Volume 22 Issue 7 - April 2017

MUSIC AND HEALTH
How Music Matters
VIVIEN FELLEGI
It’s Glee Club choir day at
Toronto’s Baycrest Hospital.
The grey-haired seniors, all
diagnosed with dementia, are
seated in a semi-circle in a room
with colourful paintings and a big
welcome sign. Most of them sit
sedately. Some stare into space.
Dr. Amy Clements-Cortes,
music therapist and assistant
professor, University of Toronto,
strides into the room and begins
singing to the accompaniment of
the keyboard.
Several clients join in and the
group begins to awaken. Some
tap their toes. Others clap their
hands. A few bob their heads.
Their eyes brighten as they focus
on their conductor. Some don’t
sing, but smile quietly. One man sits open-mouthed and lethargic for
a while, but eventually grabs the hand of the staff person sitting next
to him and pumps it up and down to the beat.
Clements-Cortes beams at the group. “You’re sounding
nice,” she says.
Though she’s impressed with the quality of the singing, she’s also
pleased by the ability of the music to temporarily revive her clients,
many of whom suffer from Alzheimer’s.
Baycrest clients share the condition with about 376,000 Canadians,
according to the Alzheimer Society of Canada. The disorder is
projected to afflict 625,000 lives by 2032.
The disease is caused by abnormal protein clusters that build up in
the brain and clog the connections between individual nerve cells,
says Lee Bartel, professor of music at the University of Toronto. Over
time the presence of these gummy blobs disrupt the circuits in the
brain, barring structures from communicating.
Loss of memory is the hallmark of Alzheimer’s disease.
Autobiographical memory, the recall of life events, is one type of recollection
degraded by the disorder, says Ashley Vanstone, PhD candidate
in clinical psychology at Queen’s. When patients forget pivotal
moments in their lives, they lose pieces of themselves and their very
sense of identity is shattered. “You see people slipping away from who
they are.”
In a Toronto nursing home, the Villa Colombo, resident Maria
Mirabelli sits motionless in her wheelchair. Her eyes are glassy, and
she’s chewing on air.
The sentimental Italian song, Mama, comes over the speakers, and
Mirabelli focuses, smiling softly and clapping. She starts mouthing the
words to the song.
Her son John Mirabelli has seen this transformation before, but
never fails to be astonished. “It’s incredible – she doesn’t even know
my name,” he says.
The music is also inspiring flashbacks from her past, says activity
aide Teresa Cribari. It returns her to the days when she cooked in her
kitchen on Sundays while listening to the radio. “I think the music
soothes her,” says her son. “It’s great to see her like that.”
Music has the uncanny ability to momentarily reanimate clients by
activating their fraying memories, says Vanstone. One famous case
involved EN, an Alzheimer patient who spoke in garbled sentences but
still recognized familiar songs. Researchers concluded that memory
for speech and for music resided in different locations in the brain,
and the latter was relatively spared even in advanced dementia.
Scientists have since pointed out several mechanisms accounting
for the doggedness of musical
memory. To pull a tune out of
storage you first need to make
sense of it, says Vanstone.
Compared to speech, music
lends itself well to this task, as
the grammar of music is internalized
early in life. And, unlike
in speech, the components of
music are replicated – the melody
is reinforced by accompanying
chords, which are connected to
regular rhythms. That means
we’re not dependent on any one
conveyor of musical meaning. “If
your ability to perceive one mode
is shaky, you’ve got lots of others.”
Not only can Alzheimer’s
patients often recall melodies,
they can also remember their
lyrics long after they’ve forgotten where they live. The close association
between the brain pathways for melody and lyrics accounts for
this surprising feat, says Vanstone. “Melody and lyrics are like two
parallel tracks joined by rungs – like a ladder. So the memory for
melody can support the memory for lyrics.”
But music’s best stunt is its capacity to rekindle the milestones of
our lives. These autobiographical memories include landmarks such
as graduations and weddings, and are rich in sentiment. Music relies
on these emotions to resurrect the recollections, says Vanstone. “Music
is very good at conveying feelings – it builds up and lets go, giving
a sense of tension and release,” he says. This ability to tap into our
deepest passions helps us to draw out the experience that was laid
down with the same fervent backdrop.
Music can also aid in recovering memories through its impact
on our body’s physiology, says Ryerson PhD candidate Katlyn Peck.
Music can stimulate areas of the brain responsible for releasing the
chemical dopamine, which helps reconstruct memories. Retrieving
a remembrance requires the brain to function at an optimal level of
arousal – neither over-stimulated nor under-activated. Music can
soothe anxious patients or activate depressed ones, creating the ideal
environment for reminiscence.
While memory loss is hard enough for sufferers of Alzheimer’s, this
problem can be compounded by depression. In the initial stages of the
disease, clients are aware of their declining function. “They become
frustrated with themselves when they recognize their problems,” says
Clements-Cortes.
Fortunately, attending live concerts can partially reverse this
complication, says Michael Thaut, professor of music at the University
of Toronto. He led a study in which patients with Alzheimer’s attended
nine monthly concerts along with their significant others. He noted
striking changes in their moods over the course of the study. “They
went from being frozen and inaccessible to smiling and singing along
with the music.”
Back at Baycrest, one man with piercing emerald eyes and matching
green pants becomes increasingly animated as the hour progresses.
He acts out the songs with dramatic facial expressions and theatrical
gestures. His baritone voice belts out Love Me Tender, as he gazes
wistfully at Clements-Cortes and points his index finger right at her.
“I enjoy expressing myself,” he says. “Today I was expressing love – I
can feel what the songs were saying.”
Music bolsters the mood many different ways, says Clements-
Cortes. For starters, it provides an alternative method of communication
when words have become compromised. As well, music stirs
JUSTINE DUDZIAK
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