Music Effects on Cognitive Function of the Elderly

Whether the music is orchestral, rock, country, or jazz, most seniors like to listen to some kind of music. Music can soothe or energize, make us happy or sad, but the kind we like to hear does something that can be positively reinforcing or otherwise we would not listen to it. As my 80-year-old jazz trumpeter friend, Richard Phelps, recently said at his birthday party, "Where there is life there is music. Where there is music, there is life."

Relatively little research has been done on the effects of music on brain function in older people. But one study recently reported the effects in older adults of background music on brain processing speed and two kinds of memory (episodic and semantic). The subjects were not musicians and had an average age of 69 years.

The music test conditions were: 1) no music control, 2) white noise control, 3) a Mozart recording, and 4) a Mahler recording. All 65 subjects were tested in counter-balanced order in all four categories. The music was played at modest volume as background before and during performance of the cognitive tasks, a mental processing speed task and the two memory tasks. The episodic memory task involved trying to recall a list of 15 words immediately after a two-minute study period. The semantic memory task involved word fluency in which subjects wrote as many words as they could think of beginning with three letters of the alphabet.

Processing speed performance was faster while listening to Mozart than with the Mahler or white noise conditions. No improvement in the Mahler condition was seen over white noise or no music.

Episodic memory performance was better when listening to either type of music thatn while hearing white noise or no music. No difference was noted between the two types of music.

Semantic memory was better for both kinds of music than with white noise and better with Mozart that with no music.

Recognizing that emotions could be a relevant factor, the experimenters analyzed a mood questionnaire comparing the two music conditions with white noise. Mozart generated higher happiness indicators than did Mahler or white noise. Mahler was rated more sad than Mozart and comparable to white noise.

Thus, happy, but not sad, music correlated with increased processing speed. The researchers speculated that happy subjects were more around and alert.

Surprisingly, both happy and sad music enhanced both kinds of memory over the white noise or silence condition. But it is not clear if this observation is generally applicable. The authors did mention without emphasis that the both kinds of music were instrumental and lacked loudness or lyrics that could have been distracting and thus impair memory. I think this point is substantial. When lyrics are present, the brain is dragged into trying to hear the words and thinking about their meaning. These thought processes would surely interfere with trying to memorize new information or recall previous learned material.

A point not considered at all is personal preference for a certain types of music. There are people who don't like classical music, and the data in this study could have been made "noisy" if enough of the 65 people disliked classical music and were actually distracted by it. In other words, the effects noted in this study might have been magnified if the subjects were allowed to hear their preferred music.

My take-home lesson was actually formed over five decades ago when I listed to jazz records while plowing my way through memorizing a veterinary medical curriculum. Then, I thought that the benefit was stress reduction (veterinary school IS stressful and happy jazz certainly reduces stress). Now perhaps I see that frequent listening to music that was pleasurable for me might have actually helped my memory capability. If you still have doubts you might want to check my latest blog post, "Happy thoughts can make you more competent" (http://thankyoubrain.blogspot.com/2015/01/happy-thoughts-can-make-you-more.html).

Anyway, now that I am in the elderly category, I see there is still reason to listen to the music I like. Music can be therapy for old age.

“People haven't always been there for me but music always has.”

    —Taylor Swift

"Memory Medic's" latest book is "Improve Your Memory for a Healthy Brain. Memory Is the Canary in Your Brain's Coal Mine." It is available in inexpensive e-book form at Amazon or in all formats at Smashwords.com.

Bottiroli, Sara et al. (2014). The cognitive effects of listening to background music on older adults: processing speed improves with upbeat music, while memory seems to benefit from both upbeat and downbeat music. Frontiers in Aging Neuroscience. Oct. 15. doi: 10.3389/fnagi.2014.00284.

How does the brain work?

We have no idea. We are still in the very beginning stages of understanding most of the basics. From a researcher's perspective, it's a very exciting time to be a scientist, because you get to rummage around on the ground floor. But from an overall perspective, most of it is spooky.  

