Download Music and feelings of emotion in persons with Alzheimer`s Disease

Music and feelings of emotion in persons with Alzheimer’s Disease
Jasmine Leahy, Alaine E. Reschke-Hernández, MA, Daniel Tranel, PhD
Department of Neurology & Psychology and School of Music, University of Iowa
Charlotte Latin School, North Carolina
♫ ♬ ♫ ♬ ♫ What do you feel when you listen to happy or sad music? ♫ ♬ ♫ ♬ ♫
Background
Methods
Baseline
emotion
measure
What is Alzheimer’s Disease (AD)?
Participants
• 
• 
• 
• 
Participants self-reported familiar music selections
Ø  10 songs that made them feel happy, 10 that made them feel
sad
Ø  Ranked songs from most to least happy/sad
First 5 songs on each list were condensed into two 4.5 minute
soundtracks (1 happy, 1 sad).
Studies about emotion combined with those about music
beg further investigation into how actively listening to
self-selected music can affect the mood of an individual
with AD.
Self-reported Feelings
Mean self-reported sadness after sad music
induction
70
50
40
AD
30
NC
20
AD individual
NC individual
10
0
v
baseline
0
Time(min)
10
20
The findings of this study could have implications for the use of
music as a therapeutic tool for patients with AD.
•  Not only can self-selected familiar music improve the levels of happiness
in patients with AD, but may also connect them with a more familiar
sense of self they may have felt disconnected from.
•  Many of our participants with AD cited memories as a source of
happiness during the experiment.
Self-reported Feelings
100
90
80
70
60
50
40
30
20
10
0
100
90
80
70
60
50
40
30
20
10
0
“Music brings back memories.” –Participant with AD
Mean self-reported happiness after sad music
induction
4 out of 7 participants cried during the sad induction.
This was 4.5 minutes of music.
AD
NC
AD individual
NC individual
baseline
Figure 4. All but 1 participant started with no sadness at baseline. Only 1 AD participant
experienced levels of sadness over 25, whereas 2 out of 3 NC participants hit 50 or more at
some point. Every NC participant experienced increased levels of sadness right after the sad
music ended, but only half of the AD participants did.
0
Time (min)
10
20
Figure 5. The mean baseline level of happiness (75) for participants with AD did not change
right after the sad music ended (at 0 min), but decreased slightly 10 and 20 mins later. The
mean baseline level of happiness for the NC group (45) decreased by 30 points after the sad
music ended and increased by about 25 points 10 and 20 minutes later.
Mean self-reported happiness after happy music
induction
Mean self-reported sadness after happy music
induction
AD
NC
AD individual
NC individual
0
Time (min)
10
20
Figure 6. Every AD participant either experienced more or maintained the same level of happiness
from right before the happy music started to right after it ended. 2 out of the 3 NC participants
experienced a lower level of happiness during the same time. Happiness faded slightly in the AD
participants and increased slightly for the NC participants as time continued.
References
El Haj, M., Antoine, P., Nandrino, J. L., Gély-Nargeot, M., & Raffard, S. (2015). Self-defining
memories during exposure to music in Alzheimer's disease. International Psychogeriatrics,
27, 1719-1730.
Feinstein, J. S., Duff, M. C., & Tranel, D. (2010). Sustained experience of emotion after
loss of memory in patients with amnesia. Proceedings of the National Academy of
Sciences, 107, 7674-7679.
Guzman-Velez, E., Feinstein, J. S., & Tranel, D. (2014). Feelings without memory in
Alzheimer Disease. Cognitive and Behavioral Neurology, 27, 117-129.
50
Matthews, S. (2015). Dementia and the power of music therapy. Bioethics, 1-8.
40
30
AD
20
Sarkamo, T., Tervaniemi, M., Laitinen S., Numminen, A., Kurki, M., Johnson, J. K., &
Rantanen, P. (2013). Cognitive, emotional, and social benefits of regular musical
activities in early dementia: Randomized controlled study. The Gerontologist, 54, 634-650.
NC
AD individual
NC individual
10
0
baseline
•  The AD group appeared more happy than sad after the sad music
induction despite their memory impairment.
