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Abstract

Dementias, such as Alzheimer's disease, include a progressive deterioration of language functioning. While some researchers have reported an increase in patients' self-expression following music therapy, it is not clear whether these changes specifically reflect improved language skills or whether simple interpersonal interaction with a therapist could account for the improvement. In this study, the effects of music therapy were compared to conversational sessions on language functioning in dementia patients. Participants were selected according to the following criteria: (a) residing in a facility specializing in Alzheimer's and related disorders; (b) possessing sufficient verbal ability to answer simple questions and to comply with requests to speak, participate, or sit down; and (c) attaining the written consent of the patient's guardian or representative. All participants had been in music therapy twice per week for at least 3 months prior to the study onset. One week prior to the beginning of the study, subjects were assessed for cognitive functioning using the Mini-Mental State Examination (MMSE), and language ability via the Western Aphasia Battery (WAB). A within-subjects design was used, with order of condition (music or group conversation first) counter-balanced between participants. Subjects participated in groups of 2 to 4, twice per week for 20-30 minutes for a total of 8 sessions (4 music therapy and 4 conversation sessions or vice-versa), and were re-tested on the WAB at the end of each 2 week (4 session) interval. Results from 20 participants revealed that music therapy significantly improved performance on both speech content and fluency dimensions of the spontaneous speech subscale of the WAB (p =.01). While the difference in overall Aphasia Quotient (AQ) for music and conversation sessions (mean AQ = 76 vs. 70, respectively) did not reach statistical significance, data were only available for 10 participants (5 per condition). Hopefully, these findings will stimulate additional research on the use of music therapy interventions with demented patients, as it may offer a noninvasive mechanism to enhance communication between victims and their caregivers.
... In Autism Spectrum Disorder (ASD), it enhanced social interaction and communication skills (25,30). Patients with Dementia or Alzheimer's Disease often experience improved memory recall and reduced agitation through MT interventions (6). Those with Traumatic Brain Injury (TBI) benefit from enhanced cognitive function and emotional stability as a result of MT interventions (19,20,24). ...
... -Receptive MT: Listening to familiar and meaningful music to stimulate memories and cognitive functions (6,7,10). ...
... Emery and colleagues showed that exercise plus music resulted in improved verbal fluency compared to exercise alone [32]. Another study showed the music therapy resulted in improvements in verbal fluency in dementia patients [33]. Thus, it is possible that this music listening group might be considered an active intervention group as well, in which case both KK meditation and music resulted in improvements in cognitive function in these patients, but appeared to be associated with different physiological correlates. ...
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This preliminary study determined if subjects with memory loss problems demonstrate changes in memory and cerebral blood flow (CBF) after a simple 8-week meditation program. Fourteen subjects with memory problems had an IV inserted and were injected with 250MBq of Tc-99m ECD while listening to a neutral stimulus CD. They then underwent a pre-program baseline SPECT scan. Then subjects were guided through their first meditation session with a CD, during which they received an injection of 925MBq ECD, and underwent a pre-program meditation scan. Subjects completed an 8-week meditation program and underwent the same scanning protocol resulting in a post-program baseline and meditation scan. A region of interest (ROI) template obtained counts in each ROI normalized to whole brain to provide a CBF ratio. Baseline and meditation scans and neuropsychological testing were compared before and after the program. The meditation program resulted in significant increases (p < 0.05) in baseline CBF ratios in the prefrontal, superior frontal, and superior parietal cortices. Scores on neuropsychological tests of verbal fluency, Trails B, and logical memory showed improvements after training. This preliminary study evaluated whether an 8-week meditation program resulted in improvements in neuropsychological function and differences in CBF in subjects with memory loss. While the findings are encouraging, there are a number of limitations that can be addressed in future studies with more participants and more detailed analyses.
