Ashleigh Hatsell Hatsell 1

ENC 2135

Professor Rob Cole

March 26, 2017

Is Music Therapy more effective than drug treatment methods in Alzheimer patients?

Alzheimers Disease is a disorder that is progressive and can not be reversed. It is also

the most common form of Dementia. People that develop Alzheimers disease are typically in

their mid-60s, so it is definitely a disease that is most prevalent in older communities, but

early-onset Alzheimers occurs between the

ages of 30 to 60. Due to the fact that

Alzheimers disease is a progressive,

irreversible disease, there is no one cure yet

for it, but there are many drug and nondrug

treatments that will help with the cognitive

and behavioral symptoms. This essay

specifically focuses on Alzheimers

patients and their reactions to music

therapy and other forms of treatment.

This image shows the amount of people 65 or older with

Alzheimers and the cost to care | http://bangordailynews.com/2012/01/22/
health/alzheimers-treatment-sees-major-setback/
 Hatsell 2

Alzheimers disease is a very progressive disease which means that it happens

very gradually and can not be reversed. People living with Alzheimers disease have lives that,

depending on what stage they are in, are filled with memory loss, wandering, trouble

remembering friends and family, unable to learn new things, or even a loss of communication.

The way that Alzheimers is treated can either be with therapy related treatment, or even drugs

including cholinesterase inhibitors and memantine. These two types of drugs are the only ones

that are currently approved for the treatment of Alzheimers disease. These drugs will treat the

main symptoms of memory loss, and problems with thinking and reasoning.

The problems with drugs is that they can sometimes create side effects that are not so

great for individuals with diseases. A study was conducted that looked at NSAID drugs which

stands for Nonsteroidal Anti-inflammatory Drugs. In this study, the researchers developed

conjugate drugs because the problem with these types of drugs (NSAIDs) is that if you use them

for a long period of time, they can produce something called gastrointestinal toxicity. According

to Cacciatore et al, NSAIDs diminish the risk of AD, delay dementia onset, slowing its

progression and reducing the severity of cognitive symptoms (2). In this specific article, these

types of drugs have been said to possibly be able to treat Alzheimers disease. This article and

study, however, have found ways to alter these drugs in order to prevent that. Altering drugs can

cost a lot of money and time which can be less beneficial and effective in the long run. When

deciding what type of treatment to give an alzheimers patient, it depends on if they want to use

drug related therapies, or maybe even something such as music therapy.

 Hatsell 3

Music Therapy is an up and coming method of therapy that is actually very beneficial for many

different types of people. Music Therapy has

been used for autism, alzheimer's patients,

people who have had strokes, and more.

Music Therapy does not use drugs of any

type, and can be even better for patients with

Alzheimers because they do not have to

consume anything to feel better. When using

Music Therapy, patients can play

instruments,

This infographic shows the brain and how music works in each part |

https://www.kindermusik.com/mindsonmusic/benefits-of-music
/your-brain-on-music/

sing, or just listen to the music being played by others. In a study that was conducted and

recorded in an article by Palisson et al, 12 mild Alzheimer patients and 15 control patients were

asked to either memorize a text with musical association, non-musical association, or spoken

with or without a 5 minute delay; after this, recall of the text was measured. The results showed

that overall, the texts that were sung were remembered far better than the spoken texts both with

and without the 5 minute delay. To come to the conclusion based on this article, musical

association in alzheimers patients memorization and learning is more effective than just
 Hatsell 4

speaking it aloud. This is important to realize because this study is showing that music therapy is

helping these patients to remember things that they normally may not be able to remember on a

regular basis. Due to the fact that music produces emotions, alzheimers patients might

remember a memory in which they felt the way they do with the music. Music Therapy is a very

important form of therapy especially in people that may have a disease involved with memory, or

retention of information, because music is definitely a form that aids in boosting these areas.

