Hearing, cognitive abilities and music therapy

Our time does not make music anymore. It camouflages the solitude of men with noise by giving them to hear what it believes to be music. – Jacques Attali

The sounds that reach us are not simply decoded by the sensory organ and integrated by the auditory cortex1 : they stimulate other brain areas and are connected to many other integrative functions.

Hearing loss affects cognition

Any significant hearing loss results in an increase in the concentration required to hear. This results in a decrease in cognitive capacity, affected by this new effort to hear, causing brain fatigue that reduces attention and cognitive resources useful for other tasks. This increases with the degree of hearing loss. At the same time, age naturally leads to a cognitive decline2, increasing the difficulties in understanding, especially in a noisy environment.

At the end of the 1980s, a relationship between dementia and deafness was established, and the more profound the deafness, the greater the risk of suffering severe cognitive decline.

We now know that age-related deafness multiplies by three the risk of suffering from senile dementia, with its major economic implications. If we can delay the onset of cognitive decline in the population by even one year, the overall prevalence of dementia would decrease by 10% by 2050. However, the annual direct and indirect costs of neurological diseases in Europe exceed 790 billion euros (compared to 200 billion euros for cardiovascular diseases and 150 billion euros for malignant tumors).

Rehabilitating hearing as early as possible : the role of hearing aids

Hearing rehabilitation with hearing aids as soon as possible for moderate to severe deafness and eventually with a cochlear implant for profound deafness can reverse the phenomenon. We cannot stress enough the need to use hearing aids at the first sign of discomfort, both to regain listening comfort and to stay young3 ! A recent study has shown that a 70 year old person without hearing aids saw their cognitive decline accelerate (by 6 to 7 on average) and thus had the same cognitive capacities as a 77 year old person! Mentalities must evolve: today, invisible and efficient hearing aids exist, which allow us to affirm that it is not the hearing aid that “makes you old” but rather the fact of making you repeat.

Carriers of dementia or advanced Alzheimer’s disease : what role can music play ?

Since antiquity, music has been known for its therapeutic and cathartic effects. In France, it was in the 1960s and 1970s that the first music therapy center was opened.

In 2006, Dan Cohen created the Music & Memory Foundation, which reconnects seniors with dementia or Alzheimer’s with the music they loved in their youth. And the results are spectacular, as shown in the documentary “Alive inside,” which aired in 2014 and in 2017 on Arte. “Alive inside” received the audience award at the American Sundance Film Festival. We meet Henry, a resident of a retirement home and suffering from dementia, headphones screwed on his ears, whose face lights up when listening to the music he loved in the past; Marylou, a carrier of very advanced Alzheimer’s, who comes back to life by listening to her favorite music.

This therapy, studied in 196 retirement homes, has a clear result.
Music & Memory significantly reduces the need for antipsychotic and anxiolytic medication. The residents also recreate spontaneous links between themselves.

What can we learn from this double analysis?

• Firstly, that everything possible must be done to preserve one’s hearing4,
• When the hearing impairment is present, that it is necessary to fit hearing aids as soon as possible so as not to affect the subject’s cognition,
• Finally, if the dementia is present, sometimes favored by the deafness without hearing aids, the introduction of a music liked by the past brings back joy of living and happiness to the patients, decreasing moreover the therapeutic load.

This shows how vital auditory stimulation is for the development of the subject, even when the latter is suffering from Alzheimer’s or senile dementia.

We now know that a sound stimulus is much more than a simple signal. It activates many areas of the brain, not just the auditory area, depending on the knowledge network established. For example, the word “top” activates the areas of the cortex where words referring to the appearance of things are grouped, as well as the area related to dimensions and spaces. The reverse follows from this finding. An impairment of cognitive processes influences the perception of sounds!

Sources:

• Music therapy file : ACMF le mag n° 541
• The auditory brain : The close correlation between hearing and cognition. Result of a study of the available scientific literature on the subject, conducted by an Italian and American team. Consensus paper 2018/ The auditory brain.

Additional articles :

¹ The ear and its hearing function
² Presbycusis, what is it ?
³ The hearing aid simply, Hearing aid : in-the-ear VS behind-the-ear, what to choose ?
⁴ Can we prevent hearing loss ?

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