... For instance, music therapy facilitates children's voluntary gestures, decreases repetitive behaviors, and improves hand-eye coordination (Chou et al., 2019;Gross et al., 2010), postural and fine motor skills (Pereira et al., 2019;Weller and Baker, 2011). In addition, music therapy increases the connection between verbal and musical language (Attar et al., 2022;Brotons and Koger, 2000), attention span levels (Jacob et al., 2021), and the ability to emit sounds, babbling, syllables, and small words (Salomon-Gimmon and Elefant, 2019). Finally, music therapy increases the motor and language skills of children experiencing neurodevelopment delays (Hoskins, 1988;Shi and Zhang, 2020), such as cerebral palsy (Tomaino, 2012;Vinolo-Gil et al., 2021). ...
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Children experiencing neurodevelopmental delay have motor, linguistic, and cognitive problems that affect their skills in various domains, especially interpersonal ones. Since music therapy is based on musical exchange, these three case studies explore how child–music therapists’ interactions change within and between sessions. Moreover, we evaluated whether the children’s and parents’ musical interaction changed in everyday life. Three children experiencing neurodevelopmental delay participated in 70 psychodynamic music therapy sessions, relying primarily on musical improvisation techniques. The initial (i.e. pre-test) and final sessions (i.e. post-test) were video recorded and codified with the Kategoriensystem Musik Therapie (KAMUTHE) in the 10th and 30th minutes. Videos were analyzed using the Behavioral Observation Research Interactive Software (BORIS). In addition, parents completed the Music in Everyday Life (MEL) Scale to evaluate how they experienced musical activities with their children. Reliable Change Indexes (RCIs) were calculated to assess significant changes in everyday musical activities. Based on video analysis, three children were more active at the 30th minute and the post-test, while Music Therapists stimulated them less. In addition, therapists adapted the activities and stimuli based on the children’s responses. Based on RCIs, parents reported an increased musical engagement with two children. Music therapy might help children experiencing neurodevelopmental delays modify their interaction style and improve motor and interpersonal skills.
... Research suggests that the bicortical involvement occurring during musical syntactic processing stimulates language regions within the brain suggesting a link between language and music (Monroe et al., 2020;Patel et al., 1998;Patel, 2003). Subsequently, research has begun to explore how music-based therapeutic interventions can improve speech, voice and language outcomes in adults with neurogenic aetiologies, such as stroke, Parkinson's disease (PD) and dementia (Baird & Thompson, 2019;Brotons & Koger, 2000;Lim et al., 2013;Machado Sotomayor et al., 2021;Raglio et al., 2016;Ridder & Gummesen, 2015). Typically, neurogenic communication disorders occurring secondary to these conditions, such as aphasia, apraxia and dysarthria are assessed and treated by speech-language therapists (SLTs) (Manasco, 2017). ...
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Background A growing body of research indicates that music‐based interventions show promising results for adults with a wide range of speech, language and communication disorders. Aims The purpose of this scoping review is to summarize the evidence on how speech‐language therapists (SLTs) use music and music‐related elements in therapeutic interventions for adults with acquired neurogenic communication impairments. Methods This scoping review was completed using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Reviews guidelines. A systematic search of three databases (Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature and OVID Medline) was conducted and articles were included if they (1) incorporated adult human participants; (2) received an assessment or intervention facilitated by an SLT; (3) incorporated techniques and interventions which included music‐related elements (e.g., rhythm, melody, harmony and dynamics); (4) were written in the English language; and (5) were peer‐reviewed full‐text articles. Data were extracted using the Rehabilitation Treatment Specification System framework. Main Contribution A total of 25 studies met the inclusion criteria. The studies included participants with neurogenic communication impairments secondary to stroke, Parkinson's disease, dementia and traumatic brain injury. Musical interventions identified in the studies were Melodic Intonation Therapy, Modified Melodic Intonation Therapy, choral singing, singing therapy and songwriting. The majority of the studies reported interprofessional collaboration between SLTs and at least one other healthcare clinician and/or musician. Many studies also included music‐based interventions lead and facilitated by musically trained SLTs. Conclusion The results of the studies included in this review indicate that SLTs are using music‐based interventions to target therapeutic goals to improve speech, language, voice and quality of life in collaboration with other clinicians and professional musicians. WHAT THIS PAPER ADDS What is already known on this subject A growing body of research indicates that interventions using music (i.e., choirs and songwriting) and musical elements (i.e., rhythm and dynamics) show promising results for adults with neurogenic communication impairments. Currently, however, there is no clear indication of how speech‐language therapists (SLTs) are using music in their clinical practice. What this study adds This scoping review collates the current evidence on how SLTs use music and musical elements in their clinical practice. SLTs are using music and musical elements for individuals with neurogenic communication impairments in populations such as Parkinson's disease, dementia and traumatic brain injury. Common interventions described in the literature include Melodic Intonation Therapy, choral singing, singing therapy and songwriting. What are the clinical implications of this work? Many SLTs collaborate when delivering music‐based interventions, particularly with music therapists (MTs). This scoping review suggests that SLTs should continue to explore music‐based interventions in collaboration with MTs and professional musicians to target therapeutic goals to improve speech, language, voice and quality of life.
