To what extent can music therapy be used to treat and relieve patients

with Alzhiemer’s, dementia, and Parkinsons?

Cedar Fisher

Senior Project Advisor: Lori Fisher

Abstract:
Music therapy is a relatively new and very exciting form of therapy that involves the listening of
familiar music to treat or relieve certain mental conditions. While it has been used to treat many
conditions like autism and schizophrenia, my paper focuses on its effect on degenerative
diseases. In dementia, Parkinson’s, and Alzhiemer’s, music therapy has been shown to have
drastic effects on many areas of the brain, and can help relieve serious symptoms such as
cognition, movement, and mental health. Music therapy has only recently started to be
considered as a treatment for these conditions, and experts have started to realize the amazing
effects it can have. My thesis argues that music therapy should be a forefront treatment for all
degenerative patients due to its effectiveness, lack of side effects, and accessibility to all
demographics.

12th grade Humanities

Animas High School

2/22/24

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 Part I: Introduction

The treatment of degenerative diseases is one of those complex issues that is constantly

being studied, partially because there is no definitive cure or solution. Combined, Alzhiemers,

Dementia, and Parkinson's disease affect over 40 million people worldwide, over 10 percent of

all people 60 years of age or older (Kate 4). Extremely draining, depressing, and even painful

symptoms come with these conditions; there is a reason that it is a common fear in elderly folks

everywhere. There have been a slew of different interventions and medications introduced over

the years to treat them, and while some can provide relief from pain, there has never been a

medication able to treat or even improve degenerative diseases. All three of these diseases are

incurable, but patients can still be treated for relief and improvement. Each of these medications

has a laundry list of side effects and warnings, and for the most part have proven to be

ineffective. However, there is another option. Music therapy, the use of music or musical

components to provide treatment and mental improvement, is an obscure and fairly new practice

that works miracles in the treatment of Alzheimers, Dementia, and Parkinson’s patients. Music

therapy is a non-invasive, low stress, medicationless form of therapy that is proven to have

significant effects on memory, cognition, movement, and mental health in degenerative patients.

While there is no cure for these diseases, music therapy is the best option for many of these

patients; it can be used in some capacity for any stage of Alzheimer’s, dementia, or Parkinsons, it

is low cost, and can even be performed at home to an extent. One area that music therapy has

been proved to be very effective, unsurprisingly, is mental health. At such a low cost, this alone

is enough to recommend the application of music therapy everywhere, but it goes much further

than that. Music therapy has been proven to be an effective treatment for degenerative diseases,

and should be considered early on as a treatment option for these patients.

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 Degenerative diseases like Parkinson’s, dementia, and Alzhiemers have long been one of

the mysteries of medicine, as they affect so much of the human population while still not being

fully understood. Throughout this paper, these diseases will be referred to generally as

“degenerative diseases.” Alzheimer's disease is a mental disease that gradually destroys memory

and thinking skills, and eventually even the ability to complete basic tasks or have basic

conversations. Dementia is a broader term, simply meaning loss of cognition to an extent that it

interferes with daily life and basic tasks. Finally, Parkinsons is a degeneration of nerves and

neural control, often presenting itself as an inability or difficulty to move the body.

Part II: Historical Context and Background

The study of degenerative diseases began in the early 1900s, when a man named Dr.

Alois Alzheimer noticed decreased function in the brain tissue of a woman who had died of a

strange mental illness. From there, over the years hundreds and hundreds of studies have been

conducted and the focus on degenerative diseases has spiked, but there is one big problem with

the research. There is no cure, and further, you could argue that there are not even any effective

treatments. Because of this, the science behind these diseases has gone deeper and deeper over

the years, to no avail.

But what if there was a simple way to relieve and even treat these patients without any

physical medication whatsoever? Music therapy, a new form of treatment that has emerged in the

last decade or so, has been a very interesting development in the treatment of degenerative

diseases. Music therapy, simply put, is the use of music, or elements of music to accomplish a

goal, such as decreasing stress or improving quality of life. While music therapy has roots dating

back to as early as the mid 1700s, its modern application in medicine began around the 1940s.

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Schooling and certifications for music therapists began around that time as well, but it was not

until the 90s that the AMTA (American Music Therapy Association) was formed. Since its

founding, the association advocates for music therapy everywhere, and has a presence in 30

countries around the globe. It helps provide education to therapists to be, and facilitate the use of

music therapy in different settings around the world.

