@ Dahzen

The role and significance of music naturally varies from person to person. For some, it is counted among the most important things in life. For others, it may be a superfluous additive of limited value. Due to this difference in perception relating to music, it may be difficult for some individuals to recognize the benefits of compiling a personalized music playlist. However, the value of music as a therapeutic tool for people already suffering from advanced dementia has been repeatedly demonstrated, and sometimes with astounding, although temporary, results. The internet is full of studies and stories, and YouTube searches yield an abundance of video evidence ranging from clinical studies to anecdotal family recordings of elderly relatives. All of these data and anecdotes point to a compelling suggestion and an exciting conclusion: music appreciation has tremendous potential as a supplemental activity for mental health maintenance. With insights gained from the study of neuroplasticity, the neurological benefits for musicians and performers are easy to see, but less clear is the fact that mere exposure to music as a casual listener can be of profound psychological importance, even for individuals who don’t consider themselves to be music lovers. The transformative effect of music is on full display in many of the available videos on YouTube. We can simply search “dementia music,” or ‘Alzheimer’s music” for fast, relevant results. In video after video, we can see elderly subjects who may be slow to speak, detached, disoriented, barely-intelligible, or unresponsive. In care facilities and at gatherings with families, they are interviewed about their youth, and about their feelings related to music. Many of the videos first show footage of the individual’s normal daily cognitive state, and them listening and responding to the questions, followed by a period of music listening, and then another brief, post-music discussion. The transformation of mental states tends to be very clear when we compare the quality of their cognitive performance before and after the introduction of music. People remark that “a light has been turned back on,” or “his personality returned,” or “it’s as if the person has woken up from sleep.” Unfortunately, these positive responses are only temporary, and music does not have the power to permanently reverse the symptoms and pathology of advanced dementia and age-related cognitive decline. Also there is no guarantee it will work for every person, or to what degree. Nevertheless, it does not mean that music as therapy is completely without value. In fact, it can be quite the opposite. When the response is positive, the event can have multiple benefits, and may even be a therapeutic experience for certain listeners. Faces once despondent or vacant become animated and radiant. Long lost smiles return from faraway times and places. Memories and associations from previous ages shake loose and rise to the surface. Many listeners were asked to recount their experiences related to the songs and the time in life with which they were primarily associated. Some of them were able to describe events, places, people, emotions, and reactions with a degree of clarity, dexterity, and articulation that was completely inconsistent with their medical diagnosis and their cognitive performance prior to hearing the music. The song quite literally revives the personality that makes the person, temporarily and superficially reversing the undoing of the mind. For a mind that is coming undone, music as therapy has potential to mitigate suffering and confusion, provide moments of joy and enthusiasm, and ease the transition into and experience of the end-of-life period that awaits all who are fortunate enough to “die of natural causes” in old age. The benefits described above are specific to “treatment” recipients, but the merit of music as therapy cascades into the lives of everyone involved. Doctors and caretakers are uplifted and encouraged by success stories, which contributes to further proliferation and advancement of music as therapy. More critically, it can have a profound impact on families of dementia patients. In some cases, relatives get a chance to communicate with their loved ones again. Grandchildren have a window of opportunity to learn more, directly from their grandparents, about the youthful experiences and memories of past generations. It’s clear that generational bonds are also strengthened, which can positively impact the future prospects of the young generation as they in turn grow old, and lay new groundwork for generations that follow. It is unfortunate that some elderly individuals seem to derive less cognitive benefit than others from music therapy. It is not entirely certain why this is so, because there are many factors to consider, but two of the clearest factors are a person’s degree of cognitive decline, and their degree of interest in and enthusiasm for music in general. While these are the most popular metrics by which to judge the potential effectiveness and suitability of music as therapy for a given individual, by far the most important consideration is relevance to each particular person’s life experiences. This is the opportunity to finally state the obvious: It’s not possible to simply pick any song at random and expect it to have a beneficial effect on the cognitive function of every person who hears it. It’s not as if there’s a Britney Spears song that sparks joy in the heart of every soul on Earth. And the legend of Bill and Ted’s ultimate song that united the world could never be a true story (also because, as we finally learned in 2020, it was not two men and a song that united the world, but rather, the world uniting together to create that song.) However, everyone in the world can make their own playlist custom-tailored to their individual life, experiences, and memories, and some of those playlists might have a song or two by Britney Spears, or even some from one of the “Bill and Ted” soundtracks. Throughout my decades of music appreciation, an ever-growing level of respect for the enduring spirit of music has overwhelmed me, and it’s clear that no song will ever be loved by all. But every song will be loved by some, certainly at least by someone, or it would cease to exist. This is why a personalized playlist is infinitely more valuable than randomly selected songs, and we can see the truth of this claim upon close examination of recorded interviews with the elderly subjects. The songs that triggered the greatest reactions were songs that interviewees felt strong connections to, based primarily on the song’s associations to the time and place, as