S A L LY B O W E L L • R E S E A R C H F E L LO W • I N T E R N AT I O N A L L O N G E V I T Y C E N T R E – U K
Sally Bowell discusses ILC-UK’s new report on dementia and music which outlines a blueprint for positive change.
For many, music is a part of the fabric of life. Encompassing different cultures, genres and eras, music brings people together, promotes communication and helps with emotional expression. Music is also indelibly tied to memories; a nursery rhyme, the song for the first dance at a wedding, or a favourite Christmas carol can take us back to a time, place and feeling. Research also shows that our connection to music stays with us throughout our lives, even whilst living with dementia. The implications of this have been explored by a recent Commission on Dementia and Music, co-ordinated by ILC-UK and supported by
The Utley Foundation. In a unique new report, ILC-UK explores the dementia and music ecosystem of activity, the evidence base of proven benefits and opportunity areas for further work. The report brings together learning from a literature review, alongside a combination of both oral and written evidence from interested individuals and organisations. The report highlights recent research in the journal, Brain, which helps begin to explain why musical memory may be preserved in advanced Alzheimer’s disease. The study observed brain responses to music, then used this data to demonstrate an overlap of brain regions key to musical memory with areas that are relatively spared in Alzheimer’s disease. The report also points to a ‘memory bump’, with people with dementia retaining the clearest memories for music they enjoyed and heard between roughly the ages of 10 and 30, which is based on research published in Memory & Cognition. Whilst we are still not fully sure why music is such an invaluable tool for people with dementia, research into the proven benefits is becoming increasingly well-developed. Outcomes include minimising the impact of behavioural and psychological symptoms of dementia (BPSD) such as wandering, agitation and physically aggressive behaviour; helping to tackle anxiety and depression; better retention of speech and language; and improvements in wellbeing and quality of life. Throughout the lifecycle of the Commission, academic studies have been enhanced by site visits which have provided highly-valuable, first-hand evidence of the amazing impact that music can have for people living with dementia. Online footage is also doing much to help raise awareness of the value of music, for example, the Alive Inside project’s video. Interestingly, some studies into music
and dementia have demonstrated a reduction in the use of antipsychotic medication for study participants. This is crucially important given the recent concerted effort to review and reduce the reliance on antipsychotic medication for individuals living with dementia. Studies also discuss the positive impact of music for carers, such as reduced stress and, for those employed in caring, increased capacity for other tasks. For example, if day-to-day tasks can be made less stressful for the resident through using therapeutic music (for example, getting dressed), the care worker can have more time to dedicate to other residents and activities. We conclude that there is a need to unify existing activities in the field, and improve local information and data collection for use by professionals and the public alike. At the same time, researchers should focus on developing cost-effectiveness evidence, particularly important in a time of belttightening. Meanwhile, private sector and philanthropic organisations can play a powerful role by recognising the value of music, and by utilising their own resources and expertise to help grasp some of the opportunities available. This could include the increased involvement of technology companies to help make music available to all, for a minimal cost. Ultimately, raising public awareness will be crucially important. With the ambitious aim that every person with dementia should be able to access music by 2020, The Utley Foundation is committed to launching a new Ambassador for Dementia and Music role to help provide leadership and impetus to the agenda. This Ambassador will lead a taskforce dedicated to positive change and will be key in taking this work forward. At the heart of this debate is the right for people with dementia to have not just a life, but a good life and to be comforted and enlivened by the power of music. After all, without a song or a dance, what are we?
Sally Bowell is Research Fellow at International Longevity Centre – UK. Email: SallyBowell@ilcuk.org.uk Twitter: @ILCUK For the references mentioned here and to access the report, visit www.caremanagementmatters.co.uk Subscription required. 50
CMM March 2018