Emotional reactions to music in dementia patients and healthy controls: differential responding depends on the mechanism

Music is frequently regarded as a unique way to connect with dementia patients. Yet little is known about how persons with dementia respond emotionally to music. Are their responses different from those of healthy listeners? If so, why? The present study makes a first attempt to tackle these issues in a Portuguese context, with a focus on psychological mechanisms. In Experiment 1, featuring 20 young and healthy adults, we found that musical excerpts which have previously been shown to activate specific emotion induction mechanisms (brain stem reflex, contagion, episodic memory, musical expectancy) in Sweden were valid and yielded predicted emotions also in Portugal, as indexed by self reported feelings, psychophysiology, and post hoc mechanism indices. In Experiment 2, we used the same stimuli to compare the responses of 20 elderly listeners diagnosed with Alzheimer’s disease (AD) with those of 20 healthy lis teners. We controlled for cognitive functioning (Mini-Mental State Examination) and depression (Geriatric Depression Scale). Our predictions about how mechanisms would be differentially affected by decline in brain regions associated with AD received support in that AD patients reported significantly lower levels of (a) sadness in the contagion condition, (b) happiness and nostalgia in the episodic memory condition, and (c) anxiety in the musical expectancy condition. By contrast, no significant difference in reported surprise was found in the brain stem reflex condition. Implications for musical interventions aimed at dementia are discussed, highlighting the key role that basic research may play in developing applications.