dementia

Music therapy and dementia are often discussed together because music can provide enjoyment, connection and opportunities for self-expression even when memory and communication abilities have changed.

Familiar songs can sometimes prompt singing, movement, conversation or emotional responses in people living with dementia. Structured music therapy may also provide benefits for some people.

However, it is important not to overstate what music therapy can do. It does not cure dementia or reverse the underlying disease, and research into many of its effects is still developing.

What Does Research Say About Music Therapy and Dementia?

A recent Cochrane review of music-based therapy for people with dementia included 30 studies involving 1,720 participants.

The researchers found that, compared with usual care, music-based therapeutic interventions probably produce a small improvement in depressive symptoms and may improve overall behavioral problems at the end of treatment.

The evidence was less convincing for several other outcomes. Researchers did not find clear evidence that music-based therapy improves agitation or aggression, anxiety, cognition or overall emotional well-being compared with usual care.

There was also uncertainty about whether any benefits continued after therapy ended.

This does not mean music has no value for someone living with dementia. Instead, it means we should view it as a supportive and enjoyable activity rather than a treatment that can reliably improve every symptom.

Here are seven ways music may be helpful.

7 Ways Music Therapy and Dementia Care Can Work Together

1. May Support Mood and Depressive Symptoms

One of the stronger findings from current research relates to mood.

The Cochrane review found moderate-certainty evidence that music-based therapeutic interventions probably produce a small improvement in depressive symptoms immediately after treatment when compared with usual care.

For a person living with dementia, listening to a favorite song or participating in music can also simply be an enjoyable experience.

This is particularly valuable because depression can occur alongside dementia and can have a significant impact on quality of life.

Music should not replace assessment or treatment for depression, but it can form part of a broader person-centered approach to care.

2. Can Encourage Social Engagement

Music provides a natural reason for people to participate together.

Singing, listening, clapping or playing simple instruments can create opportunities for interaction without requiring complicated conversation.

Research comparing music-based therapy with other activities suggests it may improve social behavior for some people with dementia, although the evidence is still limited.

Group music sessions can also be incorporated into group activities for people with dementia.

The aim should not be to force participation. Some people may prefer to listen quietly rather than sing or move. Following the person’s interests and responses is more important than completing a particular activity.

3. Can Create Moments of Connection and Reminiscence

Familiar music can have strong personal associations.

A song from someone’s childhood, wedding, favorite performer or important period of life may provide an opportunity to reminisce and connect with family members or caregivers.

The Alzheimer’s Association notes that even during later stages of Alzheimer’s, some people may still be able to tap to a beat or sing lyrics from familiar songs.

Rather than thinking of music as a way to “restore” lost memory, it is more helpful to think of it as another route for connection.

A familiar song might lead to a smile, a few words, movement, singing or simply a peaceful shared moment.

That experience can be meaningful even when the person cannot explain the memory associated with the music.

4. Can Support Communication and Self-Expression

As dementia progresses, communication can become more difficult.

Music offers ways to participate that do not depend entirely on spoken language.

A person might hum, sing, tap a rhythm, make eye contact or respond through facial expressions and movement.

The Alzheimer’s Association describes music as a way for people to connect even after verbal communication has become difficult.

This does not mean music therapy will restore speech or prevent language decline. Those claims go beyond what current evidence can establish.

Its value may instead lie in providing another way for the person to express themselves and interact with those around them.

5. Can Encourage Movement and Participation

Music naturally encourages movement for many people.

Someone may clap their hands, tap their feet, sway, dance or move their arms in time with a familiar song.

The Alzheimer’s Association recommends encouraging activities such as clapping and dancing when the person enjoys them.

Movement should always suit the person’s mobility, balance and physical abilities. A person who cannot safely stand may still enjoy tapping, clapping or moving while seated.

Music can therefore complement other appropriate physical activities for people with dementia, although it should not be described as a treatment that directly improves physical health or motor function in every person.

