Student duo uses music to evoke lost memories

In a hospital unit for residents suffering from severe dementia, a piano sat neglected in the activity room until one elderly man remembered how to play.

“He sat down at that piano and started to play, and I just remember being really blown away and surprised at his capacity to revive that skill,” said Jennifer Lingler, who worked as a nurse in the unit for dementia residents who developed behavioral problems at University Hospitals of Cleveland.

Lingler, now the director of the Education and Information Core for Pitt’s Alzheimer’s Disease Research Center, was most astonished because the resident was nearly nonverbal when he revived his instrumental skills.

Two Pittsburgh students founded a nonprofit organization that has operated for more than two years based on music’s ability to help improve the quality of life of residents with dementia. Maureen Deken, a sophomore majoring in Spanish at Pitt, co-founded iPods for Alzheimer’s with Serena Mani, a senior at the Ellis School in Shadyside. The organization collects and uses donations to purchase iPods filled with individualized music from the Alzheimer’s residents’ pasts, after the duo meets with each resident to determine music tastes. While Deken and Mani are the only members of iPods for Alzheimer’s at the moment, they said they hope to expand the group to add more volunteers as they continue to develop their organization.“These residents can listen to music from their childhood and songs from the past, and it helps them reconnect with these memories,” Mani said. 

Deken and Mani work with five residents at Schenley Gardens Senior Living. As often as every other day, Deken and Mani also visit some residents who are unable to operate the music players by themselves.

“There’s an entire floor of people who have Alzheimer’s at Schenley Gardens, and we want to have somebody be able to go to all of them if we can,” Deken said.

The iPods for Alzheimer’s website has generated funds from donors as far as Texas, and Deken and Mani have also raised funds by approaching neighbors and family members. The cost to purchase iPods and music for each resident is about $30.

Alzheimer’s disease is the most common form of dementia, or mental deterioration, characterized by the accumulation of a protein called amyloid, the presence of neurofibrillary tangles and a loss of brain tissue. 

“At the time of autopsy, if you weigh the brain of a resident with Alzheimer’s compared to the brain of a healthy older adult, the Alzheimer’s brain is going to weigh less because there’s actually loss of brain volume,” Lingler said.  

According to Lingler, residents experience symptoms that progress over time. Essentially, all aspects of cognition are degenerated by loss of memory, attention and judgment as well as difficulties expressing and comprehending language.

Lingler said more than half of residents with Alzheimer’s experience behavioral changes such as withdrawing from other people or performing inappropriate actions. Residents typically live between eight and 12 years after a diagnosis of Alzheimer’s, according to Lingler, and the disease often places an emotional and physical burden on residents’ family members. 

“Family members of residents with Alzheimer’s are known to have increased morbidity and mortality,” Lingler said. “Some people attribute it to the chronic stress of the disease. Others attribute it to caregivers neglecting their own health.”

Deken’s high school paper on the effects of music on memory inspired the mission of iPods for Alzheimer’s. Mani and Deken met at Girls of Steel Robotics, a robotics team for high school girls supported by Carnegie Mellon University’s Field Robotics Center, before the duo created their organization’s mission.

“I’m really interested in neuroscience and medicine,” Mani said. “[Deken] was very interested in the specific idea of music and memory. It was sort of a team idea where we bounced ideas back and forth and thought about what population we wanted to help with our project.” 

Deken said her mother urged her to pursue the endeavour because of her familiarity with Music and Memory, another organization that helps residents with Alzheimer’s using personalized music. 

The effect of music on residents with dementia is still a topic of debate for researchers.

“There are different ways in which music or musical memory is stored and can be recalled, perhaps even in instances where memory in the way we think of it for daily functioning purposes is really impaired,” Lingler said.

According to Lingler, the Alzheimer’s Disease Research Center at Pitt hopes for more research on Alzheimer’s disease. Pitt researchers pioneered technology that allows researchers and clinicians to visualize Alzheimer’s pathology in the brain of a living resident. Before this innovation, Alzheimer’s could only be diagnosed at autopsy. 

Besides the sparse amounts of scientific data, the founders of iPods for Alzheimer’s have noticed significant improvement in the residents with whom they work.

The two have noticed notable advancement within the past year of one resident who has become happier and learned to walk at Schenley Gardens. 

Progress like this, Mani said, is unusual with a disease usually characterized by a downward spiral. 

“We really saw her start to reconnect with her memories more and more,” she said. 

The resident was initially very anxious and struggled with short-term memory loss, but over time Deken noticed a change.

“She often didn’t know what was going on around her, which made her more anxious, but now she remembers our names. She knows what’s going on. She’s aware of what our project is about,” Deken said.

Rosemarie Malanoski, activities director at Schenley Gardens Senior Living, said Mani and Deken have had a very positive effect on the residents. She said Schenley Gardens is a personal care community with a focus on memory care and cognitive issues — similar to Mani and Deken’s project.

According to Malanoski, the music must be geared toward the individual in order to be effective. She said residents are more communicative and enjoy when Mani and Deken visit the community.

“While [residents] might not remember their names, they know they’re coming for some reason and they do get a big smile on their face,” Malanoski said. “If they’re agitated at the time, the music does soothe them.”

Lingler said when playing music for an Alzheimer’s resident, the focus should be on quality of life for that person. 

According to Lingler, music can help a resident who is very withdrawn to engage and can also avert a resident’s attention during daily care activities that may be agitating, such as bathing or dressing. 

“Sometimes, those kinds of interventions can be distressing for somebody who doesn’t understand what’s going on,” she said. “So there’s an interesting opportunity there to consider using music as a distraction.”  

Lingler said music enhances a resident’s ability to draw upon remote memories.  

“Music definitely helps people with encoding, but the really fascinating thing is the power of music when it comes to [memory] recall,” she said. 

Sherri Livengood, a post-doctoral fellow at Northwestern University’s Feinberg School of Medicine, said memories associated with music are deeply encoded in our brains almost immediately. 

“Music evokes deeply episodic memories,” Livengood said. 

Livengood’s research focuses on determining how sound affects the body, specifically in the way music influences the formation of social bonds in the brain. 

According to Livengood, music has a fractal, or self-repeating, structure often found in nature, such as in the patterns within snowflakes. These types of arrangements activate the brain’s nucleus accumbens, a reward center often associated with addiction and social value. When the nucleus accumbens processes both the fractal structure of music and social interactions simultaneously, the two start to overlap.

This reaction explains why people often describe events surrounding their favorite song, Livengood said, and rarely speak about the music itself. 

In this way, playing music for Alzheimer’s residents could help them to recall memories associated with certain songs or artists. 

“These memories might be stored in structures that are preserved and haven’t started to decline yet,” Livengood said. 

Livengood also pointed out that contemporary research has shown that autobiographical memories require the individual to use the same parts of the brain that they used when forming the memory. Therefore, when recalling personal memories through music, Alzheimer’s residents might be activating multiple parts of their brains. 

“It’s more than just putting someone in a good mood. It’s actually working their brain in a comprehensive way,” she said. 

Deken said iPods for Alzheimer’s isn’t just for those impacted by the disease, but has also affected her personally.

“It has given me a lot of experience with how I should talk to people with Alzheimer’s. It’s changed the way I interact with people, just on a daily basis,” she said.