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Topic: Gen'l Interest: Music stave off dementia?
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Jerry P. Becker

Posts: 16,576
Registered: 12/3/04
Gen'l Interest: Music stave off dementia?
Posted: Sep 4, 2013 7:01 PM
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From, Monday, September 2, 2013. See
Playing for time: Can music stave off dementia?

By Elizabeth Landau

(CNN) -- At 101, Frank Iacono still plays the violin. The
concertmaster for the Providence Civic Orchestra of Senior Citizens
in Rhode Island, he particularly enjoys playing polkas and jigs.

"It keeps my mind active, and it gives me a lot of pleasure," Iacono said.

The orchestra's executive director and co-founder, Vito Saritelli,
said Iacono is extremely sharp for his age.

"Music has played a good part of his longevity," said his wife, Mary
Iacono, 94. "We're blessed that we're both in good health."

As scientists race to figure out how to promote healthy aging of the
brain, and prevent dementia, their preliminary advice for senior
citizens has become a chorus of voices: "Stay active! Have hobbies!
Be socially engaged!"

Playing music, for some people, is a natural answer to all of those
recommendations. Frank Iacono, for instance, has been playing violin
since he was 13 -- just because he loves it.

But does music playing in particular stave off dementia? What about
just listening to music? How many years do you need to engage in
music before it benefits your brain?

Researchers are exploring these questions in the face of staggering
statistics about the aging population. The number of Americans 65 and
older with Alzheimer's is expected to triple nearly by 2050 -- 13.8
million from 5 million now. The annual cost of dementia in the United
States in 2050 will be $1.2 trillion, according to the Alzheimer's

Early research suggests playing music may hold back dementia symptoms
by about five years -- which would be significant if it proves to be
true, said Brenda Hanna-Pladdy, assistant professor of neurology at
Emory University, who studies cognitive functioning among musicians.

"If you can delay the presentation (of dementia) by five years, then
you add an extra five years of functioning to an individual at the
end of the life span," she said. "In terms of fiscal cost and
everything, that's actually quite a lot."

Being engaged

A large study using Sweden's twin registry is looking at
intellectually and physically stimulating lifestyle factors that
could help stave off cognitive decline. One component of this effort
is exploring whether playing music protects against dementia. The
results, discussed at the Interdisciplinary Society for Quantitative
Research in Music and Medicine meeting in July, are not yet published.

Twin studies carry special importance in science. Usually, when
people participate in a study, they each carry a different set of
genetics and may have had different upbringings. Those factors could
influence whatever researchers want to investigate. Fraternal twins,
however, share about 50% of genes, and identical twins share almost
all. Twins also likely grew up in the same environment.

"To me, the most intriguing aspect is, in a twin pair, if one becomes
demented and the other doesn't, what did (one not do)? Or what did
the one who did become demented do that might give you some clues
about ways that other people can mitigate their risk?" asked Margaret
Gatz, director of the Study of Dementia in Swedish Twins, and
professor at the University of Southern California.

Researchers examining the broader twin data have found that, for
women specifically, participating in intellectual and cultural
activities was linked to lower dementia risk in one study. Activities
such as exercise at midlife for both sexes are also protective
against dementia, the study suggests.

"All of these kind of add up in suggesting that a more engaged
lifestyle is a good thing for the aging brain," Gatz said.

Why would an "engaged lifestyle" help prevent dementia? The idea is
that brain stimulation may counteract brain changes that occur
because of cognitive decline so that a person can function for
longer, Gatz said.

Music playing in particular is something that people can continue to
enjoy for longer than their occupations, or strenuous physical
activity, Gatz said. It also has cognitive, physical and potentially
socially components, so it engages many brain networks.

Unfortunately the twin study has so far only looked at associations
between lifestyle factors and dementia; it doesn't prove that music
can protect you against cognitive decline. The study also doesn't
include brain imaging or autopsies, so the precise mechanism -- how
engagement in activities would prevent dementia -- is unknown.

The brain's backup

There is other emerging evidence that playing music could help
prevent dementia.

Hanna-Pladdy, the Emory neurologist, is interested in exploring the
biological underpinnings further. Her theory agrees with Gatz's:
Brain networks that have been strengthened by musical engagement
compensate to delay the detrimental effects of aging, a process
called cognitive reserve.

So far her research has demonstrated that extensive musical
instrumental training, even in amateur musicians, provides a
cognitive benefit that can last throughout a person's life. Her
studies were published in 2011 in the journal Neuropsychology and in
2012 in the journal Frontiers in Human Neuroscience; they included
instrumentalists, not singers.

Hanna-Pladdy and her colleagues found in their first study that even
if participants did not continue playing music as they aged, they
still performed better at tasks of object-naming, visuospatial memory
and rapid mental processing and flexibility than those who didn't
play at all -- as long as they had played for at least 10 years.
That's critical because as they age, people may lose motor skills or
eyesight that prevents them from playing their instruments.

The study also suggests the cognitive benefits of instrumental
training can last a lifetime.

One of the study's participants said in an interview that he felt
like having played for so long was akin to "an insurance policy,"
Hanna-Plady said.

