Affect Change in Older Adults with Dementia

Music therapists who work with older adults will often notice a change in affect and interest with music stimuli. A recent study compared music to 25 other forms of stimuli including social interaction, work, or reading.

Cohen-Mansfield et al (2011), observed 193 older adults with a diagnosis of dementia over a 3-week period. Adults were exposed to 25 different forms of stimuli in random order and observed for affect changes using the Lawton’s Modified Behavior Stream scale.

Results indicated that live social interaction yielded the greatest changes in affect among the participants. Participants also showed more interest when the task was specific to their self-identity. Individuals who had higher cognitive skills showed the most pleasure when introduced to stimuli. Compared to other stimuli, music ranked low in pleasure and interest.

The music category included passive music listening and the authors did not list the music utilized. Given findings that stimuli had a greater impact if within the individual’s self-identity, this makes sense. The authors recognize that the music was not individualized and did not include the social elements of live music therapy intervention.

Some of the method in this article was not clear to me – I couldn’t tell how many people observed and rated affect changes, as the authors provide inter-rater reliability numbers from a previous study.

Clinical Importance: As music therapists, we are aware that client-preferred music is an integral component to working with any population. This article did not use client-preferred music and showed a low interest/pleasure in recorded music. If we look at the two stimuli that scored the highest – those related to self-identity and social interaction – live music therapy intervention would include both of these categories. To me, this would support the use of live music therapy intervention over imposed passive music listening.

I think it would be interesting to replicate this study using live music and live music therapy intervention. Calling grad students looking for a master’s thesis idea or the next clinician-scientist!

Reference:

Cohen-Mansfield, J., Marx, M.S., Thein, K., & Dakheel-Ali, M. (2011). The impact of stimuli on affect in persons with dementia. J Clin Psychiatry, 72(4), 480-6. PMID: 21527124

One thought on “Affect Change in Older Adults with Dementia

  1. JoAnn Jordan

    I agree this needs revisited with live music & with music therapy intervention. I would be curious as to how long they waited for a response, too. It seems that depending on the dementia stage, it can take awhile for responsiveness to kick in. Also, I’ve had staff in dementia units they notice a change in alertness for several hours after I lead a session. More food for thought.

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