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A Prescription for Music Lessons

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Learning to play a musical instrument provides a peaceful retreat from the pressures of daily life. Therapeutic outcomes of playing music include better communication skills, improved emotional release, and decreased anxiety and agitation.1 Musical training promotes cognitive function, mental health, and a connection to others.2,3

Depression

Impacting 14.8 million people, depression is the most prevalent mental health issue for adults aged ≥ 55 years and accounts for 10% of all medical disability in the U.S. and Canada.4-6 About half the people diagnosed with depression also have an anxiety disorder, which can lead to smoking, drinking alcohol, overeating, and complicated health care issues.5 By 2020, depression is predicted to be the second most common disease in the world and cost employers about $23 billion in absenteeism.4

Hays and Minichiello found that learning to read music and play the piano might enhance mood and certain aspects of the quality of living indicators in older adults. Those aged ≥ 65 years who participated in playing music reported improved self-esteem, greater independence, and fewer feelings of isolation. In addition, playing music created a temporary escape from the stress of daily life.7 Seinfield and colleagues compared a piano training group with a control group (nonplaying) and found that those who played piano experienced a decrease in psychological distress, depression, and fatigue.8 Playing an instrument can positively impact the well-being of older adults throughout life by promoting empowerment, autonomy, and social cohesion.7-11Manalai and colleagues found that a single episode of playing the piano was beneficial for a 91-year-old female patient who previously played when she was young and who was currently experiencing psychotic and depressive symptoms. Following playing, the patient’s vocabulary and insight temporarily improved. For the first time since her admission, the patient provided many details about her past mental and physical health. Even though the patient never played again, due to her delusional disorder, the improvement in mood and cognition were sustained for several months.12 The researchers noted that the patient’s temporary improvement may have been attributed to other factors.12

Another study measured levels of anxiety, depression, and loneliness in senior citizens. Study participants who regularly participated in a keyboard class were less anxious, depressed, and lonely compared with the control group.13 Other studies support the idea that music can modulate emotional responses and enhance cognitive performance.14,15

Mind Stimulation

As people age, they will experience progressive physiologic losses in function, such as auditory, cognition, memory, and motor control.16,17 Affect or mood can also be impacted.8 Consequently, there is a focus on promoting nonpharmacologic solutions that protect against age-related health issues. For example, musical training for adults that involves sensorimotor practice produces greater changes in the auditory cortex than does the equivalent experience involving only auditory training.18 Research indicates that age-related auditory decline can be mitigated by musical training.19 Evidence also supports cognitive stimulation, which may help reduce the likelihood of cognitive impairments in advanced age.16,17

The brain works on a principle of “use it or lose it.” Therefore, exercising the brain is important, and musical training may fill that need. Learning a skill such as playing an instrument reorganizes the brain’s neural pathways.2,16 Brain plasticity is the ability of the brain to change its structure, and engaging older adults in sensory, cognitive, and motor activities creates positive outcomes.16,17 Research also indicates active participation in music lessons creates larger plasticity effects than does passively listening to music.16 Musical training provides a multisensory activity that requires integrating signals from different sensory modalities with motor responses.16 Verghese and colleagues found that individuals who played a musical instrument were less likely to experience dementia than were those whose leisure activities consisted of reading, writing, and working crossword puzzles.20 Verghese suggested that 6 months of piano lessons in older adults improved the brain’s executive functioning (regulates abilities and behaviors) and working memory (ie, keeping track of information).20 Balbag and colleagues who conducted a study of twins found that “playing an instrument in older adulthood is significantly associated with reduced likelihood of dementia and cognitive impairment.”21 Musical training is also associated with improved visual memory and the ability to divide the individual’s attention between several activities. This ability is crucial for activities such as driving and is useful for navigating crowded areas, such as a mall.22,23

Dexterity

Musical training also has been found to be beneficial for stroke survivors, because this type of training elicits a change in the reorganization of the sensorimotor cortex that results in improved movement quality.24 Piano playing can lead to meaningful improvements in manual dexterity, finger movement coordination, and functional use of upper extremities.25

Zelazny studied the effects of keyboard playing on 4 older adults with osteoarthritis who over 4 weeks had 30-minute sessions of electronic keyboard playing 4 days per week.26 The researcher found that participants reported decreased arthritic pain, increased dexterity, and increased finger strength. Playing the piano requires both eye and hand coordination, which is essential as a person ages. Improved dexterity of fine motor skills can assist individuals with the activities of daily living, such as buttoning a shirt and using a remote control.26

Stress Reduction

Life is filled with stressors, and anyone can have difficulty coping with daily stress. According to Toyoshima and colleagues, playing the piano can lower cortisol levels and decrease a person’s anxiety level.27 These researchers compared the activities of piano playing, calligraphy, and clay molding and found that playing the piano was significantly more effective at lowering stress levels when measuring salivary C-reactive protein levels and State-Trait Anxiety Inventory (STAI) scores.

Another study found stress reduction was significant for participants who played the keyboard compared with participants who relaxed, read magazines, or solved puzzles.28 Stress has a negative impact on the immune system, which can increase an individual’s risk of disease. According to Mohd “emotional stress is a major contributing factor to the 6 leading causes of death in the U.S.: cancer, coronary heart disease, accidental injuries, respiratory disorders, cirrhosis of the liver, and suicide.”29

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