Part III: Research and Analysis

Music’s perplexing effect on the brain has led to strides being made in the therapeutic

treatment of degenerative diseases, as it can have a profound effect on cognition, memory, and

notably, brain plasticity. The way music affects the brain in general is important to understand in

order to contextualize this topic, since it directly ties into how it affects a degenerating brain.

Simply listening to your favorite music can reduce pain, depressive symptoms, and stress, as

well as cognition and brain function, in the average “normal brain” (Stefan 5). Music’s effect on

the brain can be viewed and visualized using an MRI, which shockingly shows that music has an

effect on every major brain process, in one way or another. One example is music's effect on the

nucleus accumbens, which is stimulated by music in an addiction-like way, stimulating dopamine

response in the brain receptors in a way that is chemically similar to cocaine (Sotomayor 2). If

you have ever gotten into your car after a late night of work, turned on your favorite song or a

song you have been really into recently, and felt a sort of flood of relief or excitement, you have

likely felt this effect for yourself.

Music can also have an effect on our frontal lobe, the largest part of our brains and the

piece that dictates thinking, decision making and planning. There is arguably no substance,

treatment, or medicine in the world that can affect every area of the brain, making music

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technically the most mentally active “medication” of all time. Perhaps the most interesting piece

of music’s effect on the brain to me is the fact that in a therapeutic setting, the brain's favorite

type of music is simply your favorite type of music (Stefan 4). This means that the genre or type

of music does not matter at all; if a patient's favorite artist is Metallica therapy will be

administered using Metallica, if it’s 2pac they will use 2pac, and everything in between. This is

perhaps the most essential piece of the picture when it comes to music therapy; it shows that the

effects of therapy take place in the deep memories and are very personal, and can lend some

explanation to how music therapy can cut through the fog of a deteriorating brain to provide

treatment and relief.

Music therapy has also been proven to improve brain plasticity, the ability to break down

and build new neural pathways (Jancke 1). This is more or less the ability to learn, and the ability

to change existing ways of thinking and doing things. A large part of early stage education

focuses on improving neuroplasticity, because it improves children's learning abilities later in

life. In a paper that argues for widespread music education in children in relation to brain

plasticity, Lutz Jancke claims that “6-year-old children receiving instrumental musical training

for 15 months (compared with children receiving non-musical training) not only learned to play

their musical instrument but also showed changed anatomical features in brain areas known to be

involved in the control of playing a musical instrument. Most of these brain areas are part of the

cortical motor system, but there were also structural changes in the auditory system and in the

corpus callosum” (Jancke 2). The corpus callosum is the area of the brain that affects cognition

and movement, and the cortical motor system generates signals to create movement in the body.

It is no coincidence that listening to and playing music has essentially the opposite effects of a

disease like Alzheimer's or dementia. It comes as no surprise that advanced neuroplasticity is one

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of the first things to go in degenerative patients. Listening to or playing music can have profound

effects on their mental capabilities, and help to counteract the symptoms of dementia and

Alzhiemer’s.

When it comes to Alzhimers and dementia, music therapy has proven over recent years to

be one of the most if not the most effective treatments. There was an extensive case study

conducted on this topic, based on patients in an assisted living community in Massachusetts. The

participants were divided into three groups, two that received clinical music and dance therapy,

and 1 control group that were essentially just told to watch a tv show for the same amount of

time with no therapeutic purpose. The two active groups were divided based on severity of

symptoms; one group had the milder dementia patients and one the more moderate group. The

results were measured using five categories; the Neuropsychiatric Inventory Nursing Home

(NPI-NH), the Dementia Mood Picture Test (DMPT), and the Montreal Cognitive Assessment

(MoCA). The NPI-NH measures the frequency and severity of neuropsychiatric symptoms of

dementia patients; it examines 10 behavioral areas including apathy, depression and anxiety. The

DMPT is an assessment of mood using facial line drawings to indicate feelings. The MoCA is a

one page response exercise that measures executive functioning such as attention, language and

orientation. This written test of sorts took patients an average of 10 minutes to complete.

According to this study, the patients in both groups both experienced a positive change in

cognition and happiness after each session, with some lingering effects present even after the

sessions were over. The control group, unsurprisingly, experienced no change, proving at the

very least that music therapy has some effect on the brains of these patients. Both groups

experienced improvements in memory and thinking measures by the MoCA, more so in the mild

dementia group than the moderate. The most permanent noted improvement in both groups,

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however, was mental health as measured by the Hospital Anxiety and Dementia Scale (HADS).

