Compared to earlier centuries, people live longer now. Longevity has steadily increased across the world, thanks to various health care efforts. This has also lead to an increase in the incidence of age-related disorders, such as senile dementia. Today there are about 47 million people across the world affected by cognitive disorders such as Parkinson’s, Alzheimer’s and related disorders. We have about 4.1 million people across India affected by dementia, China is worse, with 9.2 million there.
An individual with dementia tends to have short-term memory loss, problems in movement of limbs, incoherent speech and related problems. It is a cognitive disorder where the normal nerve circuitry in the brain has become distorted. Nerve fibres tend to get entangled (much like a cross connection or short circuit), protein molecules in the cells precipitate out of solution and form plaques, affecting nerve conduction. Part of the brain becomes dysfunctional. As of today, there are no effective drugs to treat and overcome Alzheimer’s, Parkinson’s and related disorders, though molecules such as L-Dopa offer some short-term relief. And it is well nigh impossible to take the brain out, correct the misconnection, do some rewiring and place the repaired brain back. Transplanting a brain is, of course, unthinkable, since it effectively means transplanting a person!
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Signs of hope
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Against this bleak picture, there are some hopeful signs. If we cannot remove errors and rewire, can we stop further damage, allow neighbouring nerve cells to do double duty and make up for what has been damaged? We know that this may be possible; for example when a finger is lost or amputated, the neighbouring brain areas take over the functions of that area of the brain which previously handled the amputated digit. In other words, the brain is not a static, stone-like entity but a plastic, remouldable one. If we can find ways to trigger such neuro-plasticity, we may be able to recover some of the lost functions, and hopefully delay any further damage to the brain circuitry.
Remarkably, and gratifyingly, music is able to do so. We have now come to realize that music not only calms and comforts the mind but also can take on a therapeutic role. “Music Therapy is a non-pharmacological way, with a long history of use and a fine usability for dementia patients” write Dr David Calimag and colleagues in their paper ‘Music Therapy is potential intervention for cognition of Alzheimer’s disease: a mini-review’, which has appears in the journal
That music plays a key role in cognitive development has long been known. We process music with almost every part of our brain. The baby in the womb feels the pulse of the mother, and likely even her humming in tune. Lullabies calm and comfort and teach the baby. While the oft-quoted claim that the IQ of children improves upon listening to Mozart needs solid scientific proof, it seems likely that not just listening, but training in music appears to foster cognitive development. The book ‘Musicophilia: Tales of Music and the Brain’ by the famous neurologist-writer Dr. Oliver Sacks points out that music is part of being human. And that many people with neurological damage learn to move better, remember more and even regain speech through listening to and playing music.
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Therapy for Alzheimer’s
This is the basis of music therapy. Dr. Concetta Tomaino, a music therapist, is reported to have played an old Yiddish song to an old man in the last stages of Alzheimer’s, and after repeatedly listening to it for a month, he attempted to speak and sing it himself and resumed talking and moving about. Closer home, the renowned music therapist Mrs. Rajam Shankar of Secunderabad tells me that her singing the Raga Kalyani likewise activated a lady patient, who eventually started singing herself and slowly regained her activities. Readers will also enjoy the captivating award-winning film ‘Alive Inside’ which tells the stories of several dementia-afflicted patients and how music turned their lives around (available at https://www.youtube.com/
watch?v=6FwfV9pnj8o).
Music therapy is a growing field, taught and practised in India and across the world. But it is important that appropriate and rigorous guidelines are drawn and certification done in order to separate the wheat from the chaff. It is also useful to analyse the reported individual cases where it has helped (and where it has not), and attempt to draw rational and empirical guidelines, particularly since it involves human subjects.
Not without caveats
Some caveats are in order. There are claims on the Web that raga X helps liver function, raga Y helps in diabetes, and so forth. These are over-claims, since music affects the brain and helps in cognition, not in curing metabolic disorders. Some others claim that some ragas are better than others for dementia. This too is a “one size fits all” claim. Music therapy is a deeply personal one, and depends on the mental condition, background and similar factors and thus is individual-specific. Also, is a song better or just chanting a note or even meditating - or a combination thereof? Here again, is it not better for the therapist to decide, based on the conditions of each specific patient?