Music Engagement in Alzheimer Disease
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Alzheimer disease (AD) is characterized by progressive memory loss and deterioration of functional abilities, but anecdotal and clinical observations suggest that many individuals with AD continue to respond in meaningful ways to music, sometimes well into the course of the disease. Previous research in the psychology and neuroscience of music has established that some music cognitive and perceptual abilities are less affected by AD than others, but it is unclear what implications these preserved abilities have for how individuals with AD engage with music in their daily lives. The purpose of this dissertation is to explore the relationship between music cognition and engagement. Study 1 examined episodic, implicit, and semantic memory for melodies in participants with AD relative to older adult and younger adult control groups. AD participants showed impaired ability to form new memories for melodies, but their semantic memory for melodies was on par with that of the older and younger control participants. Study 2 addressed the need for an informant-report measure of music engagement. 35 items were created in parallel self-report and informant-report formats. Exploratory factor analysis of data from a large development sample guided the construction of six subscales, each of which showed high internal reliability. A further study showed a high correlation between self-report and informant-report versions in a sample of older adult respondents. Study 3 explored patterns of association between semantic memory for melodies, melody perception, and music engagement in a series of 15 AD cases. No single cognitive or perceptual ability was sufficient to explain cases of high music engagement. Heterogeneity between cases supports the hypothesis that there are multiple pathways by which music engagement may be sustained in those with AD. Individual cases are examined to draw out implications for basic and clinical research on music and AD.
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