the brain and music through the lifespan · • overall term for neurodegenerative...

The Brain and MusicThrough the Lifespan

Alison Balbag, PhD, DMAUSC Davis School of Gerontology

2.13.18

When does aging begin?A. 20B. 50C. 65D. None of the above

Aging = pre-womb to tomb

• Aging begins before birth.• Lifespan development

Dementia

• Overall term for neurodegenerative symptoms/conditions• Characterized by decline in memory, behavior, language, problem-solving, &

other cognitive skills• Affects one’s ability to do everyday activities

• Alzheimer’s disease (60-80% of dementia cases)• Eventually impairs ability to do basic bodily functions (walk, swallow)• Patients are bed-bound in final stages• Ultimately fatal

• Why is dementia and Alzheimer’s disease a leading health concern today?

Problem:

Source: http://www.alz.org

• Unprecedented population aging• Age is the #1 risk factor for neurodegenerative disease, e.g. dementia• Dementia is a leading cause of disability and death world-wide• 5.5 million have AD (U.S., 2017)• $259 billion direct 2017 AD costs (U.S.)• 15 million+ unpaid caregivers • $230 billion unpaid care (U.S., 2016)• Projected 2050 costs: $1.1 trillion

Problem, cont.

• No known cure• Combination / interaction of various factors

• Strong focus on identifying protective factors to:

• Promote healthy cognitive aging• Protect against age-related neurodegenerative disease (e.g.

AD & dementia)

Protective factors

• Modifiable factors

• Education• Physical Activity• Cognitive Engagement• Lesiure activities

Protective factors

• Modifiable factors• Early – mid-life influences

- Education- Physical Activity- Cognitive Engagement

- Leisure activities

Why look at music?• Uses a lot of the brain

• “total brain workout”?

Why look at music?• Uses a lot of the brain

• “total brain workout”?

• Universal• Non-pharmacological• Non-invasive

Music Listening

0

10

20

30

40

50

60

70

80

90

100

0 10 20 30 40 50 60 70 80 90 100

Memory Retrieval

Ability (%)

Age (Years)

Normal Aging

0

10

20

30

40

50

60

70

80

90

100

0 10 20 30 40 50 60 70 80 90 100

Memory Retrieval

Ability (%)

Age (Years)

Normal Aging

Dementia

0

10

20

30

40

50

60

70

80

90

100

0 10 20 30 40 50 60 70 80 90 100

Memory Retrieval

Ability (%)

Age (Years)

Normal Aging

Dementia

Music Memory

Music listening activation

19

Left hemisphere

Right hemisphere

Whole brain

Seung, Y. et al. (2005) Neuroscience Research 52(4)

Music memory & dementia

• Music as a key to “unlock” one’s memory• Patients remember lyrics, melodies• Activating music memory facilitates other types of memory• Added benefits:• Increased communication with family, caregivers• Reduced agitation, depression

Excerpt from Alive Inside

Janata, P. (2009). The neural architecture of music-evoked autobiographical memories. Cerebral Cortex, bhp008.

Music Making

What we’ve seen:

Playing an instrument in childhood – young adulthood:

• Structural differences in the brains of young musicians

• Learning to play music positively associated with cognitive development in youth

• Requires many different areas & functions of the brain to work simultaneously

(Ho et al., 2003; Schellenberg, 2004; Schlaug et al.,2005; Schellenberg, 2006; Forgeard et al.,2008)

Transfer

• When practicing one task leads to improvements in another unrelated task

What we’re starting to see:

• Better preserved:• Verbal & nonverbal memory• Visuospatial abilities• Executive functioning(Hanna-Pladdy & MacKay, 2011; Hanna-Pladdy &

Gajewski, 2012)

• Learning an instrument later in life improves:• Working memory• Executive functioning

(Bugos et al, 2007)

What we don’t really know:

Are musicians protected against adverse cognitive health outcomes later in life?



Does playing an instrument reduce your risk for dementia & cognitive impairment?



Does playing an instrument reduce your risk for dementia & cognitive impairment?

Dementia à used as a measure of long-term cognitive health over the lifespan

Balbag et al., 2014. Playing a musical instrument as a protective factor against dementia and cognitive impairment. International Journal of Alzheimer’s Disease Volume 2014, Article ID 836748

Case control study

case

control

Case control study

case

control

exposed

not exposed

exposed

not exposed

Case control study

Twin approach:

Twin approach:• Improves on traditional designs

• Twins are matched on• Typical demographic characteristics (age,

race)• Genetic makeup

• Identical twins: ~ 100% • Fraternal twins: ~ 50%

• Early life environment

• Reduces confounds

• Allows us to more effectively tease apart risk & protective factors

Results

• 157 twin pairs (ages 65+)• Discordant for dementia• Study of Dementia in Swedish Twins (HARMONY)

• Control for gender, education, & physical activity

- Odds ratio (OR) = 0.36 (95% CI: 0.13, 0.99)

Musicians’ likelihood of developing dementia or cognitive impairment is reduced by 64%

Why?

Possible mechanisms:

• Music activates the whole brain• Multimodal activation

• Music may efficiently build cognitive reserve

Cognitive Reserve

The picture can't be displayed.

The picture can't be displayed.

Stern, 2012 http://dx.doi.org/10.1016/S1474-4422(12)70191-6

So what?

• Highlights music-making as a health promoting activity• Reduced prevalence• Reduced healthcare costs

• Given music’s universality, this evidence may serve a large and diverse population.

• Importance of early music exposure

• Neuroplastic effect

So what?

• Highlights music-making as a health behavior• Reduced prevalence• Reduced healthcare costs



• Neuroplastic effect

So what?

• Highlights music-making as a health behavior• Reduced prevalence• Reduced healthcare costs



• Neuroplastic effect • Neuroplasticity: The brain's ability to reorganize itself by forming new neural connections

throughout life. Neuroplasticity allows the neurons to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.

Boomwhackers

Ode to Joy

Thank [email protected]

the brain and music through the lifespan · • overall term for neurodegenerative...

Documents