The researcher's more recent study showed that musicians who began
playing before age 9 had better verbal working memory functions than
those who started later or didn't play at all.

This finding is consistent with verbal language acquisition --
linguistics studies have shown that there is a critical period during
which the brain is open to learning a language, and fluency becomes
far more difficult after a certain age in childhood.

It also jives with the findings of a 1995 study that showed
professional musicians who began training before age 7 had a thicker
anterior corpus callosum, part of the pathway that links the right
and left hemispheres of the brain.

And participants who continued to play their instruments at older
ages tended to perform better on tasks of visuospatial judgment,
"suggesting that there continues to be plasticity in advanced age,"
Hanna-Pladdy said.

"Finding a way to harness this plasticity is probably one of the
biggest hopes we have for treating brain disorders or dealing with
cognitive decline in advanced age," she said. "Similarly, continuing
to play music in advanced age added a protective benefit to
individuals with less education, which has previously been
demonstrated (to be) one of the most robust ways to create cognitive
reserve. Thus, musical training appears to be a viable model for
cognitive stimulation, and can be conceptualized as an alternate form
of education."

Should we start now?

Is it worth it then to teach an older person to play an instrument,
perhaps one who already shows signs of cognitive decline? Recent
research suggests it's harder, but still possible, to modify the
brain in an older person. But no one has a definitive answer on
whether teaching an elderly person a new instrument would lead to the
same kinds of benefits that scientists have found in lifelong

"It would be pretty challenging, considering they're having a hard
time remembering," Hanna-Pladdy said of dementia patients. "It may be
beneficial to provide musical stimulation to individuals in the
earlier phases (referred to as mild cognitive impairment) or to
re-initiate musical practice in individuals who are no longer

Regardless, since people find music enjoyable, trying to learn an
instrument won't hurt. But more research is needed over a long period
of time to assess fully the benefits of music among elderly people,
Hanna-Pladdy said.

Evidence may continue to emerge that long-term music playing has a
preventive effect against dementia, but that's not to say that
nonmusicians are totally out of luck, Hanna-Pladdy said.

Music is becoming a hot area of study because it's easier to quantify
the number of years that people play music than, for instance, the
length of time reading or playing games.

"This is just meant to be a model for cognitive stimulation, and how
cognitively stimulating activities can change your brain,"
Hanna-Pladdy said.

So music may be good for you, but so may other pastimes.

After all, violinist Frank Iacono and his wife, Mary -- married for
66 years -- play Scrabble together every night.

Tuning in

For patients who already have dementia, music can be used in a
different way to help the mind.

The emotional response that people get from listening to music, and
the brain chemicals associated with pleasure that get released in the
process, are distinct from the structural changes in the brain that
playing music over time may instigate, scientists said.

Trends emerging from research show that music exposure -- whether
through casual listening or more formalized music therapy -- can help
reduce the incidences of behavioral issues and generally calm
dementia patients, said Beth Kallmyer, vice president for constituent
services at the Alzheimer's Association.

"Anecdotally what we hear is that people can be upset, even a little
agitated, and when they're listening to music, even in the late
stages, people can appreciate music," Kallmyer said.

Family members should help caregivers choose music that is meaningful
to a person with dementia, she said. "The most important thing is
keeping your interventions person-centered as much as possible."

Naomi Ziv of the Academic College of Tel Aviv Yaffo in Israel and her
colleagues showed in a Journal of Music Therapy study that background
music is associated with an increase in positive behaviors --
laughing, smiling, talking -- a decrease in negative ones, including
aggressiveness and crying.

Music attracts attention; it also enhances focus and affects emotion,
Ziv told CNN in an e-mail.

"When we hear familiar and preferred music, we mentally follow it,"
she said. "It seems that whereas general memory deteriorates in
dementia, memory for music remains relatively intact."

Familiar or preferred music evokes memories and influences mood,
which is perhaps the underlying reason for these results, Ziv said.

Catherine Shmerling appreciates the effect that certain musical
events have had on her father, Dr. Sanford A. Shmerling, 85. The
elder Shmerling used to be the medical director of the William Breman
Jewish Home in Atlanta; now, he lives there. He has Alzheimer's, and
most of his speech is not comprehensible, his daughter said.

On a recent weekend, a swing band performed at the nursing home. At
first the former medical director sat in his wheelchair staring into
space, but soon his daughter noticed him clapping his feet. She
started swinging his arm with the music, and after a few minutes he
gave her "a cute little smile."

"It's gratifying," Catherine Shmerling said. "There is something
about -- I don't know, the music or the auditory or something -- that
does seem to get past whatever it is that's blocking their normal
communication, and somehow it gets in there."

Science may not have all the answers, but Shmerling savors these
small signs that her father is listening.
Jerry P. Becker
Dept. of Curriculum & Instruction
Southern Illinois University
625 Wham Drive
Mail Code 4610
Carbondale, IL 62901-4610
Phone: (618) 453-4241 [O]
(618) 457-8903 [H]
Fax: (618) 453-4244

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