... • Emotional Well-being: Gómez-Romero et al. [28] explained that, at least for patients with moderate dementia, music therapy helps alleviate symptoms such as agitation, anxiety, and depression. Therefore, music's capability to impact emotions and mood and facilitate the expression of emotions plays a positive role in enhancing the emotional status and quality of life [42]. ...
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Alzheimer’s disease (AD) poses significant challenges to individuals, families, and healthcare systems globally. Currently, there is no cure for AD, and available therapies focus on managing symptoms and slowing disease progression. Given the limitations of pharmacological treatments in halting the progression of AD, there is increasing interest in non-pharmacological interventions such as music therapy. This review explores the therapeutic benefits of music therapy for AD patients, evaluating empirical evidence from clinical studies and exploring the underlying mechanisms that contribute to its effectiveness. Additionally, this review discusses the practical implications of integrating music therapy into treatment plans. It identifies future research directions to understand further and enhance its impact on AD patients’ cognitive functioning and quality of life.
... cognitive training, such as spatial retrieval training 3,4 ; cognitive stimulation, such as recall therapy 5,6 ; cognitive rehabilitation, such as the application of cue cards 7 ; and other methods, for instance, painting therapy 8 and music therapy. 9 Indirect interventions include training in communication skills and conducting communication activities. ...
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Objective The aim of the study was to investigate the effectiveness of arithmetic and drawing writing on communication skills, quality of life, and cognitive impairment among people with mild and moderate dementia. Methods We recruited 45 patients diagnosed with mild-to-moderate dementia into this study. The participants were randomly divided into arithmetic group (n = 14), drawing writing group (n = 16), and control group (n = 15). The arithmetic group was educated to understand the addition and subtraction formulas, then wrote down the correct answers between the number of 20 and 100. The drawing writing group was guided to name, draw, and write a given object. Both were trained by therapist for 12 weeks (40 minutes per week). Blinded assessors measured global cognitive function, communication skills, and quality of life using Mini-Mental State Examination (MMSE) scale, the subscales of Functional Assessment of Communication Skills scale and Quality of Life—Alzheimer’s Disease scale at baseline and after 12 weeks’ intervention. Results After the 12-week intervention, the participants with mild-to-moderate dementia of the arithmetic writing group and the drawing writing group showed statistically significant improvement in communication skills and quality of life compared with the control group (social communication: 6.00 ± 0.69 vs. 6.06 ± 0.92 vs. 3.98 ± 1.33; basic needs communication: 6.32 ± 0.48 vs. 6.42 ± 0.53 vs. 4.25 ± 1.49; quality of life: 33.23 ± 5.34 vs. 34.07 ± 3.49 vs. 25.07 ± 2.60). In addition, MMSE scores of the arithmetic group tended to improve after the 12-week intervention (14.77 ± 3.06 vs. 17.31 ± 4.80, P < .01), but stabled in drawing writing group (14.27 ± 4.28 vs. 14.53 ± 5.26, P > .05) and significant decreased in the control group (13.73 ± 2.58 vs. 10.13 ± 3.23, P < .01). Conclusion Arithmetic, drawing, and writing are effective in improving communication skills and quality of life; arithmetic also could delay the decline of cognitive function in people with mild-to-moderate dementia.