This image shows performances by controls and alzheimers patients recall of texts | Palisson et al
 Hatsell 5

Continuing on with the article about the alzheimers patients recalling a text, an

interesting fact was found. Palisson et al says thus, contrary to what Simmons-Stern and

colleagues found, music may improve recollection of specific content (involved in free recall)

and not only familiarity (511). This little fact is very key because with Alzheimers and

dementia patients, a lot of memory that is recalled from memory might be vague and broken up,

but when music is used, suddenly they are able to remember more specific content and it may

flow more when being recollected. Music is used in a variety of ways, but when it comes to the

association with memory, its form is one of the most effective.

http://www.aarp.org/health/brain-health/info-2015/music-therapy-for-alzheimers.html

Music therapy is a treatment that uses the aspects of music, such as rhythm, lyrics, and

even beats to help with memory, learning, cognitive functions, and even behavior. Music is a

diverse form that can help with many different things and with many different types of people as

well. When looking at Alzheimers disease, this is a disease that causes memory loss, cognitive
 Hatsell 6

problems, and even behavioral problems. Ridder et al says that basically music is a form that

helps with social interaction communication because music makes people feel empathetic

expressions that are almost better than verbal communications. It is most common in older

individuals, because it is progressive and can start as young as 30. Music is something that is

introduced at young ages, starting even when you are a baby. Music being used with older

individuals is effective because they are most likely familiar with music, and they might

remember things such as memories and recall of basic information when using musical forms.

Caroline Bartle is part of a collaborative called 3 Spirit which is a group that provides training in

the health and social care sector. From a blog about music and dementia, Bartle says,

Music can be active or receptive, active often involves playing an instrument but can also

include singing. For many of the people I teach receptive music is what they will use,

however active music engages a wide range of cognitive skills, and from that perspective,

a great tool for cognitive stimulation (paragraph 9).

This being said, music therapy helps in any way for alzheimers patients, but in order to engage

with the cognitive skills these patients must be more active with the music; playing an instrument

or singing. Bartle also states that, our association with music often has a cultural, and emotional

significance in our lives. It can elicit emotions and associations that have previously been

forgotten (paragraph 10). Emotions are important to be brought up through music therapy

because those are what will help patients remember certain memories in their lives.

This picture shows the benefits of music in dementia care |

http://www.3spirituk.com/adventure-music-dementia-new-zealand-personal-story/
 Hatsell 7

When looking at other forms of treatment, drugs are going to be another form that is

somewhat simple to get, and is easy to use. There are side effects that will come along with

drugs, but that is to be expected. In terms of Alzheimers disease, there are just a few different

types of drugs that have been found to help treat this disease, but they have to be altered in order

to be suitable for use. Cummings et al says,

Despite the evaluation of numerous potential treatments in clinical trials, only four

cholinesterase inhibitors and memantine have shown sufficient safety and efficacy to

allow marketing approval at an international level. These five agents are symptomatic

treatments, temporarily ameliorating memory and thinking problems, and their clinical

effect is modest; they do not treat the underlying cause of AD and do not slow the rate of

decline (2).

Something important to remember about drugs are that they are most likely going to work pretty

quickly, but they might not reach certain areas for alzheimer patients that another form of

treatment might reach, such as music therapy.

Due to the fact that there are multiple drugs that can be used to help treat alzheimers

disease, there can be issues with all those types that need to be looked at. In an article about a

specific drug called Memantine, there were studies that have been done on alzheimers patients

to test whether this drug reacts well with the patient and whether it helps treat their symptoms or

not. According to Jue Jiang and Hong Jiang Yang et al. found that memantine did not

significantly improve the activity of daily life in AD patients. Lockhart et al. and Yang et al.
 Hatsell 8

reported no significant benefits of memantine on mental behavior, as assessed by the NPI. This

being said, this specific type of drug

was shown to help with certain types of

symptoms, but was not shown to

actually help with everyday life or

mental behavior. This is the issue with

these drugs and the help that they create

for people with this disease; some drugs

might help with everyday life, and

http://www.medicaldaily.com/antipsychotic-drugs-among
-elderly-raise-death-risk-dementia-patients-326150

some may not. The drugs that have been found to work in Alzheimers patients are good forms

of treatment, but only temporarily help with memory and thinking problems. These drugs do not

treat or cure the causes of alzheimers, and they do not slow the rate of decline, according to