•  One participant with AD could not remember hearing music 5 minutes
later.
•  The sadness from the sad induction seemed to persist into the beginning
of the happiness induction for the NC group.
•  Memories evoked during the happy/sad music appeared to bring
nostalgic feelings to both groups. This seemed to cause heightened levels
of sadness in the NC group and heightened levels of happiness in the
AD group.
•  Many participants reported difficulty in distinguishing between their
own feelings of happiness and sadness.
“Happy and sad are close together.” –NC participant
“Even though it is sad music, I like it.” –NC participant
Figure 3. Table of average scores from the two-part memory test for AD and NC groups
Research Question
3.  These effects will hold in both participant groups.
Figure 2. The scale used by participants on the emotion measure to express their feelings of
happiness. This scale is also used to express feelings of sadness but with the 0 meaning “I do not
feel sad,” 100 meaning “I feel extremely sad,” and so on.
60
2.  The results supported our hypothesis that feelings would last
irrespective of memory for music listening.
3.  The results did not support our hypothesis that these effects would
hold with both groups.
Results
•  Persons with amnesia and AD still experienced heightened
levels of sadness/happiness after watching, and
forgetting, sad and happy movie clips (Feinstein, Duff, &
Tranel, 2010; Gúzman-Velez, Feinstein, & Tranel, 2014).
2.  Feelings will persist irrespective of memory of what
caused the feelings.
• 
Audiometric screening, Beck Depression Inventory
AD patients: Language comprehension screening and Clinical
Dementia Ratings Scale
Participants filled out an emotion measure 4 times per
induction (see Figure 1). They self-reported their feelings of
happiness and sadness on a scale of 0 to 100 (see Figure 2).
“Recall” and “Recognition” memory test
Table 1. Demographics of the participants from both groups
broken down by mean and range of age and education
• 
1.  Music will induce specific feelings (i.e., sad music
would evoke sadness).
• 
• 
• 
•  Self-chosen music appears to have a more powerful effect
on personally meaningful autobiographical recall for
persons with AD as opposed to normal adults (El Haj,
Antoine, Nandrino, Gély-Nargeot, & Raffard, 2015).
Hypotheses
1.  The results did not support our hypothesis that music would evoke
specific feelings in both groups (i.e., sad music would evoke sadness).
Measures
Probable AD group
Normal Comparison (NC) group
Ø  Matched for age, sex, and level of education (see Table 1).
All participants were Caucasian (2 females, 5 males).
Prior to participation
What is the effect of self-chosen happy and sad music on
the feelings of emotion in patients with AD compared to
healthy individuals of the same age, sex, and education
level?
Break and
repeat with
happy
music!
Figure 1. Experimental protocol. All participants completed the sadness induction first and happiness induction second so they would end with a positive experience.
•  Incorporating music into everyday care for patients with
dementia may improve demeanor, cognitive functioning, and
quality of life (Sarkamo et al., 2013).
Research Objectives
10 and 20
min:
Emotion
measures
5 min:
Memory
test
Self-reported Feelings
•  Personally meaningful music can help a person with AD
because they can become more connected to memories and
personal stories (Matthews, 2015).
0 min:
Post-music
emotion
measure
Self-reported Feelings
AD is the progressive deterioration of brain tissue
caused from protein plaque deposits and nerve cell damage,
making up 60-80% of dementia cases. It impairs skills like
memory and communication. Currently, 5.4 million
Americans live with AD and, with a rapidly growing adult
population and no known cure, effective treatment to improve
the quality of life of patients and their families is needed more
than ever.
4.5 minutes
of sad
music
Discussion
baseline
0
10
Time (min)
20
Figure 7. Every NC and 1 AD participant had some leftover sadness from the sad phase at
the baseline. The levels of sadness for the NC participants either remained the same or
increased after the happy music ended. As time continued, sadness faded completely in all
but 1 of the participants.
Acknowledgments
Special thanks to:
•  Dr. Lori Ihrig and Kristin Flanary, Belin Blank Center
•  Secondary Student Training Program
•  Kathy Jones and Ken Manzel, Department of Neurology
•  Briarwood Health Care Center
www.postersession.com