Music: A Prescription for Health and Social Connection

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Globally, more than 55 million people live with dementia, and that number is expected to nearly triple by 2050. Based on current trends, researchers predict that the number of dementia cases will rise to over 150 million in less than 30 years.¹ And without intervention, health inequities will persist. It is estimated Black and Latinx communities will account for more than 40 percent of Americans with dementia by 2030.²

Globally, there are more than 55 million people living with dementia, and that number is expected to nearly triple by 2050.

For public health professionals, this raises the question: What can be done to mitigate the burden of dementia? It turns out, an answer may lie at the intersection of the arts and science and, in particular, with music.

Researchers and mental-health practitioners from Northwestern University, the Mayo Clinic, and the Institute of Therapy through the Arts have joined forces to examine how music-based therapy can improve social engagement among patients with dementia. Their findings demonstrate that music not only improves dementia patients’ social communication but can also reduce caregivers’ distress.

Relatedly, there is a growing ecosystem of interventions that utilize the healing power of music to improve community health, such as the work of the Black Music Therapy Network, Inc. This national network supports the health and wellbeing of Black communities through community-based, culturally sustaining music practices. BMTN uplifts and preserves Black Indigenous music-based healing methods to dismantle “relational and structural violence through the liberatory practice of music.”³

Given the rising prevalence of dementia, could these efforts serve as a premise for broad-scale investments in community-led interventions that utilize the power of music to support people who are impacted by cognitive impairment?

What is dementia?

Dementia is a syndrome that leads to a decline in cognitive health—that is, the ability to make decisions and to clearly think, learn, and remember.⁴ This decline disrupts daily life and profoundly impacts one’s mood, emotional control, behavior, and relationships.⁵

Various forms of dementia, such as Alzheimer’s disease, can make it difficult to socially connect and maintain healthy relationships.⁶ Although a dementia diagnosis can certainly strengthen family ties, for many, it can lead to feelings of isolation, loss, and loneliness. A 2020 study surveyed adults living with dementia and found that more than one-third reported feeling lonely, particularly those who were experiencing depression and living alone.⁷

While dementia can lead to social isolation, the reverse is also true: recent studies suggest social isolation can lead to a 50 percent increase in the risk for dementia and other medical conditions.⁸ This data adds to the body of evidence that social connections, and the lack thereof, impact disease progression and quality of life. It also explains why we should invest in programs that reduce isolation and foster connection in communities.

Who is impacted by dementia?

Dementia mostly impacts older adults across all races and ethnicities, although some forms of dementia do impact younger people as well. In the US, one in 10 older Americans have dementia.⁹ This finding is based on a nationally representative study released in October 2022—the first of its kind in over 20 years. Led by neuropsychologist Dr. Jennifer Manly, a research team estimated the prevalence of dementia and mild cognitive impairment, providing insights on the societal burden associated with these health outcomes.

Dr. Manly’s research demonstrates people with dementia and mild cognitive impairments are likely to be older, and there is a disproportionate burden among older Black and Latinx adults who share a higher prevalence compared to other racialized groups. However, dementia is not a normal process of aging, nor is it a function of race, which is a social construct. Research studies provide a window into the underlying cause of these differences, and as Dr. Manly states, these particular findings are important:

Dementia research in general has largely focused on college-educated people who are racialized as white.…This study is representative of the population of older adults and includes groups that have been historically excluded from dementia research but are at higher risk of developing cognitive impairment because of structural racism and income inequality. If we’re interested in increasing brain health equity in later life, we need to know where we stand now and where to direct our resources.¹⁰

How can music help dementia patients?

For people living with dementia, a new program offers a supportive path to building social connections and reducing loneliness through music. Led by the Institute for Therapy through the Arts, Musical Bridges to Memory^TM is a 12-week program designed to bridge “relationships between people with dementia, their families, and the greater community who serve them through live musical interactions, training, and research in music-based approaches.”¹¹

MBM engages participants in weekly sessions facilitated by trained music therapists. These sessions include interactive performances and training in communication skills to improve caregivers’ relationships with loved ones living with dementia. According to a 2022 study that examined MBM’s impacts, this music-based therapy can increase social engagement between caregivers and their loved ones despite ongoing declines in cognitive health.¹² How?