Cummings et al. (Alzheimers Research & Therapy). The problems with drugs is that they can

have toxic effects, which can actually end up harming people that are taking them. Therapy, and

more specifically music therapy is going to help patients to become more emotionally stable and

be able to remember things more easily with no type of influence except the influence of natural

music.
 Hatsell 9

In a book titled, Musicophilia - Tales of Music and the Brain, there is a section that

specifically talks about music therapy and how it works in individuals with dementia, or more

specifically, alzheimers disease. Oliver Sacks says:

Music therapy with such patients is possible because musical perception, musical

sensibility, musical emotion, and musical memory can survive long after other forms of

memory have disappeared. Music of the right kind can serve to orient and anchor a

patient when almost nothing else can (373).

This comes directly from a study that was conducted on a patient by the name of S.L. in

Oklahoma. Although this man was affected by alzheimers, he could still play musical

repertoires from the past, but he could not simply recall information on other memory tests.

There is something so remarkable about music and how someone that can not even recall basic

information like how to tie a tie can remember an entire solo from a piano piece and play it spot

on. Music touches parts of our brain that only can be affected with music, and nothing else.

Music and Music therapy go beyond the realms of just helping with a specific thing. Music

therapy in Alzheimers patients goes into the emotion, cognition, thoughts and memories of these

individuals and touches on these specific brain parts that might need an extra boost.

A study was conducted that wanted to see the effects that music therapy had on two

different patients with frontotemporal dementia, which is a form of alzheimers. The test was

taken before and after music therapy was used. This study used the Cohen-Manseld Agitation
 Hatsell 10

This picture shows the effects that music therapy has on agitation, physical and verbal aggression, and

physical and verbal nonaggression | Ridder et al

Inventor model of testing agitated behaviors. The results show that according to Ridder et al, it

was noted that sta experience frequency as having decreased after the course of music therapy,

and that Mr As expression of agitation seemed less disturbing after the therapy course of

intervention (122). In this study, a lot of the agitation and aggression was seen to have

decreased in some areas, which is beneficial because behavior is one thing that is affected in

Alzheimers patients. The importance of this study is that alzheimers is a disease that can create

many different challenges in peoples lives. This specific study looks at agitation and aggression

which are issues that some patients come across when dealing with Alzheimers. The effects that

music and music therapy have on these patients is important because the music can actually

relieve alzheimers patients throughout their life with these problems.

 Hatsell 11

Verbal memory is an important thing for people to be able to recall, but autobiographical

memory is probably one of the most important types of memory that an individual person will

want to recall in order to live a happy life, and be able to enjoy memories that they have. Music

Therapy is something that can help aid in the process of patients with alzheimers trying to

remember these autobiographical memories. Drugs might help with this, but it can also cause

health effects if used too much for a long period of time. In an article from Mohamad El Haj,

Virginie Postal, and Philippe Allain, there was a study done that involved 12 mild Alzheimer

patients in which they were exposed to either silence, the Four Seasons, or chosen music. The

results show that the patients that chose their own music, recall was the highest. Both types of

music were higher than silence, however. These results directly show that music regardless of if

it is a certain type or it is chosen is much more effective than trying to recall things in silence.

This study is directly tapping into the emotional aspects that music therapy can invoke. This is

more than drugs can do, because drugs do not have the power to tap into our emotional sides like

music can. According to this article, Music Enhances Autobiographical Memory, studies have

found that when people are trying to remember memories, the emotional ones are more

remembered than the unemotional ones. This is an important factor because music is known to

invoke emotions in people depending on what type of music they may play.