well as the emotional context imprinted on the memory of the events surrounding the songs. This simply means that songs for which we have emotional attachments and vivid memories are songs that invigorate our neural circuits, activating cognitive pathways and opening doors of memory similar to how olfactory sensations can trigger a memory or a sense of déjà vu. There are some exceptions, but a lot of these songs are from a person’s formative years, particularly early developmental years and their teenage period. This comes as no surprise to the discerning neuroplastician, because these are periods of life when neural plasticity is most fluid, neural development and refinement functions are most active and receptive, and the degree of exciting novelty in life tends to be highest when we are young and inexperienced. Novelty and emotion are critical components of memory formation and whether a given experience will be memorable or not. Something completely new (novelty) can be memorable if it commands your attention, or derails you from your usual pattern of behavior. Similarly, the content of a tedious lecture may be harder to recall without taking notes, while that of an exciting, fun, and funny, interactive lesson has a greater chance of being memorable, and recalled with more clarity and detail (emotion). When it comes to music, the connection to novelty and emotion is crystal clear. The first time you ever heard that song, it was new and your emotional response was strong. You might even remember the events of that first time you heard it, but not necessarily. Your emotional attachment to the song may have developed later on, when you heard it playing at a party, on one of the most memorable nights of your teenage life, for example. Perhaps it’s just a song (or songs) your parents played a lot when you were young, and it could be a song you yourself heard many times, and looking back realized it holds a special place in your heart, for whatever reason. There are also songs that are special to romantic couples (This song was playing when we…; This is our song; We were together the first time we heard this song; etc.) and these songs, for obvious reasons, can be added to a personalized music playlist at any time in life, as new and old songs take on added personal significance in various ways. There are a multitude of ways that novelty and emotion can combine to form experiences worth remembering, by which memories are made, and if these experiences are imprinted with a musical stamp, the song stamped onto the memory is likely to remain just as memorable as the event itself, and conversely, listening to the song has the potential to vivify the memories and feelings of nostalgia related to the song. Therefore, as a preventative measure we can implement now, and an insurance policy we may benefit from later, it is advisable that each person should endeavor to compile their own personal, individualized cognitive reserve playlist. When speaking to someone about this idea, they responded, “But what’s the hurry? After all, you’re still quite young.” Just then, it spontaneously occurred to me that a traumatic head injury could befall me the following day or any day hence, and the simple point that “it’s never too early” was well taken. To create your own cognitive reserve playlist, it is helpful to have a few guiding parameters. Most important of all is to keep an open mind without setting anything in stone. It’s not necessary to finalize the list immediately, if ever. This is a project that deserves your thoughtful consideration, so you deserve to be allowed to take your time. It’s better to get the list populated with your definite favorites, and as many others that come to mind, just to kick-start the process. Besides, due to the virtually infinite number of songs and compositions in existence, we will never be able to make the perfect list in one day, one month, or even one year. We can always revisit the list and make changes later, because our minds cannot retrieve all the data at once. We must go about our business of carrying on, and wait for it to come to us. (It’s guaranteed to be worth the wait, so never fret about it.) You may even find yourself removing one of those “definite favorites” from the list, which is welcome and fine, because it’s not merely a list of your favorite songs. Being a “favorite” is just one of multiple indicators that a song might be appropriate for a cognitive reserve playlist. “Memorable” is another key word. There are still other factors that determine a song’s suitability for a personal playlist, such as a song that isn’t a personal favorite, but which nevertheless evokes a strong emotional response in some other way. This is best described as nostalgia, and nostalgic emotions are powerful anchors for memories. So any song that arouses some sense of nostalgia also has the power to arouse the memory of events, places, times, and other details tied to that nostalgia. To know what songs are nostalgic for you and add them to your list today, may help you if a time should come that you need music as therapy in order to trigger your memory and cognitive function. It is because of nostalgia that many songs from our youth are good candidates for inclusion on the playlist. Songs that were popular on the radio or TV when we were children, theme songs from popular television programs that are unforgettable for us, and songs that acted as the soundtrack to our lives, so to speak, while growing into childhood, and then blossoming again from adolescence into adulthood. This period is rich with music of great significance to our personal center. It is my sincere hope that all people earnestly endeavor to compile their own personalized cognitive reserve playlists, and encourage their loved ones to do the same. Maybe it can help those who suffer to better cope with the condition. Perhaps starting this project now, and focusing on mental health now can be a significant contributing factor to developing robust cognitive reserve in the first place, thereby heading off the worst of what this condition can throw at us, and delaying it until later. And of course, not only should we create the lists, but it’s highly recommended that we also play the songs frequently, and dance to them as well, preferably. It is in the interest of your future health, ability, mobility, enjoyment, and ease of living that I offer this potentially beneficial suggestion, and I am grateful that you have taken the time to hear me out regarding my passion about the restorative and healing properties of music, as they relate to the broader topic of neuroplasticity. So on that note, shall we press play and dance?