overtones and greater energy across multiple frequencies, leading to a messy spectrogram pattern.
Music Creation Strategy for Dementia
The project's author can 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
To "validate" the potential effects of these original musical pieces on individuals affected by dementia, the researchers conducted a clinical study. The clinical study had limitations due to the absence of standard protocols, limited resources, and the need for a control group. They included different types of dementia in the analysis. The patients were in the early stages of dementia, allowing for conversation engagement.
The researchers experimented with five patients, subjecting them to two music sessions within a week. They measured vital signs before and after each session, along with observing cognitive and psychological aspects. The patients wore headphones in a quiet room to avoid distractions.
Data Analysis
The study's data analysis revealed positive outcomes for patients. A notable 60% of patients demonstrated improved mood and communication abilities, with many finding solace in the soothing piano sound.
Throughout the sessions, patients displayed non-violent and non-aggressive behaviours, constituting a positive result. Physiologically, the observations were exciting. Blood oxygenation increased, and body temperature rose, aligning with the relaxing effects of the music. However, an unexpected increase in systolic and diastolic blood pressure occurred.
Recent studies emphasize that the enjoyment and pleasure of music may lead to a temporary increase in blood pressure.
While overall responses were positive and elicited happiness, one emotional response was worth noting. A patient started crying approximately an hour after listening to the music, a significant event as the patient's daughter had never witnessed this emotional expression before. Including music in a minor key could have triggered this response, evoking feelings of sadness despite its beauty.
Objective Evaluation
Salvatore stated, "Working on this project was a valuable experience, although it presented challenges due to the limited research on music and therapy. As a musician and researcher, I had to balance creativity with following guidelines, and the music we created is considered pleasing."
The study had limitations, such as the lack of differentiation between dementia types and using non-standard protocols. Patients' fragile conditions required careful planning, considering their habits and caregivers' input.
Despite these challenges, this project represents an essential step in research-based music. It adheres to a scientific approach and aligns with Neurologic Music Therapy principles, which utilize music to stimulate the brain and enhance patient well-being.
References
ALDRIDGE, D. et al. (2004) An overview of Music Therapy Research, Complementary Therapies in Medicine. Available at: https://www.sciencedirect.com/science/article/abs/pii/0965229994900213 (Accessed: 10/5/ 2023).
BAIRD, A., GARRIDO, S. & TAMPLIN, J. 2019. Music and dementia: From cognition to therapy, Oxford University Press.
BAIRD, A., GARRIDO, S. AND TAMPLIN, J. (2020) Music and dementia: From cognition to therapy. New York, NY, US: Oxford University Press.
CEVASCO, A. M. & GRANT, R. E. 2006. Value of musical instruments used by the therapist to elicit responses from individuals in various stages of Alzheimer's disease. Journal of Music Therapy, 43, 226-246.
CHIASSON, A. M., LINDA BALDWIN, A., MCLAUGHLIN, C., COOK, P. & SETHI, G. 2013. The effect of live spontaneous harp music on patients in the intensive care unit. Evidence-Based Complementary and Alternative Medicine, 2013.
CLAIR, A. A., BERNSTEIN, B. & JOHNSON, G. 1995. Rhythm playing characteristics in persons with severe dementia including those with probable Alzheimer's type. Journal of music therapy, 32, 113-131.
COUNSELING SERVICE (2023) Releasing stress through the power of Music: Counseling Services, University of Nevada, Reno. Available at: https://www.unr.edu/counseling/virtual-relaxation-room/releasing-stress-through-the- power-of-music (Accessed: 23 May 2023).
COUSINEAU, M., McDermott, J.H. and Peretz, I. (2012) ‘The basis of musical consonance as revealed by congenital amusia’, Proceedings of the National Academy of Sciences, 109(48), pp. 19858–19863. doi:10.1073/pnas.1207989109.
CUDDY, L., BELLEVILLE, S. & MOUSSARD, A. 2020. Music and the Aging Brain, Academic Press.
ELLIOT, D., POLMAN, R. AND MCGREGOR, R. (2011). Relaxing music for anxiety control. Journal of Music Therapy, 48: 264288.
ELLIOTT, D., POLMAN, R. & MCGREGOR, R. 2011. Relaxing music for anxiety control. Journal of music therapy, 48, 264-288.