Many different forms of treatment for diseases, and specifically alzheimers disease are

all important and are all widely used. Some forms of treatment, however, might be more

effective and even be more healthy. Music therapy is definitely a more widely used form of
 Hatsell 12

treatment and is becoming more used as it progresses as a form of therapy. Drugs are also

another form of treatment. With drugs might come some side effects and even some health issues

later on. People are developing drugs in order to avoid these types of things, but that can also

take longer to work through. The beauty of music therapy is it is always there and there is no

need to alter it in order for it to work. Music therapy might not work for everyone, but it

definitely might help. From the different studies that were mentioned above, it is known that

different types of uses with music were all seen to have positive effects and outcomes in

alzheimer patients that were trying to recall memories whether that be verbal or

autobiographical.

Music therapy is something that is becoming more popular to be used because it is all

natural and does not require any drugs to be taken of any kind. Music has such a powerful aspect

to it that works through many different people. Based on studies that have been done, music

therapy has actually worked with individuals in order to memorize things such as a simple text.

When singing is used, there is a tendency in people to remember it a whole lot better than when

saying it aloud. The reason for this is because of maybe a certain beat or rhythm that they

remember from childhood that help them remember what they were saying. Music also aids in

recalling memories that may be associated with an emotion that is brought up. Music therapy is

also beneficial and effective in alzheimers patients with behavioral or cognitive issues. This is

important because cognitive and behavioral functions are used in everyday life, and having

music to help aid in relieving these issues is an effective way.

Annotated Bibliography

Bartle, Caroline. An Adventure, Music, Dementia and New Zealand - A Personal Story.
3SpiritUK, 15 Dec. 2014, Accessed 26 Mar. 2017. www.3spirituk.com/adventure-music-
dementia-new-zealand-personal-story/.

This blog post comes from a website that helps in the health care areas. Caroline Bartle
works specifically with people in New Zealand, and this is where she learned about
Music Therapy. She learned a lot about music and the brain, which fascinated her. She
basically goes into talking about how she used receptive music to help with dementia
patients. She says that music is important in a disease that erodes memory because it can
actually restore it.

Cabedo-Mas, Alberto, and Diego Moliner-Urdiales. "Music Therapy and Cognitive Capacity in
People with Alzheimers Disease: A Call for Action." Nordic Journal of Music Therapy, vol.
23, no. 2, (2014), pp. 195-197. Accessed 12 March. 2017.

This article talks about how they want to encourage researchers to investigate the
effectiveness and impact of music therapy on cognitive functions. This is important to
know about because cognitive functions are used in everyday life. The main part of this
article is to bring a call to action that music therapy has an impact on these functions in
people with Alzheimers disease.
Cacciatore, Ivana, Lisa Marinelli, Erika Fornasari, Laura S.Cerasa, Piera Eusepi, Hasan Trkez,
Cristina Pomilio, Marcella Reale, Chiara DAngelo, Erica Costantini, and Antonio Di
Stefano. "Novel NSAID-Derived Drugs for the Potential Treatment of Alzheimer's
Disease." International Journal of Molecular Sciences, vol. 17, no. 7, (2016), pp. 1-16.
Accessed 14 March. 2017.

The main aspect of this article is about NSAID drugs and how they have potential to treat
alzheimers. The authors of this article have authority because they are most likely very
proficient in what they are studying or researching about. Throughout this article it goes
into detail about these types of drugs and how there are conjugate drugs that will not
produce gastrointestinal toxicity.

Cummings, Jeffrey, Paul S. Aisen, Bruno DuBois, Lutz Frlich, Clifford R. Jack Jr, Roy W.
Jones, John C. Morris, Joel Raskin, Sherie A. Dowsett, and Philip Scheltens. "Drug
Development in Alzheimer's Disease: The Path to 2025." Alzheimer's Research & Therapy,
vol. 8, (2016), pp. 1-12. Accessed 12 March. 2017.

