Familiar songs reduce dementia patients’ anxiety, trigger lost memories

Scientists unlock music therapy’s potential to soothe advanced patients

CAMBRIDGE, England — What happens in the brain when music meets memory? For people with advanced dementia, who often experience significant distress, this question could hold the key to better treatment. A new British study has uncovered how music therapy can effectively reduce distress and improve well-being for people with advanced dementia in institutional settings.

These findings, published in Nature Mental Health, shed light on one of healthcare’s most pressing challenges. Among the estimated one million people living with dementia in the UK, over half are diagnosed with advanced dementia, requiring specialized care that often leads to placement in institutional settings like care homes or specialized hospital units. Patient distress can manifest as agitation, wandering, or resistance to care. Managing these behaviors becomes crucial, as they significantly impact both the individual’s quality of life and the ability of caregivers to provide effective care.

Music therapy, delivered by trained and registered professionals, has emerged as a promising intervention. Unlike casual music listening or entertainment, music therapy involves structured sessions where therapists engage patients in meaningful musical experiences. A typical session might include singing familiar songs, playing simple instruments, or moving to music. These activities can be conducted one-on-one or in small groups, allowing therapists to tailor their approach to each individual’s needs and abilities.

“With an aging population and increasing numbers of people diagnosed with dementia, music is a relatively straightforward and cost-effective way of improving the quality of life of those affected,” explains lead author Naomi Thompson of Anglia Ruskin University’s Cambridge Institute for Music Therapy Research, in a statement.

Using a research method called a realist review, which examines not just whether an intervention works but how and why it works in different contexts, the research team analyzed decades of evidence. They examined 11 systematic reviews, 29 peer-reviewed research articles, and numerous policy documents and professional reports. The study included interviews with staff and music therapists about inpatient mental health dementia wards at the Cambridgeshire and Peterborough NHS Foundation Trust, along with a national survey of healthcare professionals. The researchers also collaborated with the dementia specialist nursing charity Dementia UK.

Their findings revealed that when music therapy is designed to meet individual needs, it can deliver immediate, short-term reductions in agitation and anxiety while improving attention, engagement, alertness, and mood. Musical interactions help people feel safer and more oriented in their surroundings, which can lower levels of distress and improve wellbeing.

Much like a doctor prescribing medication with specific dosage and frequency, music therapists can design individualized programs that outline how music should be used throughout someone’s day. The therapy works by providing cognitive and sensory stimulation, activating networks across both sides of the brain to access remaining abilities and memories. Music-evoked memories, especially those triggered by familiar music, are recalled more quickly and are more positive than memories recalled without music. Songs from when the individual was between 10 and 30 years old prove most effective.

The physiological benefits are equally impressive. Music therapy can help regulate the autonomic nervous system, reducing physical stress responses. As a form of nonverbal communication, music remains accessible regardless of cognitive impairment or musical ability, providing opportunities for social interaction with staff, carers, and fellow residents.

“Our study not only shows why music therapy is successful – including meeting the person’s need for stimulation, supporting familiarity through memories, encouraging relationship and emotional expression, and crucially helping with the reduction of distress and anxiety – it also paves the way for its wider use in dementia care,” says Thompson.

The research strongly recommends that music therapists train other healthcare professionals to use music effectively, regardless of their prior musical experience. This includes making resources like musical instruments readily available and providing guidance on creating personalized playlists. Families should be encouraged to participate in this musical approach to care, as it can reduce stress levels and improve wellbeing for both care staff and family members.

“People with advanced dementia can sometimes become quite distressed and we need to find the best ways to help them. Music is one thing which can help, and so I am excited to see such high-quality work being done in partnership to see how we can bring music therapy to NHS dementia patients,” adds study co-author Dr. Ben Underwood, Research and Development Director at Cambridgeshire and Peterborough NHS Foundation Trust.

Understanding music therapy’s effectiveness marks a crucial step toward wider implementation in dementia care settings. With this blueprint in hand, healthcare providers can now make informed decisions about incorporating music therapy into their standard care protocols, potentially improving outcomes for millions of people living with advanced dementia.