According to the author of the study, “Anxiety as measured on the NPI improved significantly in

the mild dementia group; improvements were less marked in the group with moderate dementia”

(Gallego 7). Dementia patients are stereotypically anxious and confused people, and anything

that can ease their anxiety has the potential to vastly improve their quality of life. Cognition was

the second most improved area in the study. As has been shown using neuroimaging technology,

listening to music has an effect on many areas of the brain involved in cognitive function. The

most affected areas of cognition were visuospatial awareness, orientation, and executive

thinking, which are advanced mental areas that have not been accessed before in the treatment of

degenerative diseases, by any medication or other form of therapy. Alzheimer’s and dementia are

devastating ailments, but as shown by the study in question, even they cannot escape the benefits

of music therapy.

Another area in which music therapy has proven to be an effective treatment is for

symptoms of Parkinsons and Parkinsonian gait. The effects are measured in terms of gait speed,

which is simply the amount of time it takes a person to walk a certain distance on flat ground

autonomously. In a study involving over 500 participants, music therapy was administered

continuously for four weeks to Parkinson's patients, with no additional gait training. A control

group was studied, which was given standard gait training without any music therapy. The results

spoke for themselves. “The patient's task was simply to listen to rhythmic auditory stimulation

(2Hz) embedded in familiar styles of music at home, without gait training, for at least 1h a day

for 3–4 weeks. Following completion of the task, patients’ gait speed and stride length

significantly improved (p<0.0001, <0.001, respectively). The step cadence was not significantly

changed, however, there was a tendency for the cadence rhythm below 2Hz to approach the

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rhythm of auditory stimulation” (Sotomayer 9). Across the board, consistent music therapy has

been proven to help Parkinson’s patients with their gait speed and movement abilities, as well as

their mental health.

In some cases, music therapy can go even further in treating Parkinson’s patients. There

have been instances where very late stage Parkinson's patients who have little to no autonomous

movement respond extremely well to music therapy. This isn’t just referring to minor movements

either; wheelchair bound patients have been known to regain an unbelievable amount of control

over their bodies during music and dance therapy. Sotomayer concludes that “music therapy

provides an effective treatment approach to improve motor function, balance, freezing of gait,

gait speed, and mental health in patients with Parkinson's disease” (Sotomayer 5). This

phenomenon is illustrated in a documentary about music therapy and degenerative diseases

called “Power of Music on the Brain.” The documentary shows different types of degenerating

patients and the effect of music therapy on them. Perhaps the most shocking was the late stage

Parkinson's patient, who was treated using music therapy and then eventually dance therapy. All

of a sudden, after years of struggling just to move their own body, now the patient is out of her

wheelchair dancing to her favorite song, with nothing but slight assistance from a partner (ABC

Science). One of the great things about music therapy is that it is inherently fun and enjoyable;

who doesn't like dancing around a room, especially someone who has been starved of the feeling

for years? It explains why every group researched has a long standing mental health increase,

making it the most consistent and definitive effect of music therapy treatment. Clearly music

therapy is not only a healthy form of relief for Parkinson's patients, but also a viable and exciting

treatment.

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 Part IV: Conclusion

Throughout my research one thing has made itself apparent: music therapy should be the

forefront treatment for people suffering from degenerative diseases. From the diagnosis, the

family should take it upon themselves to surround the person with music from their past and

music that's important to them. Once the disease progresses, if the family decides to put the

person in a home, they should request music therapy treatment regularly, and attend the sessions

whenever possible. Music therapy should be administered to degenerative patients like aspirin

for chest pain; every patient, no matter what. The worst thing music therapy can do is nothing,

unlike the slew of medications that are used to treat these diseases which come with laundry lists

of side effects. According to Gomez, “The positive effect of NMT on general cognitive

functioning for residents with moderately severe cognitive decline was remarkable. These results

suggest that NMT with a habilitative approach is a viable tool to engage older adults with

dementia. The promising results on cognition and its high treatment acceptability make a

powerful case to increase NMT use with this population and continue studying its effectiveness”

(Gomez 7). Since the effects can truly improve a patients quality of life, it should be further

studied and pushed into treatment of degenerative diseases.