This article is about the drug development in Alzheimers disease and how researchers
and scientists are trying to treat alzheimers disease by 2025. The main aspect of this
article is about how certain drugs, such as ones in late phase 1, will have a chance of
being approved by 2025. Basically this article is saying that people need to be aware and
educated on Alzheimers in order to be able to develop more intense drugs to hopefully
treat AD someday.
El Haj, Mohamad, Virginie Postal, and Philippe Allain. "Music Enhances Autobiographical
Memory in Mild Alzheimer's Disease." Educational Gerontology, vol. 38, no. 1, (2012), pp.
30-41. Accessed 13 March. 2017.

This article goes into detail about Alzheimers disease and how music aids in the memory
aspect. This article goes in depth about a study that was conducted about patients with
Alzheimers Disease and how when they listened to specific types of music, or no music
at all, helped aid in autobiographical memory recall. This is an important article because
it helps explain how music itself benefits in memory for these patients.

Fukui, H., A. Arai, and K. Toyoshima. "Efficacy of Music Therapy in Treatment for the Patients
with Alzheimer's Disease." International Journal of Alzheimer's Disease, (2012), pp. 1-6.
Accessed 10 March. 2017.

In this study, these researchers find that music therapy is an effective way to possibly
treat alzheimers disease or at least help with the effects of alzheimers disease.
Testosterone hormone is supposed to have preventive effects on the disease, and
apparently is increased with music in the presence of individuals. The aspect of this
article is showing that behaviors such as fugue had decreased with music therapy.

Jiang, Jue, and Hong Jiang. "Efficacy and Adverse Effects of Memantine Treatment for
Alzheimer's Disease from Randomized Controlled Trials." Neurological Sciences, vol. 36,
no. 9, (2015), pp. 1633-1641. Accessed 16 March. 2017.

In this specific article, clinical studies have been done that show the role of a drug called
memantine in Alzheimers patients. In these 2,293 studies that have been conducted, only
about 13 of those met the criteria. Memantine did show benefits to cognition, mental
state, and activities of daily life. This drug still seems to be low in the positive outcomes
that it has produced in Alzheimer patients.
Palisson, Juliette, Caroline Roussel-Baclet, Didier Maillet, Catherine Belin, Jol Ankri, and
Pauline Narme. "Music Enhances Verbal Episodic Memory in Alzheimers Disease."
Journal of Clinical & Experimental Neuropsychology, vol. 37, no. 5, (2015), pp. 503-517.
Accessed 12 March. 2017.

This is another article that I wanted to include in my research because it talks again about
Alzheimers and how music enhances verbal episodic memory which is important in
peoples lives. This article talks about a study in which groups of people with the disease
and a control group of people that were healthy were given a text to learn and present
with either singing, speaking (to a silent movie sequence), or speaking alone. The results
directly showed that sung texts were by far more remembered than the spoken texts. This
article is important to use for the research because it talks about those with diseases, and
how music directly helps them with something as basic as memorization.

Ridder, Hanne M., Tony Wigram, and Aase M. Ottesen. "A Pilot Study on the Effects of Music
Therapy on Frontotemporal Dementia - Developing a Research Protocol." Nordic Journal of
Music Therapy, vol. 18, no. 2, 2009, pp. 103-132. Accessed 26 March. 2017.

This article is interesting because it goes into detail about a more specific type of
dementia included in alzheimers which is frontotemporal dementia. A study was
conducted that looked at the different types of instruments used to measure quality of
life. Music therapy was used in these tests to determine specific aspects of alzheimers
that are affected when music is used.
Sacks, Oliver. Music and Identity: Dementia and Music Therapy. Musicophilia: Tales of
Music and the Brain, Vintage Books, 2008, pp. 371-385. Accessed 23 March. 2017.