FARBOOD, M.M. AND PRICE, K.C. (2017) “The contribution of timbre attributes to musical tension,” The Journal of the Acoustical Society of America, 141(1), pp. 419– 427. Available at: h#ps://doi.org/10.1121/1.4973568.
GARCÍA-CASARES, N., TORRES, M. B., WALSH, S. F. & GONZÁLEZ- SANTOS, P. 2013. Model of music cognition and amusia. Neurología (English Edition), 28, 179-186.
GARRIDO, S., DUNNE, L., CHANG, E., PERZ, J., STEVENS, C. J. & HAERTSCH, M. 2017. The use of music playlists for people with dementia: A critical synthesis. Journal of Alzheimer's disease, 60, 1129-1142.
JUDAH (2018) Study shows that listening to music is relaxing and healing, Ditmas Park. Available at: https://ditmasrehab.com/study-shows-that-listening-to-music-is- relaxing-and-healing/ (Accessed: 03 June 2023).
GARRIDO, S., STEVENS, C. J., CHANG, E., DUNNE, L. & PERZ, J. 2018. Music and dementia: individual differences in response to personalized playlists. Journal of Alzheimer's Disease, 64, 933-941.
GARRIDO, S., STEVENS, C. J., CHANG, E., DUNNE, L. & PERZ, J. 2019. Musical features and affective responses to personalized playlists in people with probable dementia. American Journal of Alzheimer's Disease & Other Dementias®, 34, 247- 253.
GERDNER, L.A. (2000) ‘Effects of individualized versus classical “relaxation” music on the frequency of agitation in elderly persons with alzheimer’s disease and related
disorders’, International Psychogeriatrics, 12(1), pp. 49–65. doi:10.1017/s1041610200006190.
GERDNER, L.A. (2009) “Top cited papers in international psychogeriatrics: 4. effects of individualized vs. classical ‘relaxation’ music on the frequency of agitation in elderly persons with Alzheimer's disease and related disorders,” International Psychogeriatrics, 21(4), pp. 667–671. Available at: h#ps://doi.org/10.1017/s1041610209008771.
GODDAER, J. AND ABRAHAM, I.L. (1994). Effects of relaxing music on agitation during meals among nursing home residents with severe cognitive impairment. Archives of Psychiatric Nursing, 8: 150–158.
GOLDEN, H.L. et al. (2017) ‘Music perception in dementia’, Journal of Alzheimer’s Disease, 55(3), pp. 933–949. doi:10.3233/jad-160359.
HAIGH, C., DUNKERLEY, J. AND ROGERS, M. (2021) Classical recording: A practical guide in the Decca tradition. Abingdon, Oxon, USA: Routledge, Taylor & Francis Group.
GROUSSARD, M. et al. (2019) Preservation of musical memory throughout the progression of alzheimer’s disease? toward a reconciliation of theoretical, clinical and neuroimaging evidences, Journal of Alzheimer’s Disease. Available at: https://www.hal.inserm.fr/inserm-02094132 (Accessed: 22 May 2023).
HAILSTONE, J. C., OMAR, R., HENLEY, S. M., FROST, C., KENWARD, M. G. & WARREN, J. D. 2009. It's not what you play, it's how you play it: Timbre affects perception of emotion in music. Quarterly journal of experimental psychology, 62, 2141-2155.
HALLAM, S., CROSS, I. & THAUT, M. 2011. Oxford handbook of music psychology, Oxford University Press.
HERNANDEZ-RUIZ, E. ET AL. (2018) ‘What makes music relaxing? an investigation into musical elements’, Psychology of Music, 48(3), pp. 327–343. doi:10.1177/0305735618798027.
HICKS-MOORE, S. AND ROBINSON, B. (2008) ‘Favorite Music and hand massage’, Dementia, 7(1), pp. 95–108. doi:10.1177/1471301207085369.
HO, S.-Y., LAI, H.-L., JENG, S.-Y., TANG, C.-W., SUNG, H.-C. & CHEN, P.-W. 2011. The effects of researcher-composed music at mealtime on agitation in nursing home residents with dementia. Archives of psychiatric nursing, 25, e49- e55. Increased functional connectivity after listening to favored music in adults with Alzheimer dementia. The journal of prevention of Alzheimer's disease, 6, 56-62. International, 2013, pp. 1–10. doi:10.1155/2013/752965.