Let me give you some examples of how little we know about how the brain works. We know that you use the left-side of your brain for speech. Under normal circumstances, if you get a stroke on the left side of your brain, your speech can be greatly affected. Depending upon where you got the stroke, it could affect your ability to speak language or your ability to understand language.

There is a little six year old who suffered from something Sturge-Weber syndrome, a catastrophic brain disease. Because he had this disorder, the little guy had to have his entire left hemisphere removed. No left hemisphere, no language. That should have completely destroyed his language ability. Right?

Wrong!

Within two years, the little guy had regained his language abilities entirely. The right side of his brain seemed to have noticed there was a deficit and simply rewired itself to take over talking. Do we understand this?

We do not.

We do not understand how you learn a language of any kind. We don't know how you know how to walk. We don't know how you know how to read. You have a complete map of your body in your head. Actually, you have several maps of your body in your head. Some of them tell you where you are, some of them tell you how to move. One even tells you how to see. We don't know how they coordinate their information. We don't know how it knows its you - and what, if anything, YOU are. Consciousness remains a slippery fish as ever.

So you ask me how the brain works. I am happy to repeat my answer. We have no idea.

Visit brainrules.net to learn about the 12 things we know about how the brain works. These are the Brain Rules

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Mental practice & Mental rehearsal

Mental practice

In 1972, Corbin defined mental practice as the repetition of a task, without observable movement with the specific intent of learning’. It is to enhance performance in the absence of a physical activity.

There is some agreement that mental practice frequently has a beneficial effect on other the learning of a new skill or the betterment of performance of an existing skill.

Mental practice has been found to improve both cognitive and psychomotor performance.

The use of mental visualization in sports, mental practice was used in the context of sports psychology as a possible means for improving performance on a wide range of sport related task.

The mental practice most helpful to improve riding skills, is the mental practice of those skills in the midst of being improved or attempted for the first time.

Mental practice is most famous for the gains achieved in terms of muscle memory and the mental organization of sub-skills needed to successfully achieve a new skill.

Mental rehearsal

Mental rehearsal is one aspect of imaginary. It means the mental practice of performing a skill as oppose to actual practice. This is sometimes called mental practice and is a strategy adopted by many sportsmen and women.

It is a strategy for practicing something in mind before actually performing the task.

By mentally rehearsing it form mental image of the skill or event that the people are going to perform. No physical movements are involved in mental rehearsal. Some performers find mental rehearsal easier than other but the ability can be improved with practice. Mental rehearsal appears to be particularly useful in therapy settings with patients who are unable to engage in large amounts of physical practice because they lack endurance.

Mental rehearsal is used either to learn a new skill or to improve existing skills. There are a number of ways in which metal rehearsal is used including skills practice and rehearsal, practicing for events, competition practice, practicing ‘What if….?’, scenarios, replaying performance and performance routines.

Sleep in Your bad attitude, avoid!!

Generally speaking, you cannot learn from sounds of new information while you sleep, though this was a fad several decades ago. But in an earlier post, I discussed a new line of research where sleep learning can occur. The key is to play sound cues that were associated with learning that occurred during the previous wakefulness period. The explanation I posted was that cue-dependent sleep learning can work because a normal function of sleep is to strengthen memories of new information and that presenting relevant cues during sleep increases the retrieval of these memories and makes them accessible for rehearsal and strengthening.

The latest experiment by a different group shows that this cuing during sleep can modify bad attitudes and habits. The test involved counter stereotype-training of certain biased attitudes during wakefulness, and investigators reactivated that counter-training during sleep by playing a sound cue that had been associated with the wakefulness training.

In the experiment, before a 90-minute nap 40 white males and females were trained to counter their existing gender and racial biases by counter-training. A formal surveyed allowed quantification of each person's level of gender or racial bias before and after counter-training. For example, one bias was that females are not good at math. Subjects were conditioned to have a more favorable attitude about women and math with counter-training that repeatedly associated female faces with science-related words. Similarly, racial bias toward blacks was countered by associating black faces with highly positive words. In each training situation, whenever the subject saw a pairing that was incompatible with their existing bias they pressed a "correct" button, which yielded a confirmatory sound tone that was unique for each bias condition. Subjects were immediately tested for their learning by showing a face (female or black) and the counter-training cue, whereupon they were to drag the appropriate bias-free face on to a screen with the positive word. For example, if the first test screen was that of a woman, accompanied by the sound cue, the subject dragged a woman's face onto a second screen that said "good at math." Results revealed that this conditioning worked: both kinds of bias were reduced immediately after counter-conditioning.