The added factor of mental health benefits furthers the argument for widespread music

therapy; effectiveness of every other category is fairly variable, but the positive effect on mental

health in patients is consistent throughout all of them. Also consider that while of course no

treatment is free in America, music therapy can be administered with nothing more than a

practitioner and a pair of headphones. The practitioner isn't even fully a necessity, seeing as the

principle concepts of music therapy are fairly simple and can be done at home, and can even be

better received if conducted in the presence of loved ones. All this to say, even the lowest income

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family can afford some aspect of music therapy. This is especially beneficial because families

living in poverty generally cannot even consider care for a family member going through

Alzhiemer’s, Dementia, or Parkinson’s. How can you justify spending money on treating an

incurable disease if you are struggling to put food on the table? The fact is, some form of music

therapy can always be administered so long as the preferred music of the patient is known. As far

as a clinical setting is concerned, every establishment that treats degenerative patients should

consider the use of music therapy, whether that be a nursing home, hospital, or even a caregiver

of the elderly.

The future of music therapy is bright, if a little uncertain. It has only recently been

introduced into the world of degenerative diseases, and really hasn’t been used at all in modern

medicine for that long either. Studies like the ones examined in this paper are coming out all the

time, with results that seem to be slightly variable and all over the place. This can be attributed in

part to the fact that music therapy affects different brains in different ways. However, it seems

that the main cause for this conflicted information is differences in the way therapists administer

music therapy. This is one major limitation of studies involving music therapy; since the

parameters are not consistent it is very difficult to get an accurate representation of the

effectiveness in a broad sense. Another more obvious limitation of music therapy is the fact that

old age is known to go hand in hand with decline in hearing and deafness. A patient who cannot

hear naturally will not be able to respond to music therapy, and diminished levels of hearing

could also affect how effective and consistent the therapy is. With all that being said, since music

therapy is so gentle and non-invasive, as well as affordable and accessible, it should be the front

line treatment for degenerative patients. Many studies over the years have proven that the

therapy can have insurmountable effects on a slew of different symptoms that these patients

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experience including, cognitive function, memory, mental health and happiness, and

parkinsonian gait. These benefits combined with the fact that there has never been a negative

side effect ever recorded makes music therapy a perfect first intervention for these patients.

Further research on the effects of this therapy is a necessity, as there are some important lacking

aspects in studies thus far. One method of this that could be illuminating would be looking at the

electrical activity in the brain when music therapy is administered, and studying that for changes

in chemical brain function. This could lead us closer to understanding what is happening

physiologically in the brain in music therapy, and thus lend more understanding to the therapy in

general. A massive study should also be conducted, involving over 1000 participants and a

control group of the same size. In this study, dementia, Parkinson’s, and Alzhiemer’s patients

should be included. Any family who has a loved one going through this unfortunate process

should consider music therapy, and look into what aspects of music therapy will work the best

for them. So throw out those dementia pills, spend some time with your degenerating loved one,

and throw on their favorite song. Chances are, you will be amazed at the results.

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 Works Cited

ABC Science. “Power of Music on the Brain | Dementia & Parkinson’s.” YouTube, 6 June 2016,
www.youtube.com/watch?v=rnUSNbqtVJI.

Bergmann, Thomas. “Music therapy for people with autism spectrum disorder.” Oxford
Handbooks Online, 2015, https://doi.org/10.1093/oxfordhb/9780199639755.013.35.

Gallego, M. Gomez. "Music therapy and Alzeimer's disease: Cognitive, psychological, and
behavioral effects." Neurologia, 2017; 32:300-308

Jancke, Lutz. et al. "Music Drives Brain Plasticity." Biology Reports, 2009,
http://F1000.com/Reports/Biology/conent/1/78

Koelsch, Stefan. "A Neuroscientific Perspective on Music Therapy". The Neurosciences and
Music III-Disorder and Plasticity, 2009, 374-384

Machado Sotomayor, Manuel Joaquín, et al. “Music Therapy and Parkinson’s Disease: A
Systematic Review from 2015–2020.” MDPI, Multidisciplinary Digital Publishing
Institute, 4 Nov. 2021, www.mdpi.com/1660-4601/18/21/11618.

Williams, Kate. “The effectiveness of short term group therapy intervention for parents who have
children with disabilities.” Journal of Music Therapy, 2012

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