JERNIGAN, C. (2021) The science behind the sound (music therapy and our brains), Incadence Music Therapy Blog. Available at: https://www.incadence.org/post/the- science-behind-the-sound-music-therapy-and-our-brains?utm_source=pocket_saves (Accessed: 28 April 2023).
JOHNSON, R. & TAYLOR, C. 2011. Can playing pre-recorded music at mealtimes reduce the symptoms of agitation for people with dementia? International journal of therapy and rehabilitation, 18, 700-708.
JUSLIN, P. N. 2019. Musical emotions explained: Unlocking the secrets of musical affect, Oxford University Press, USA.
KING, J., JONES, K., GOLDBERG, E., ROLLINS, M., MACNAMEE, K., MOFFIT, C., NAIDU, S., FERGUSON, M., GARCIA-LEAVITT, E. & AMARO, J. 2019.
LINEWEAVER, T. T., BERGESON, T. R., LADD, K., JOHNSON, H., BRAID, D., OTT, M., HAY, D. P., PLEWES, J., HINDS, M. & LAPRADD, M. L. 2022. The effects of individualized music listening on affective, behavioral, cognitive, and sundowning symptoms of dementia in long-term care residents. Journal of Aging and Health, 34, 130-143.
MCDERMOTT, O., ORRELL, M. and RIDDER, H.M. (2015) The development of music in Dementia Assessment Scales (MIDAS), Nordic journal of music therapy. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487595/?utm_source=pocket_saves (Accessed: 01 May 2023).
MEDICINE (2023) Associations between mental health and Blood Pressure, How high blood pressure affects mental health | Max-Planck-Gesellschaft. Available at: https://www.mpg.de/20163652/0413-nepf-how-high-blood-pressure-affects-mental- health-149575-x?utm_source=pocket_saves (Accessed: 20 May 2023).
MIR, I.A. et al. (2021) Relaxing music reduces blood pressure and heart rate among pre-hypertensive young adults: A randomized control trial, Journal of clinical hypertension (Greenwich, Conn.). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8029898/ (Accessed: 24 May 2023).
MOAWAD, , H., Berry, J. and Akers , A.S. (2023) Endorphins: Effects and how to boost them, Medical News Today. Available at: https://www.medicalnewstoday.com/articles/320839 (Accessed: 28 April 2023).
MORENO-MORALES, C., CALERO, R., MORENO-MORALES, P. & PINTADO, C. 2020. Music therapy in the treatment of dementia: A systematic review and meta- analysis. Frontiers in medicine, 7, 160.
NEUROLOGIC MUSIC THERAPY SERVICES OF ARIZONA (no date) NMTSA. Available at: https://www.nmtsa.org/ (Accessed: 18 May 2023).
PEREIRA, C. S., TEIXEIRA, J., FIGUEIREDO, P., XAVIER, J., CASTRO, S. L. & BRATTICO, E. 2011. Music and emotions in the brain: familiarity matters. PloS one, 6, e27241.
PROVENZA, A. (2014) “Soothing lyres and epodai: Music therapy and the cases of Orpheus, Empedocles and david,” Music in Antiquity, pp. 298–339. Available at: h#ps://doi.org/10.1515/9783110340297.298.
REMINGTON, R. (2002). Calming music and hand massage with agitated elderly. Nursing Research, 51: 317–323.
REYMORE, L. & HURON, D. 2020. Using auditory imagery tasks to map the cognitive linguistic dimensions of musical instrument timbre qualia. Psychomusicology: Music, Mind, and Brain, 30, 124.
SARITAŞ, S.Ç. AND ARAÇ, B. (2016) The effect of music therapy on the vital signs of patients in a Surgical Intensive Care Unit, International Journal of Medical Investigation. Available at: http://intjmi.com/article-1-227-en.html (Accessed: 21 May 2023).
SCHAFFEL, V.M.- (2017) Why some songs make us cry, NBCNews.com. Available at: https://www.nbcnews.com/better/health/why-do-certain-songs-make-us-cry- ncna784801?utm_source=pocket_saves (Accessed: 29 May 2023).
SCHNECK, D. J. & BERGER, D. S. 2005. The music effect: Music physiology and clinical applications, Jessica Kingsley Publishers.
SENIOR, M. (2008) The SOS Guide To Capturing A Great Acoustic Piano Sound, Piano Recording. Available at: https://www.soundonsound.com/techniques/piano- recording (Accessed: January 4, 2023).