Then during the nap, as soon as EEG signs indicated the presence of deep sleep, the appropriate sound cue was played repeatedly to reactivate the prior learning. When subjects re-took the bias survey a week later, the social bias was reduced in the sound-cued group, but not in the control group that was trained without sound cues.

Experimenters noted that the long-term improvement of bias was associated with rapid-eye-movement (REM) (dream) sleep which often followed the deep sleep during early stages of the nap. That is, the beneficial effect was proportional to the amount of nap time spent in both slow-wave sleep and REM sleep, not either alone. It may be that memories are reactivated by cuing during deep (slow-wave) sleep, but that the actual cell-level storage of memory is provided by REM sleep.

Implications of this approach to enhancing learning and memory show a great deal of promise. Can it be used for enhancing learning in school? Can it be used in rehabilitation of addicts or criminals? But there is a dark side. Now might be a good time to re-read Huxley'sBrave New World wherein he actually described conditioning values in young children while they slept. Sleep is a state where people are mentally vulnerable and without conscious control over their thoughts. Malevolent people could impose this kind of conditioning and memory enhancement on others for nefarious purposes.  These techniques may have valid social engineering applications, but they must be guided by ethical considerations.

The importance of mentors in family medicine

Saying that my medical alma mater, NYU School of Medicine, isn't known as a school that produces family physicians is a gross understatement. Actually, it routinely ranks last in the nation in the number of students matching to Family Medicine residency programs. My class of 2001, which sent 4 students to such programs, was a one-time aberration.

So how did I get started in family medicine? I give a great deal of credit to the Reading Hospital and Medical Center, which allowed me to do an elective rotation in their residency program from June through July 2000. But what inspired me to look into family medicine rotations in the first place? I recently came across a 13-year old letter I wrote to my cousin's husband (then a family medicine resident training in Minnesota) that gives part of the answer, and speaks to the vital importance of finding mentors for medical students who are interested in primary care careers.

I hope that life in Minnesota has been treating you well! So far I have been enjoying the second year of medical school at NYU. The classes have been much more interesting than last year’s, and while I still have a long way to go, I’m slowly beginning to believe that I might someday know enough to take care of patients.

Last month we had a speaker come to talk about rotations and residencies in Family Medicine, and that made me wonder how you were doing. Is this the first or second year of residency? How do you like it? How many years are left to go? Where (geographically and what kind of community) do you plan on practicing after it’s over?

Since I haven’t even started my clerkships, I don’t really know which field interests me most, but since NYU doesn’t have a Department of Family Medicine, I thought it might be a good idea to gather information from outside sources that I know I can trust. I’ve spent several summers working with children, so the natural choice would seem to be pediatrics, but I would love to hear your perspectives on taking care of families while raising one of your own.

Have a wonderful holiday season, and best wishes to you and the kids.

Is climate change a clinical health issue?

At first glance, the topic of the cover article of American Family Physician's August 1st issue, "Slowing Global Warming: Benefits for Patients and the Planet," might seem out of place in a journal that aims to provide practical clinical guidance for family physicians. Past summer-themed articles have included reviews of heat-related illness, medical advice for commercial air travelers, and even health issues for surfers. By recognizing climate change as a clinical health issue, AFP joins other widely read medical journals such as The Lancet and BMJ in recognizing the essential role that physicians can play in mitigating the negative impacts of environmental stress on patients' health.

