Tuesday, November 12, 2013

Music therapy for Dementia

Reference:
Music therapy for dementia by SangNam Ahn and Sato Ashida
http://journals2.scholarsportal.info.myaccess.library.utoronto.ca/tmp/6032621358980111776.pdf


Review

Dementia is defined as “loss in short – and long- term memory, associated with impairment in abstract thinking and judgement, other disturbances of higher cortical function, and in some cases, personality change” and is fifth leading cause of death among older people. Although there is pharmacotherapy treatment for some symptoms, there are many side effects to patients. “Music therapy has been employed and welcomed as a safe alternative approach because of its ability to alleviate some symptoms of dementia, and to elicit remarkable responses from patients.”

Since music is familiar and predictable, it has a remarkable ability to elicit memories, movements, motivations and positive emotions from older people who are suffering from dementia. Firstly, singing is one of the methods; patients who have lost verbal skills can sometimes continue to sing lyrics to familiar songs, allowing them to express feelings. “When ability to sing deteriorates, familiar songs or the entrainment technique have been used to facilitate meaningful interactions and elicit positive reactions leading to reduction in agitation, depression, and restlessness.” Furthermore, listening to music may decrease stress hormones like cortisol and help patients cope with exhaustive dementia symptoms and associated fears. Moreover, the author pointed out that music therapist should make patients participate as possible. “Allowing patients to play music or move rhythmically can help maintain or improve gross and fine motor coordination. Music and dancing skills learned over the years often occur automatically well into the later stage of dementia, allowing patients who have lost other social and cognitive skills to participate and gain a sense of success and competency.” Although there are good responds to music therapy, the research gaps exist that hinder our confidence to call music therapy an evidence-based medicine, or a clinical expertise integrated with the best available external clinical evidence from systematic research. “The first step in filling the research gap would be to conduct more randomized clinical trials to establish the efficacy of music therapy on dementia symptoms using more vigorous measures such as structural magnetic resonance imaging and behavioral and endocrinological assessments, using established measures to better quantify cognitive status.” The ultimate goal is to develop music therapy programs that are delivered by certified music therapists who employ strategies based on extensive evidence.


Reflection

Since dementia is one of terrible diseases, this article was very interesting to me to see how music can cure or take care of this disease. I agree that music would give ability to elicit memories, motivations and positive emotions, then, I was wondering if everyone would have same effects for same music; I think it would vary a lot for each person’s personality and background. In other words, music therapist should know many types of music (classical, Jazz, pop, etc) and grasp the patient’s character. Moreover, since listening to music helps to release from stress, people should listen to music constantly to avoid dementia later on. While I was reading this journal, question popped in my mind, ‘then, musicians do not have to worry about encountering dementia?’ I have not researched for this question, but I think there may be some musicians who are suffering from dementia because dementia would occur from depression or heredity effect. Furthermore, it is very encouraging that involving or participating in learning music can help cure dementia. Later on, I hope successful establishment of its efficacy will allow us to conduct further translational research to understand how inexpensive and safe music therapy programs may be disseminated in the community. I am just surprised again by how music can role in such many ways.

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