Strength in Numbers: Large Study Suggests Role for Music in Preventing Dementia

In 2020, the AARP’s Global Brain Health Alliance published a consensus report, Music on our Minds: The Rich Potential of Music to Promote Brain Health and Mental Well-Being. The report, produced in consultation with the National Endowment for the Arts, cited promising research on the value of music training for older adults. 

Five years on, a new study suggests that cognitive health benefits can also derive from music-listening, and possibly to a greater extent than from music-making alone. 

One advantage of this new study, led by Emma Jaffa of Monash University in Melbourne, is a relatively large sample size: almost 11,000 Australian adults aged 70 and older. The underlying data are from two longitudinal studies, both supported by the National Institutes of Health. (Longitudinal studies follow the same population or sub-group over time.)

Access to data from this cohort allowed researchers to analyze dementia-related outcomes for older adults who listened to music, played a musical instrument (which may have included singing), or did both, at various levels of frequency. Jaffa and her co-investigators, including researchers from Rush University Medical Center (Chicago, IL) and Hennepin Healthcare (Minneapolis, MN), found that older adults who participated frequently in musical activities showed lower risk for dementia, compared with older adults who did those activities rarely if ever.

Music-Listening More Strongly Linked to Cognitive Wellbeing Scores 

Three years after recruitment into the longitudinal cohort, the subjects took a questionnaire asking about their participation in the two types of musical activity. Because the larger studies included routine assessments of cognitive function, Jaffa et al. could track associations between self-reported levels of music participation and the likelihood of dementia over time.

The full study results appear in the International Journal of Geriatric Psychiatry. Here’s a summary:

• The greatest benefit was experienced by older adults who “always” listened to music. Their risk for dementia was 39 percent lower than that of adults who “never,” “rarely,” or “sometimes” listened to music. They also had 17 percent lower risk for other types of cognitive impairment, and better cognition and memory scores overall.
• Playing a musical instrument “often or always” was linked with a 35 percent lower risk for dementia, though there were no associations with reduced risk of cognitive impairment, and no changes in cognitive test scores over time.
• Frequently listening to music and playing an instrument was associated not only with a 33 percent lower incidence of dementia, but also with a 22 percent lower incidence of other types of cognitive impairment.

Commenting on the results, Jaffa writes: “Interestingly, listening to music showed stronger associations with cognitive wellbeing scores than playing an instrument. This contrasts with expectations based on previous studies suggesting more active musical engagement may be more cognitively stimulating.”

On the Road to Greater Rigor

The researchers are careful to define methodological limitations, such as the lack of a randomized, controlled study design that would have allowed them to explore causal claims. The study participants were generally healthier than typical older adults, and “minorities were underrepresented,” the authors note.  Also, the study team was unaware of the specific types of music played or listened to, and how those variables might have influenced results. 

Nevertheless, the study extends a tradition of analyzing large longitudinal datasets to understand whether and how arts participation is associated with positive health outcomes when the researchers can control for other factors. 

Just over a decade ago, the NEA published its own report, based on the Health and Retirement Study, showing that adults 55 years and older who created art or attended arts events had a healthier profile, in terms of cognitive functioning, than similarly aged adults who did not do those activities.  

Studying the arts and health more broadly, the NEA’s Research Lab at the University of Florida (the EpiArts Lab), in collaboration with the University College of London, has published several papers resulting from the same approach of analyzing large longitudinal datasets.

Meanwhile, with respect to music and the cognitive health of older adults, the Arts Endowment continues to support a variety of studies through its Research Grants in the Arts and NEA Research Labs programs. 

Examples of recent studies include:

• The NEA Research Lab at Florida State University published findings from a randomized, controlled trial showing that a 16-week program of piano training “significantly increased verbal fluency skills” among older adults enrolled in the program versus those who received computer-assisted cognitive training or no program or intervention whatsoever.
• The NEA Research Lab at Rice University published findings from a pilot study showing that older adults with mild cognitive impairment (MCI) who already had a “dynamic brain network” at baseline were more likely to benefit from music-making interventions than were other older adults with MCI.
• A small study of adults aged 55 to 90 years old concluded that “music has the potential to be utilized as a non-invasive method to stimulate the brain of individuals with severe cognitive impairment in key functions.” The study resulted in part from a NEA research grant to the Medical University of South Carolina. 

This last project was co-funded by AARP. In 2024, AARP and the Music & Dementia Research Network—a National Institutes of Health (NIH) initiative—convened a summit in Washington, D.C., where NEA research staff also spoke. The Network and AARP have produced a video summarizing the event. 

Other key strides have been made to advance the rigor of such research. In 2023, NIH published an online “toolkit” to assist with the design and study of music-based interventions for brain disorders of aging. (NEA research staff participated in workshops leading to the toolkit’s creation.) As an offshoot of that project, last fall a research team published new guidelines to support “more consistent and transparent reporting of music intervention studies.”

Thus, even as the share of older adults in our population continues to climb, research on music and brain health is approaching maturity. The fruits of sustained collaboration—which enabled the toolkit and reporting guidelines, the networks and convenings, and the NIH- and NEA-funded studies—are all signs of this growth. Let’s hope it can translate into music programs and activities that will help Americans age more gracefully.