Chapter
Globally more than 300 million people are living with a rare disease: they may present unique challenges not shared by individuals with common diseases due to the specific features of their conditions. Persons with rare diseases have been often marginalized and stigmatized. Stigma generates inequality, marginalization, discrimination, and exclusion. Bridging the gaps between health and social care for rare diseases is crucial to increase the life expectancy, quality of life and autonomy of the patients. Current evidence points towards associations between art-related cultural activities and positive health outcomes, including improvements to the quality of life; general and psychological well-being; increased social engagement; reduction in experiences of depression and anxiety; and the development of cognitive, emotional, and social skills. In addition, positive stimulation of the central nervous system cross-talks with the immune and endocrine systems, the benefit being measurable by means of biomarkers, such as cytokines and cortisol. The chapter, finally, presents and discusses several pathways and models to bring the benefits of visual arts and music to patients and to achieve a holistic interpretation of the outcomes.
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A scoping review investigated the effectiveness of different communicative interventions for patients with dementia. It demonstrated that communication between caregivers and dementia patients is improved by music, multisensory stimulation, and communication training. As a result agitation, mania, fear, anger and corrective touching are reduced, and fluency, spontaneous speech, eye contact, smiling and affective touching are enhanced. The recommendations, summarized in a fact sheet, also contribute to improved therapeutic decision making with bystanders and oral health of people with dementia.
Chapter
Different methods such as pharmacological and nonpharmacological are used to treat Alzheimer dementia. Pharmacological treatments are faced with limitations such as side effects. Nonpharmacological treatments are treatments that do not involve drugs. These treatments are often used for people with Alzheimer’s with the aim of maintaining or improving cognitive function, overall quality of life, and the ability to perform daily life activities. Physical exercises, dance, music therapy, and decreasing stress are interventions for the management of dementia. Physical exercise and dance can involve sensory system and cause movement in patients that not only provide happiness but decrease anxiety and depression in patients. Music therapy causes to remember the past and memories that can help to prevent memory degradation. Other interventions have the positive effects in patients with dementia. Such interventions can be used in patients with dementia and/or for prevention of dementia. In the current chapter, we aim to review nonpharmacological interventions for the treatment of dementia with more details.
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An 82 year old musician with Alzheimer's disease (AD) showed a preserved ability to play previously learned piano compositions from memory while being unable to identify the composer or titles of each work. He also showed a preserved ability to learn the new skill of mirror reading while being unable to recall or recognise new information. Both anterograde and retrograde procedural memory may be relatively spared in AD.
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Three male subjects with a primary diagnosis of Alzheimer's-type dementia participated in weekly, 30-minute music therapy sessions for 15 months. Subjects were selected randomly from among 29 residents of a nursing unit at Colmery-O'Neil Veterans Affairs Medical Center in Topeka, Kansas. All subjects were low functioning and required consistent supervision for behavioral management. Data were gathered in the last 11 weeks of the music therapy program for communicating, watching others, singing, interacting with an instrument, and sitting. Though the subjects deteriorated markedly in their cognitive, physical, and social capacities over the course of their disease in 15 months, data in the latter 11 weeks of the program indicated that they continued to participate in music activities in a structured group context. Data analyses showed that music participation was maintained over the course of the 11 weeks. Subjects consistently sat in chairs without physical restraints for the duration of each 30-minute session. Regardless of their deterioration, subjects were able to function with others in a group context. For most, this was the only time in their week when they could successfully interact with others in some acceptable form.
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We assessed the usefulness of the Western Aphasia Battery for distinguishing the language disturbances caused by Alzheimer dementia (AD) from those caused by stroke. Using discriminant function analyses, the multiple variable "aphasia quotient--reading quotient--writing quotient" classified 29 (72.5%) of the 40 patients correctly. These 29 patients included 8 of 10 patients with left hemisphere infarction and fluent aphasia; 6 of 10 with AD; 5 of 10 patients with right hemisphere infarction; and all 10 of the neurologically normal control subjects. The patients with AD and those with right hemisphere stroke were the most difficult to classify using the aphasia battery.
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