SHAHINFARD, E. et al. (2016) ‘P4‐042: An FMRI study to investigate the benefits of music therapy in patients with alzheimer’s disease’, Alzheimer’s & Dementia, 12(7S_Part_21). doi:10.1016/j.jalz.2016.06.2131.
SLATTERY, C. F., AGUSTUS, J. L., Paterson, R. W., et al. (2019). The functional neuroanatomy of musical memory in Alzheimer's disease. Cortex; A Journal Devoted to the Study of the Nervous System and Behavior, 115, 357-370. https://doi.org/10.1016/j.cortex.2019.02.003.
SLOBODA, J. 2005. Exploring the musical mind: Cognition, emotion, ability, function, Oxford University Press.
SOUND PROJECT: Music to improve the quality of life of older people with dementia (2022) Sound. Available at: https://soundeuproject.eu/2022/06/07/sound- project-music-to-improve-the-quality-of-life-of-older-people-with-dementia/ (Accessed: January 3, 2023).
SUZUKI, M., OKAMURA, N., KAWACHI, Y., TASHIRO, M., ARAO, H., HOSHISHIBA, T., GYOBA, J. & YANAI, K. 2008. Discrete cortical regions associated with the musical beauty of major and minor chords. Cognitive, Affective, & Behavioral Neuroscience, 8, 126-131.
TABLOSKI, P.A., MCKINNON-HOWE, L. AND REMINGTON, R. (1995). Effects of calming music on the level of agitation in cognitively impaired nursing home residents. The American Journal of Alzheimer’s Care and Related Disorders and Research, 10 (1): 10–15.
TAYLOR AND FRANCIS (2017) The routledge companion to embodied music interaction. London, Uk: Routledge.
THAUT, M. AND HÖMBERG, V. (2016) Handbook of Neurologic Music therapy. Oxford, Uk: Oxford University Press.
THOMAS, K.S. et al. (2017) ‘Individualized music program is associated with improved outcomes for U.S. nursing home residents with dementia’, The American Journal of Geriatric Psychiatry, 25(9), pp. 931–938. doi:10.1016/j.jagp.2017.04.008.
THOMPSON, W. F. 2015. Music, thought, and feeling: Understanding the psychology of music, Oxford university press.
UNIVERSITY OF CENTRAL FLORIDA (2019) Music and the brain: What happens when you’re listening to music, Pegasus Magazine. Available at: https://www.ucf.edu/pegasus/your-brain-on-music/?utm_source=pocket_saves (Accessed: 28 April 2023).
TURRILL, K. (2018) High blood pressure: Listening to this music can lower hypertension, Express.co.uk. Available at: https://www.express.co.uk/life- style/health/900440/high-blood-pressure-symptoms-lower-listening-to-music (Accessed: 22 May 2023).
VOYAJOLU, A. (2009). The use of the music therapist's principal instrument in clinical practice. Unpublished master's thesis, Montclair State University.
WEI, Y., GAN, L. AND HUANG, X. (2022) “A review of research on the neurocognition for timbre perception,” Frontiers in Psychology, 13. Available at: h#ps://doi.org/10.3389/fpsyg.2022.869475.
WEISS, MICHAEL W., CIRELLI, LAURA K., MCDERMOTT, JOSH H., TREHUB, SANDRA E. (2020) “Development of consonance preferences in western listeners.,” Journal of Experimental Psychology: General, 149(4), pp. 634–649. Available at: h#ps://doi.org/10.1037/xge0000680.
WHEELER, B.L. (2005) Music therapy research. 2 Edition. Gilsum,, USA: Barcelona Publishers.
WHEELER, B.L. (2014) The importance of research in educating about music therapy, Voices. Available at: https://voices.no/index.php/voices/article/view/2231/1986?utm_source=pocket_saves (Accessed: 28 April 2023).
YANNOU, D., BALOYIANNIS, S., KOSTARIDOU-EUKLEIDES, A., KLONARU, D., NAKOPOULOU, E. AND TZEDAKI, K., 2003, September. Music perception in patients with dementia due to Alzheimer’s disease. In Proceedings of the 5th Triennial ESCOM Conference (No. IKEECONF-2014-802). Aristotle University of Thessaloniki.
ZIV, N. AND DOLEV, E. (2013). The effect of background music on bullying: A pilot study. Children and Schools, 35: 83–90.