Alzheimer's Foundation of America

Foundation of America

Setting a Spark with Music

Music has proven to be one of the most effective ways to relate to people with Alzheimer’s or other memory loss diseases. Fortunately, many of them can still sing a familiar song even if they don’t recognize the person in front of them.

“You can see there’s a real connection,” says Dr. Concetta Tomaino, DA, LCAT, MT-BC. “There was a spark that set off a series of responses that showed me that there was a level of functionality, a level of personal awareness, a way of really connecting deeply to the personhood of that person and that set me on this quest.”

Tomaino is the executive director and co-founder (in the 1980s with Dr. Oliver Sacks) of the Institute for Music and Neurologic Function. They began studying how music integrated the neurological function to enable people to regain as much access to this function as possible.

“In the past 15 years or so, the world of neuroscience has really expanded with the capacity to look at how certain aspects of music, like rhythm and pitch, and emotional responses to music, are organized in the brain and how these different networks stimulate and inform each other, allowing people with dementia to stimulate areas that are still functioning,” Tomaino says. “These areas all work in consort, so when somebody hears a piece of music that is personally important to them, there’s an emotional connection to areas of the brain, like the hippocampus and amygdala, that light up immediately. The excitement of those areas of the brain start to stimulate these other brain networks into action.”

Typically when we think of memory loss, Tomaino says, we are thinking of damage to declarative memory, which includes recalling facts like the date, where were you born, who is the President, factual things one needs to know in the moment.

“These are the types of memory skills that tend to decline in the early stages of dementia and neurocognitive issues. However, there are many implicit skills that are well-ingrained in our brain that people can still have access to.”

“I’ve been a music therapist for 44 years now
and it has been my experience early on that there
was this dramatic way we could connect with
people who seemed to have lost a lot of cognitive
function, who couldn’t recognize faces anymore,
who didn’t know where they were, who weren’t
able to verbally communicate that well but yet
would come to life and seem to be present in that
moment with a piece of music that they had a
connection to when they heard it.”

–Dr. Concetta Tomaino


“A person may have trouble thinking about how to walk. They may have poor coordination yet you put on a piece of music with a good, strong, steady beat and it seems like that person is dancing to the music,” says Dr. Concetta Tomaino. “Their habituated, implicit knowledge for how to move to music is easier for them to access than thinking about what foot goes in front of the other. Many times we see people who are able to dance when they’re not able to walk. We can use strong, rhythm-based music at a steady walking pace to enable somebody to walk with more ease and flexibility.”

Caregivers can benefit as well. Tomaino knew a husband whose wife with Alzheimer’s fought taking a shower. In younger days, they had loved to dance, so he put on Duke Ellington “and he would dance her into the bathroom.”

Singing can help people with word-retrieval skills. “We’ve done research where after you have engaged somebody in singing a familiar song, that person is more apt to be able to identify an object on the table that they couldn’t prior to the singing,” Tomaino says. “This works because singing familiar lyrics primes or stimulates areas of the brain involved with verbal processing. It bypasses the whole thinking-about-how-to-do-something skill that’s often damaged. When you ask someone with dementia to do something, they first have to think about what you mean.”

Engaging someone in music or song can carry over to other skills, such as feeding themselves and being aware of their surroundings. It can reduce agitation and frustration and improve the skills they are working on with a physical therapist. Because listening to pleasurable music increases the release of brain opioids, it can reduce the perception of pain. “Sometimes when a person with dementia is aggressive or feels restless it is because they are in pain and they can’t verbalize that. The music makes them feel comfortable.”

Tomaino suggests people create a playlist of music their person had loved and put it on an Mp3 player or choose an online streaming service. She said YouTube has karaoke-type videos that that can be used to help improve speech volume and articulation when the person sings along.

Many organizations offer music programs for seniors. She also recommends online resources like Vera and Point Motion/Sound Health (links can be found on AFA also has free in-person and online music offerings that can be found at our website by clicking here.

This article was adapted from a print version which appeared in AFA’s Alzheimer’s TODAY magazine.