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. 2012 Dec;50(14):3295-303.
doi: 10.1016/j.neuropsychologia.2012.09.019. Epub 2012 Sep 19.

Music-based memory enhancement in Alzheimer's disease: promise and limitations

Nicholas R Simmons-Stern  1 , Rebecca G Deason, Brian J Brandler, Bruno S Frustace, Maureen K O'Connor, Brandon A Ally, Andrew E Budson
Affiliations

Music-based memory enhancement in Alzheimer's disease: promise and limitations

Nicholas R Simmons-Stern et al. Neuropsychologia. 2012 Dec.

Abstract

In a previous study (Simmons-Stern, Budson & Ally, 2010), we found that patients with Alzheimer's disease (AD) better recognized visually presented lyrics when the lyrics were also sung rather than spoken at encoding. The present study sought to further investigate the effects of music on memory in patients with AD by making the content of the song lyrics relevant for the daily life of an older adult and by examining how musical encoding alters several different aspects of episodic memory. Patients with AD and healthy older adults studied visually presented novel song lyrics related to instrumental activities of daily living (IADL) that were accompanied by either a sung or a spoken recording. Overall, participants performed better on a memory test of general lyric content for lyrics that were studied sung as compared to spoken. However, on a memory test of specific lyric content, participants performed equally well for sung and spoken lyrics. We interpret these results in terms of a dual-process model of recognition memory such that the general content questions represent a familiarity-based representation that is preferentially sensitive to enhancement via music, while the specific content questions represent a recollection-based representation unaided by musical encoding. Additionally, in a test of basic recognition memory for the audio stimuli, patients with AD demonstrated equal discrimination for sung and spoken stimuli. We propose that the perceptual distinctiveness of musical stimuli enhanced metamemorial awareness in AD patients via a non-selective distinctiveness heuristic, thereby reducing false recognition while at the same time reducing true recognition and eliminating the mnemonic benefit of music. These results are discussed in the context of potential music-based memory enhancement interventions for the care of patients with AD.

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Figures

Figure 1
Figure 1
1, Study Phase (Aprox. 30min); 2, Content Test (Aprox. 20 minutes, self paced); 3, Audio Test (Aprox. 15 minutes). Text appeared as depicted in the examples; only the lyrics, object item cue (e.g., “your pills”) and responses varied by trial and subject. Each general content question was followed immediately by a specific content question as diagramed. * Note: Time at the end of the Study Phase was recorded and a filler task was provided following the Content Test such that there was a total delay of 40 minutes between the end of the study phase and beginning of the audio test.
Figure 2
Figure 2
Mean recognition accuracy (Pr; %hits - %false alarms) on the general content question for the sung and spoken conditions in healthy older adults (OC) and patients with Alzheimer's disease (AD). Error bars represent one standard error of the mean.
Figure 3
Figure 3
Mean recognition accuracy (Pr; %hits - %false alarms) on the audio recognition test for the sung and spoken conditions in healthy older adults (OC) and patients with Alzheimer's disease (AD). Error bars represent one standard error of the mean. Significant within-group differences: *(p<.05)
Figure 4
Figure 4
Mean response bias [Br; %false alarms/(1- Pr)] on the audio recognition test for the sung and spoken conditions in healthy older adult controls (OC) and patients with Alzheimer's disease (AD). Neutral response bias is 0.50; conservative bias is <0.50, liberal bias is > 0.50. Error bars represent one standard error of the mean. Significant within-group differences: **(p<.005)
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