After summarizing the serious potential health effects of climate change, Dr. Cindy Parker recommends that primary care clinicians counsel patients regarding two lifestyle changes that are likely to improve personal health as well as slow global warming: reducing meat consumption and increasing "active transportation" (substituting bicycling or walking for short car trips). In addition, physician practices and larger medical organizations can positively affect climate change by "going green":



Medical offices and hospitals can help by recycling; using recycled items and Energy Star certified appliances and computers; minimizing waste and waste transport by replacing single-use items with sterilizable or washable items; purchasing wind-generated electricity; and reducing energy use by turning off appliances, computers, and lights when not in use. In 2008, the U.S. health care sector spent $8.8 billion on energy to meet patient needs, not including the transportation of employees or patients to and from health care facilities, resulting in 8 percent of all U.S. greenhouse gas emissions.

In an accompanying editorial, Dr. Robert Gould reviews several national and international initiatives that encourage hospitals and health systems to reduce greenhouse gas emissions, including the Healthier Hospitals Initiative and Health Care Without Harm.

Optimal Spacing for Study, What's this?

We have all been told by teachers that learning occurs best when we spread it out over time, rather than trying to cram everything into our memory banks at one time. But what is the optimal spacing? There is no general consensus.

However we do know that immediately after a learning experience the memory of the event is extremely volatile and easily lost. It's like looking up a number in the phone book: if you think about something else at the same time you may have to look the number up again before you can dial it. School settings commonly create this problem. One learning object may be immediately followed by another, and the succession of such new information tends to erase the memory of the preceding ones.

Memory researchers have known for a long time that repeated retrieval enhances long-term retention. This happens because each time we retrieve a memory, it has to be reconsolidated and each such reconsolidation strengthens the memory. Though optimal spacing intervals have not been identified, research confirms the importance of spaced retrieval. No doubt, the nature of the information, the effectiveness of initial encoding, competing experiences, and individual variability affect the optimal interval for spaced learning.

One study revealed that repeated retrieval of learned information (100 Swahili–English word pairs) with long intervals produced a 200% improvement in long-term retention relative to repeated retrieval with no spacing between tests. Investigators compared different-length intervals of 15, 30, or 90 minute spacing that expanded (for example, 15-30-45 min), stayed the same (30-30-30 min) or contracted (45-30-15 min) revealed that no one relative spacing interval pattern was superior to any other.

Another study has revealed that the optimally efficient gap between study sessions depends on when the information will be tested in the future. A very comprehensive study of this matter in 1,350 individuals involved teaching them a set of facts and then testing them for long-term retention after 3.5 months. A final test was given at a further delay of up to one year. At any test delay, increasing the inter-study gap between the first learning and a study of that material at first increased and then gradually reduced final test performance. Expressed as a ratio, the optimal gap equaled 10-20% of the test delay. That is, for example, a one-day gap was best for a test to be given seven days later, while a 21-day gap was best for a test 70 days later. Few of any teachers or students know this, and their study times are rarely scheduled in any systematic way, typically being driven by test schedules for other subjects, convenience, or even the teacher's whim.

The bottom line: the optimal time to review a newly learned experience is just before you are about to forget it. Obviously, we usually don't know when this occurs, but in general the vast bulk of forgetting occurs within the first day after learning. As a rule of thumb, you can suspect that a few repetitions early on should be helpful in fully encoding the information and initiating a robust consolidation process. So, for example, after each class a student should quickly remind herself what was just learned—then that evening do another quick review. Before the next class on that subject, the student should review again. Teachers help this process by linking the next lesson to the preceding one.

Certain practices will reduce the amount of time needed for study and the degree of long-term memory formation. These include:

• Don't procrastinate. Do it now!

• Organize the information in ways that make sense (outlines, concept maps)

• Identify what needs to be memorized and what does not.

• Focus. Do not multi-task. No music, cell phones, TV or radio, or distractions of any kind.

• Association the new with things you already know.

• Associate words with mental images and link images to locations, or in story chains

• Think hard about the information, in different contexts

• Study small chunks of material, in short intervals. Then take a mental break.

• Say out loud what you are trying to remember.

• Practice soon after learning and frequently thereafter at spaced intervals.

• Explain what you are learning to somebody else. Work with study groups later.

• Self-test. Don't just "look over" the material. Truly engage with it.

• Never, never, ever CRAM!