6. May Help With Some Behavioral Symptoms

Behavioral and psychological changes can occur as dementia progresses.

The recent Cochrane review found that music-based therapy may improve overall behavioral problems when compared with usual care.

However, there was no clear evidence that it specifically reduces agitation or aggression.

That distinction is important.

A familiar piece of music may sometimes help redirect attention, encourage engagement or create a calmer environment, but caregivers should not assume music will resolve every episode of agitation.

Sudden or significant changes in behavior can also have other causes, including pain, illness, medication effects, fatigue, hunger or an uncomfortable environment.

These causes should be considered rather than simply trying to distract the person with music.

7. Can Provide Meaningful Engagement at Different Stages

One advantage of music is that the activity can be adapted as abilities change.

A person in an earlier stage of dementia might play an instrument, choose songs, dance or attend a concert.

Later, the activity may become simpler. Listening to familiar recordings, singing together, tapping a beat or quietly enjoying music may be more appropriate.

The focus should always be on the person’s enjoyment rather than performance.

Meaningful activities can contribute to quality of life for someone living with dementia, particularly when they reflect the person’s interests, history and abilities.

Music Therapy Is Different From Simply Listening to Music

There is an important distinction between clinical music therapy and playing enjoyable music at home.

According to the American Music Therapy Association, music therapy is the clinical and evidence-based use of music interventions to achieve individualized goals within a therapeutic relationship with a credentialed professional.

A qualified music therapist assesses the person’s needs and uses music purposefully as part of an individualized treatment plan.

Simply playing a person’s favorite music is not clinical music therapy.

That does not mean families and caregivers should avoid playing music themselves. Familiar music can still provide enjoyment, companionship and meaningful engagement.

The distinction simply prevents everyday music activities from being confused with professional therapy.

Practical Music Tips for Dementia Caregivers

Caregivers do not need complicated equipment to make music part of everyday life.

The Alzheimer’s Association recommends choosing music that is familiar and enjoyable to the person and, whenever possible, allowing them to choose what they want to hear.

Other useful approaches include:

• Choose songs connected with positive periods in the person’s life.
• Watch their reaction and change the music if they appear uncomfortable or distressed.
• Keep the volume comfortable.
• Reduce competing noise from televisions, conversations or other devices.
• Avoid music interrupted by advertisements if these cause confusion.
• Use gentle music when trying to create a relaxed environment.
• Try more upbeat familiar music when encouraging movement or participation.
• Encourage clapping, singing or dancing when the person appears to enjoy it.
• Do not test the person’s memory by asking them repeatedly to identify songs or artists.

A person’s response can also change from one day to another. Music that is comforting today may be irritating or overwhelming at another time.

Follow the person’s response rather than assuming a particular type of music will always work.

When Should You Consider a Professional Music Therapist?

Families may want to consider a qualified music therapist when they have a specific therapeutic goal or would like a structured program tailored to the person’s needs.

The American Music Therapy Association explains that qualified music therapists receive specialized education and clinical training and develop individualized treatment plans.

In the United States, look for a board-certified music therapist with the MT-BC credential.

A professional may use techniques such as singing, instrument playing, movement, improvisation, songwriting, music-assisted relaxation or carefully selected listening activities depending on the person’s abilities and therapeutic goals.

Music therapy should complement appropriate dementia and medical care rather than replace it.

Music Therapy and Dementia: Closing Thoughts

Music can remain meaningful even as dementia changes memory, language and everyday abilities.

Current research does not support claims that music therapy can cure dementia, restore cognition or reliably improve every behavioral symptom.

What the evidence does suggest is more modest but still valuable. Structured music-based therapy may provide a small improvement in depressive symptoms, may help with some overall behavioral problems and may encourage social interaction in certain circumstances.

Outside formal therapy, familiar music can also offer enjoyment, movement, self-expression and moments of connection between a person with dementia and those around them.

When considering music therapy and dementia, the most important principle is to make the experience personal. Choose music the individual enjoys, watch their response and focus on connection rather than achievement.