Macquarie University researchers Dr Amee Baird and Professor Bill Thompson are looking at how music might be used in individuals with dementia, not only to help reduce stress and anxiety, but also to re-engage the parts of the brain affected by degeneration.
Professor Thompson likens music to a kind of neuropsychological Swiss army knife, which can be used to tackle multiple psychological functions.
“It’s tackling attention, it’s interacting with emotion, it’s interacting with language-like processes, such as music syntax; how the pieces fit together, how the different notes and chords go together and the sense of an ending, for example,” says Thompson, Director of the Music, Sound and Performance Lab at Macquarie and Chief Investigator of the ARC Centre of Excellence in Cognition and its Disorders (CCD).
“And of course, it’s triggering autobiographical memories at the same time, and often triggering imagery and visual memories.”
In this way, music uses a large number of effective psychological tools that enhance states of mind and can reconnect people with their past and with cognitive function that has been eroded by dementia. Clinical neuropsychologist, NHMRC-ARC Dementia Research Development Fellow and CCD Associate Investigator Dr Amee Baird became interested in the impact of music on dementia after hearing about retired musicians with Alzheimer’s disease who were still able to play their instruments.
“We know that people with dementia enjoy music, they can respond to music, they can sing along, but it’s not really well researched why that is and how it works,” Baird says.
“It shows that the parts of the brain that control memory for music and the ability to sing are not as affected by dementia. Somehow music remains; music abilities can remain preserved.”
Both Baird and Thompson hope that these unique features of music may be harnessed for their therapeutic benefit.
“Researchers are starting to realise that musical activities are more than just a diversion that reduces anxiety, but can actually help to slow down the progression of the effects of dementia on memory and cognitive function,” he says. “When people with dementia are engaged with music, they can sometimes recover fragments of past memories, and get bursts of awareness and cognitive function.”
Reconnecting with memory is also the focus of work by Macquarie University’s Dr Celia Harris, but instead of music being the trigger for memory, Harris is exploring how couples serve as each other’s memory triggers.
“They have this rich shared history so they can provide each other with really rich, personalised cues to trigger each other’s memories, that’s something that somebody who doesn’t know the person simply can’t do,” says Harris.
“We found amazing effects in the difference between a person remembering just with an interviewer, where they can remember virtually nothing, and then with their partner, they can remember a great deal more,” Harris says.
The hope is that carers and partners of people with dementia could be taught how to interact in such a way as to give the greatest benefits to the affected person’s memory. Harris says the key is sensitive providing of cues; letting the person speak until they start to taper off then coming in with support and a reminder, and allowing the person to pick up the thread again.
“Some people do it naturally and have learned how to do it, but some people don’t do it, so there’s potential there to teach them how to do it better.”
Fighting on a different front
While dementia most commonly affects people later in life, when those in long-term relationships are most likely to be able to benefit from remembering together, one particularly cruel form of dementia strikes younger individuals in their 50s and 60s.
Macquarie University’s Associate Professor Ian Blair is researching frontotemporal dementia, and why this form of the disease can co-occur with the seemingly unrelated motor neurone disease (MND).
“What’s become increasingly evident over the past 10 years is that there is a profound overlap between MND and frontotemporal dementia, and it’s also increasingly recognised that a substantial proportion of MND patients develop frontotemporal dementia and vice versa,” says Blair.
“We suspect that there are similar biological mechanisms that underlie what triggers the death of those groups of nerve cells in both diseases.
“The more we can learn about the triggers, and the influence genes have on how the diseases progress and interact, the more we can understand why these two devastating diseases occur and hopefully, one day, even prevent them,” he says.