Drawbacks to Music Interventions Like every therapeutic intervention, music therapy has its drawbacks. Mahsa Soufineyestani from the University of Minnesota Duluth led a systematic review of studies investigating the effects of music intervention which revealed that while some studies concluded that most AD patients improved by listening to individualized music, some became increasingly agitated (7). A hallmark of music therapy is that it evokes memories, which are linked to emotion which is further linked to behavior such as agitation. However, it is difficult to predict whether these memories and emotions will be positive or negative. Some patients may have music triggers that foster negative memories, and ultimately increase agitation. Sensitivity to a specific song can result in emotional flooding, which overstimulates and agitates the patient. The review also cited a study that observed more behavioral disturbance was observed between experimental groups who were administered Baroque music for 4 hours over a 4-week period than the control group (7). These disturbances could be explained by the fact that not all patients enjoy Baroque music, suggesting the importance of a treatment plan that is specifically catered towards the interests of the patient. Another study that was reviewed showed that AD patients with high levels of depression demonstrated increased levels of sadness after administration of music intervention compared to AD patients with low levels of depression (7). Although music interventions have been successful for some, comorbidities (such as the presence of depression and AD together) may hinder the effectiveness of treatment. This calls for the investigation into the effects of comorbidities of AD and for music treatment approaches to be designed for AD patients with a variety of different illnesses. Lastly, two reviewed studies observed that agitation that was reduced during music therapy returned after the therapy (7). This calls into question the harm of relying on music therapy approaches as the only treatment for AD. Since effects are not sustained, music therapy should be incorporated alongside pharmacological treatments. Conclusion Music interventions are effective in managing the symptoms of AD. Therefore, it is important to promote music therapy as an alternative or co-treatment to the therapeutic management of AD symptoms. Though studies suggest interactive and familiar music is most effective in improving cognitive and behavioral symptoms, the impact of other factors, like music genre (for example, rock music versus classical music), may be of interest for further study. Researchers may also study the effectiveness of combining music interventions with pre-existing medications. Lastly, comparing and combining music therapy with other non-pharmacological therapies, such as art therapy and dance therapy, may yield results of clinical interest and allow a greater variety of people to utilize therapies catered to individual interests.
Figure 1 Even as other types of memories decline as an Alzheimer’s brain (top) deteriorates, memory of music is left intact even in late stages of the disease.
References 1. Alzheimer’s disease and related dementias, CDC, (2020). 2. M. Leggieri, et al., Music intervention approaches for Alzheimer’s disease: A review of the literature. Frontiers in Neuroscience 13 (2019). doi: 10.3389/fnins.2019.00132. 3. M. Gómez Gallego, et al., Comparative efficacy of active group music intervention versus group music listening in Alzheimer’s disease. International Journal of Environmental Research and Public Health 18, 8067 (2021). doi: 10.3390/ijerph18158067. 4. J. Enrique de la Rubia Orti, et al., Does music therapy improve anxiety and depression in Alzheimer’s patients?. The Journal of Alternative and Complementary Medicine 24, 33-36 (2018). doi: 10.1089/acm.2016.0346. 5. E. Buller, et al., The Roth Project — music and memory: a community agency initiated individualized music intervention for people with dementia. Kansas Journal of Medicine, 12, 136-140 (2019). 6. M. Gómez Gallego & J. Gómez García, Music therapy and Alzheimer ‘s disease: cognitive, psychological, and behavioural effects. Neurologia (Barcelona, Spain) 32, 300-308 (2017). doi: 10.1016/j. nrl.2015.12.003. 7. M. Soufineyestani, et al., Impacts of music intervention on dementia: a review using meta-narrative method and agenda for future research. Neurology International 13 (2021). doi: 10.3390/ neurolint13010001. Images retrieved from: 1. https://commons.wikimedia.org/wiki/File:AD_versus_CO.jpg 2. https://www.vecteezy.com/free-vector/treble-clef”>Treble Clef Vectors by Vecteezy 3. https://www.vecteezy.com/free-vector/film-grain”>Film Grain Vectors by Vecteezy
Graphics Illustrated by Ujala Dar`24
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