‘Behind the Music’: Music-making for cognitive health

The Bottom Line

  • Worldwide, dementia is a leading cause of death, disability, and dependence.
  • Active music-making therapy may improve cognitive functioning by a small but important amount in older adults with cognitive impairment or mild to moderate dementia.
  • Seek out music-based programming delivered by a professional and that emphasizes activities that actively engage participants in music-making.  

“Music is a moral law. It gives soul to the universe, wings to the mind, flight to the imagination, and charm and gaiety to life and to everything.”

― Plato, Philosopher

Sadly, dementia is the seventh leading cause of death globally, as well as one of the main sources of disability and dependency among older adults. The effects of dementia are far-reaching, negatively impacting the social, financial, mental, and physical health of both the individual living with the condition, as well as those caring for them (1). Research efforts continue to focus on identifying the most effective strategies for preventing cognitive decline and slowing or delaying dementia’s progression (2).

Over the years, music-based strategies have been investigated for everything from hospital stays to walking to sleep, yielding positive results in all of these areas. If music can help reduce anxiety and pain among cancer patients in the hospital, enhance walking speed, and improve sleep quality, it may also have benefits for dementia patients (3-6).

Research on music and dementia is not new. The relationship between the two has been under a microscope for some time, especially when it comes to music and its impacts on behavioural issues, mental health, and resistance to care. For instance, in people with dementia, music-based strategies have been shown to be beneficial for agitation, aggression, symptoms of anxiety and depression, and reducing resistance-to-care (7-9). With these positive findings under our belt, let’s shift the conversation to another important aspect of dementia, cognition. Was Plato right? Does music give the mind "wings"? A recent systematic review on active music-making therapy in older adults with cognitive impairment or mild to moderate dementia gives us some insight into this issue (2).

What the research tells us

Well, it turns out Plato may have been onto something. The review presented a promising initial result for cognitive health.

More specifically, within the review, active music-making therapies were delivered by professionals (e.g., psychologists with musical expertise, music therapists, occupational therapists, etc.) and defined as music-based strategies that involved physically participating in music. Examples of these therapies include singing, improvisation, reacting to a sound (e.g., hearing a drum) by clapping, playing percussion instruments, and music combined with exercise. Overall, the review found that active music-making therapy may improve cognitive functioning in older adults with cognitive impairment or mild to moderate dementia. Although this improvement was small, it was clinically meaningful, which suggests a tangible and noticeable effect on one’s daily life. Unfortunately, at this time, clear improvements haven't been observed for other outcomes, such as quality of life, depression, mood, or anxiety. It’s important to note that these are preliminary findings. As such, more research is needed to fully understand the impacts of these music-making activities on various aspects of cognitive and mental health (2).

Tip: If you or someone you care for is interested in music-based programming for boosting cognitive health, be sure to seek out programs developed and delivered by professionals. These programs should enable participants to actively engage in the 'music-making process,' as opposed to just having them be passive listeners.

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  1. World Health Organization. Dementia. [Internet] 2021. [cited January 2022]. Available from https://www.who.int/news-room/fact-sheets/detail/dementia
  2. Dorris JL, Neely S, Terhorst L, et al. Effects of music participation for mild cognitive impairment and dementia: A systematic review and meta-analysis. J Am Geriatr Soc. 2021; 69(9):2659-2667. doi: 10.1111/jgs.17208.
  3. Tsai HF, Chen YR, Chung MH, et al. Effectiveness of music intervention in ameliorating cancer patients’ anxiety, depression, pain and fatigue: A Meta-analysis. Cancer Nurs. 2014; 37(6):E35-50. doi: 10.1097/NCC.0000000000000116.
  4. Nascimento LR, de Oliveira CQ, Ada L, et al. Walking training with cueing of cadence improves walking speed and stride length after stroke more than walking training alone: A systematic review. J Physiother. 2015; 61(1):10-15. doi: 10.1016/j.jphys.2014.11.015. 
  5. McGee WL, Clark I, Tamplin J, et al. Music interventions for acquired brain injury. Cochrane Database Syst Rev. 2017; 1:CD006787. doi: 10.1002/14651858.CD006787.pub3. 
  6. Wang C, Li G, Zheng L, et al. Effects of music intervention on sleep quality of older adults: A systematic review and meta-analysis. Complement Ther Med. 2021; 59:102719. doi: 10.1016/j.ctim.2021.102719.
  7. Konno R, Kang HS, Makimoto K. A best-evidence review of intervention studies for minimizing resistance-to-care behaviours for older adults with dementia in nursing homes. J Adv Nurs. 2014; 70(10):2167-2180. doi: 10.1111/jan.12432.
  8. Ueda T, Suzukamo Y, Sato M, et al. Effects of music therapy on behavioral and psychological symptoms of dementia: A systematic review and meta-analysis. Ageing Res Rev. 2013; 12(2):628-641. doi: 10.1016/j.arr.2013.02.003.
  9. Elliott M, Gardner P. The role of music in the lives of older adults with dementia ageing in place: A scoping review. Dementia. 2018; 17(22):199-213. doi: 10.1177/1471301216639424.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.