The songs that played at your wedding, high school summer jams, and other cherished music may provide relief for patients with dementia.
Dementia affects more than 57 million people worldwide, and 60 percent of those diagnosed live in low- and middle-income countries, according to the World Health Organization. There are approximately 10 million new cases each year.
Patients with dementia, which includes Alzheimer’s and Parkinson’s diseases, have symptoms like memory loss, confusion, agitation and mood changes. Those diagnosed are often treated with medication, some with dangerous side effects.
Ellen McCreedy, associate professor of health services, policy, and practice at the Brown University School of Public Health, is studying a toe-tapping alternative that could reduce reliance on antipsychotic medications.
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The university’s ongoing study, “Music and Memory,” looks at how music can be used as a non-pharmacological intervention for people with Alzheimer’s disease and related dementias. In particular, McCreedy is studying music “familiar to residents” from their teenage years and early 20s.
McCreedy, who has a bachelor’s degree in music therapy and psychology, was a music therapist and is a music lover who plays the flute, piano, and guitar.
Her experience with dementia is both “professional and personal.” She had a grandmother who had Alzheimer’s disease, who loved playing her Lowrey organ for friends in Chicago.
In later stages of dementia, McCreedy’s grandmother could always connect with old Irish songs.
“‘I’ll Take You Home Again Kathleen,’ was always one,” McCreedy said. “I could sit and play on the piano and we would see moments of her, so that also inspired me.”
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McCreedy shared the results of the initial phase of the study, which began and ended in 2019.
Q. Tell us about the Music and Memory study.
McCreedy: The principal investigator for the Music and Memory study is Dr. Vincent Mor. We randomly assigned nursing homes to either receive the early preferred music intervention or the usual care, which could include group music. But the real question was, can this early preferred music (ages 16 to 26) — the songs you listened to in high school with your friends, songs you got married to — be used at early signs of agitation, with the goal of reducing the burden of agitated behaviors in people living with dementia? And, can it help reduce the use of antipsychotics and other medications sometimes used to manage agitation, which can have dangerous side effects? The idea was, if we could intervene early with a safe and efficacious treatment, could we both decrease the behaviors and need for subsequent medication management?
What were some of the key findings?
The study showed that... early preferred music reduced the frequency of verbally agitated behaviors in people living in nursing homes who have dementia. That’s the main finding. ... Then the question is, do you decrease the medications that sometimes are used to manage the behavior? We did look at antipsychotics and we found that it does look like it reduces it, but ... we can’t say definitively. We did not find that the intervention reduced physically agitated behaviors.
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Which sites participated in the study?
It was 976 residents from 54 nursing homes, 27 treatment centers, and 27 control. They were in the Midwest, in the central D.C. metro area, and in the South. We had a pretty racially diverse sample. About 25 percent of our sample was African American.
What do you do if you don’t know a resident’s musical preference?
We have a paper that shows it took 2 1/2 hours on average – or two or three sittings – to find residents’ musical preference. Often, you’re in a situation where someone is a good candidate for intervention, but we don’t have any idea what their musical preference is. We started with Billboard lists in different genres and different decades, and we’ve modified them to be a little more regionally specific, site specific, so we can get a bit more tailored to the top 10. An activity staff sat and played the music for the resident and looked for positive responses — tapping, vocalizations of any sort, just an awakening or increase in attention.
Do you see your research being used in emotion recognition apps, artificial intelligence, or mental health tools?
Yes, there are big barriers to scale here and so we’re trying to target the different pieces that affect getting this to everybody, especially older adults living with dementia, wherever they are living. But there could be broader uses of preferred music for reducing isolation and loneliness in healthy adults. ... We have a pilot to look at smartwatch-detected stress and map it to human-observed agitation, which is what we do a lot of in our lab. There’s a lot we could do if we know when a person is starting to get agitated. We’re thinking about technology in the form of consumer wearables to detect agitation and make playlists based on affect and response.
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Tell us about the effort that was needed to gather the data for this study?
This research would not be possible — 100 percent — without our nursing home partners and the staff that are already working so very hard. This is one of those environments that the people are doing the best work in, and not getting enough pay for what they do. I would recommend everybody go and volunteer at a nursing home and see how hard these folks are working and how much they care.
This interview has been lightly edited for length and clarity.
The Boston Globe’s weekly Ocean State Innovators column features a Q&A with Rhode Island innovators who are starting new businesses and nonprofits, conducting groundbreaking research, and reshaping the state’s economy. Send tips and suggestions to [email protected].
Carlos Muñoz can be reached at [email protected]. Follow him @ReadCarlos and on Instagram @Carlosbrknews.