Research shows people with dementia benefit from interventions that harness their preserved cognitive and functional abilities. Music taps into our implicit memory, linking us to past experiences and emotions without the need for conscious awareness. This is especially true for music that is personally meaningful to us, such as a favorite song, which can promote brain plasticity and cognition.

In other words, our affinity for music can help support our brain health. Neurologist Dr. Ronald Devere notes, “Musical perception, musical emotion, and musical memory can survive long after other forms of memory and cognitive function have disappeared.”¹³ Even amid cognitive declines, music can help to promote connection and shared communication—making it a viable tool to support people with dementia.

In addition to improving communication, MBM positively impacts mood and alleviates caregiver burden. Caregivers who participated in this program reported significant reductions in distress as a result of improved communication through music.¹⁴ In short, the program’s positive health impacts extend beyond individuals diagnosed with dementia to their families and loved ones because it facilitates communication and social connection, particularly in cases where verbal language is no longer possible.

These findings add to decades of research that demonstrate that music can positively impact our health,^15,16,17 and they provide further insights into the benefits of the MBM program to people with dementia and their caregivers. They also align with other community-based interventions such as BMTN, which was created by founder and CEO Dr. Marisol Norris, to utilize music to foster healing.

A growing coalition of “cultural workers, music therapy students and practitioners, musicians, educators, researchers, and community agents” working at the intersection of music, wellness, healing, and transformation, BMTN offers music-based programs that center Black Indigenous music traditions and healing practices. Its work highlights the importance of culturally centered practices, particularly when addressing health inequities in communities that experience disproportionate illness burdens. Their efforts come with an analysis of the harms caused by structural racism and cultural appropriation, and they intentionally work to promote the liberation of Black people, which is key to our collective wellness.

In addition to educational training programs for music therapists, the network offers an online course, Healing Justice in Music Therapy, which encourages practitioners to have “radical conversations, mindful collaborations and holistic visions centering the Black community.” Through guided instruction, participants explore how to embed healing justice principles in their work to support community health through music therapy.

A promising public-health future prioritizes the arts

Music-based therapy offers the public-health field a promising tool in its mission to protect and promote wellbeing. The success of interventions such as MBM and BMTN, signal the need for more resources to support arts-based health initiatives. In the case of BMTN, more investments are needed to resource community-led efforts that center culturally sustaining practices. The efforts described here are just two of the many music-based therapy programs underway, signaling a ripe opportunity for coordination and collective visioning to collaboratively leverage the power of music to improve population health.

 

1. https://www.healthdata.org/news-release/lancet-public-health-global-dementia-cases-set-triple-2050-unless-countries-address
2. https://www.usagainstalzheimers.org/health-disparities-race-and-alzheimers
3. https://www.blackmtnetwork.org/about
4. https://www.who.int/news-room/fact-sheets/detail/dementia; https://www.alz.org/alzheimers-dementia/what-is-dementia
5. https://www.who.int/news-room/fact-sheets/detail/dementia; https://ift.tt/uWVL0jx
6. https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia
7. https://onlinelibrary.wiley.com/doi/full/10.1002/gps.5305
8. https://www.cdc.gov/aging/publications/features/lonely-older-adults.html; https://nap.nationalacademies.org/catalog/25663/social-isolation-and-loneliness-in-older-adults-opportunities-for-the
9. https://www.cuimc.columbia.edu/news/one-10-older-americans-has-dementia
10. https://www.cuimc.columbia.edu/news/one-10-older-americans-has-dementia
11. https://itachicago.org/musical-bridges-to-memory/
12. https://journals.lww.com/alzheimerjournal/Fulltext/2022/10000/Musical_Bridges_to_Memory__A_Pilot_Dyadic_Music.6.aspx
13. https://practicalneurology.com/articles/2017-june/music-and-dementia-an-overview
14. https://journals.lww.com/alzheimerjournal/Fulltext/2022/10000/Musical_Bridges_to_Memory__A_Pilot_Dyadic_Music.6.aspx
15. https://www.apa.org/monitor/2013/11/music
16. https://pubmed.ncbi.nlm.nih.gov/10990596/
17. https://www.health.harvard.edu/blog/can-music-improve-our-health-and-quality-of-life-202207252786