Characterization of Live, Calming Improvisatory Music for Alzheimer’s Disease and Caregivers
Melanie Zhang1, Kate Vidano1, Clara Takarabe2, Borna Bonakdarpour3
1Northwestern University, 2Northwestern University Neurology, 3Mesulam Center for Cognitive Neurology and Alzheimer Disease
Objective:
To assess the feasibility and impact of Clinically Designed Improvisatory Music (CDIM) on anxiety, caregiver burden, physiological indicators, brain network connectivity, and to analyze CDIM’s musical structure.
Background:
Nonpharmacologic modalities, including music-based interventions (MBIs), are essential for addressing neuropsychiatric symptoms in Alzheimer’s disease (AD) and alleviating caregiver stress. Clinically Designed Improvisatory Music (CDIM) is a live MBI shown to reduce anxiety and burden in neurological conditions and healthcare professionals, but its use in AD and caregivers has not been studied.
Design/Methods:
Nine individuals with AD-related anxiety (AD-A) and ten caregivers participated in eight CDIM sessions. Pre- and post-intervention assessments included anxiety (Rating Anxiety in Dementia), caregiver burden (Zarit Burden Interview), vital signs, and resting-state functional MRI. CDIM recordings were analyzed using music information retrieval methods to quantify tempo, duration, pitch, tonality, and musical tension.
Results:
Adherence exceeded 90%. Anxiety, caregiver burden, blood pressure, and respiratory rate decreased post-CDIM. Connectivity in salience (SN), reward, and auditory-limbic (ALN) networks increased in AD-A participants; caregivers showed increased SN, ALN, and posterior default mode network connectivity. CDIM sessions featured consistent musical patterns: 1–2 minute phrases with ~10-second pauses, tempo between 51–69 bpm, pitch from C3–C5, and 5–7 key changes. Parametric temporal model analysis of musical tension revealed a continuous interplay of rising and falling pitch, shifting dynamics, and fluctuating tempo.
Conclusions:
CDIM was feasible and effective in reducing anxiety and caregiver burden while modulating emotional brain networks. Its structured yet adaptive musical features fostered engagement, highlighting its potential as a standardized non-pharmacologic intervention for AD-A and caregivers.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.