This source is a book that talks all about music and how it has helped different types of
individuals. The specific chapter I looked at was related to dementia and music therapy
and how certain people with dementia had a better outlook on life once introduced to
music.

Sauer, Alissa. 5 Reasons Why Music Boosts Brain Activity. Alzheimers.net, 21 July 2014,
www.alzheimers.net/2014-07-21/why-music-boosts-brain-activity-in-dementia-patients/.
Accessed 26 Mar. 2017.

This article talks about how music helps dementia. It goes to say that music will evoke
emotions that bring memories back into view, can shift mood, manage stress, and
stimulate positive interactions. This article is a non-scholarly source that helps us see the
benefits and effectiveness of music in alzheimer patients lives.

Digital Components

Bartle, Caroline. Music in Dementia Care. 3SpiritUK, December 15, 2014,

http://www.3spirituk.com/adventure-music- dementia-new-zealand-personal-story/

Case, Theresa. Music & The Brain, Kindermusik, 2017, https://www.kindermusik.com

/mindsonmusic/benefits-of-music/your-brain-on-music/

Geist, Mary Ellen. AARP: Real Possibilities, 2015, http://www.aarp.org/health/brain-health/

info-2015/music-therapy-for-alzheimers.html
Palisson, Juliette, Caroline Roussel-Baclet, Didier Maillet, Catherine Belin, Jol Ankri, and
Pauline Narme, Journal of Clinical & Experimental Neuropsychology, Taylor & Francis
Ltd, 2015, http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=103642146
&site=ehost-live.

Ridder, Hanne M., Tony Wigram, and Aase Marie Ottesen, Nordic Journal of Music Therapy,
Routledge, 2009, search.ebscohost.com

Yingling, Melina. Finding a cure for Alzheimers. bangordailynews.com, Linda Johnson,

2012, http://bangordailynews.com/2012/01/22/health/alzheimers-treatment-sees-major-
setback/

Rhetorical Rationale

From the start of this research paper, I originally wanted to write my paper on how music

aids in memory and learning. I first started finding sources on this topic but realized that I did not

have a strong argument. I was finding many articles about Alzheimers disease and how music

therapy and music in general were helping these types of people in their everyday lives. At this

point in the first draft phase of the project, I began to write about the effects that music therapy

has on alzheimers patients. After researching about this, I knew that I needed a strong argument

so I looked at whether music therapy was a more effective style of treatment than drugs. I found

articles on both topics and found that both are very effective and beneficial, its really just a
matter of whether or not you want to use drugs and also the effects that drugs might have on your

body negatively. My ideas developed really well throughout this paper, because the act of

researching and finding articles narrowed down my topic and argument quite a lot. The act of

writing these drafts shows that the composing process is incredibly beneficial because it allows

the writer to process their ideas and better develop something even further. For me, writing these

drafts helped me become more aware of my argument and how it needed to be revised to make

more sense. During our in-class workshops, I found that I needed to find more sources, make my

writing flow better in order for it to make sense, and make sure my argument was the strongest it

could be. After writing the first draft, I went back and revised it pretty heavily. I needed a lot

more sources especially the digital components to add to my argument of both music therapy

effectiveness and drug related therapy effectiveness.

When looking at the multimodal aspects of this paper, I used a lot of different graphs and

pictures to help show better something I mentioned in the essay. An example would be a study

that I talked about. I would include a graph in the essay to show the results of a study so that the

reader will be able to see the effectiveness of music therapy in agitation and aggression due to

Alzheimers disease. The other sources that I used were scholarly and non-scholarly. These

sources are important because they are the basis of my research and they benefit my argument

very much. The scholarly articles that I used in my paper were a lot of studies because this was a

more study based topic that I chose to pursue my research in. Overall, the process of this
research paper was beneficial in learning more on how to write a more in depth paper such as

this. I developed a more clear argument after looking at all the sources that I gathered, because

they all had to do with my topic that I chose to research about; is music therapy more effective

than drug treatment methods in Alzheimers patients?