Recreational activities that stimulate the brain have been associated with improved well-being in patients with dementia. This systematic review aims to characterize the role of music therapy as a form of non-pharmacological treatment in improving dementia symptoms compared to other recreational activities.

A systematic review was conducted following the PRISMA guidelines using various iterations of the keywords “music therapy”, “dementia”, and “recreational activities” in PubMed, Google Scholar, PsycINFO, and Cochrane, which yielded a total of 320 results after duplicate removal. 160 articles were excluded based on titles or abstracts unrelated to the topic of music therapy and dementia. Sources which were included in the systematic review had to specifically focus on dementia, address the correlation between dementia and music therapy, describe methods used to evaluate the effects of music therapy before and after the intervention, and compare the outcomes of music therapy to one other recreational activity. As a result, 25 articles were included in the review.

Receptive music therapy interventions such as listening to music showed a short-term reduction in challenging behaviors with the frequency of challenging behaviors returning to baseline after a no music washout period. When patients listened to familiar individualized music, levels of agitation (p=0.004) and caregiver distress (p=0.009) were reduced, while self-consciousness and emotional state (p=0.01) improved. Exposure to unfamiliar or undesired songs resulted in no improvement in self-consciousness and an increase in agitation (p=0.038). Active music therapy, which involves singing and playing an instrument, provided more benefits than receptive music therapy. Singing fostered a sense of belonging among dementia patients which increased social engagement, the frequency of experiencing positive emotions, physical relaxation, reduced the burden on caregivers, decreased levels of anxiety, and helped dementia patients with aphasia gain speech reconstruction skills (p=0.001). Additionally, singing improved memory as it involved memorizing song lyrics, which simulated parts of the brain involved with verbal memorization. Musical instruments stimulated cognitive function, reduced depression symptoms, improved the patient’s concentration, mood, and overall quality of life based on The World Health Organization Quality of Life Brief Questionnaire with increased physical (p=0.015) and psychological (p=0.045) health.

Painting reduced depressive symptoms and anxiety more significantly than singing interventions, but did not improve performance for verbal memory like singing did. Both interventions observed a decrease in anxiety (p < 0.0001) and improvement in quality of life (p=0.002). Cooking interventions decreased agitation (p = 0.007), reduced caregiver distress, and instilled a short term improvement on mood (p =  0.009), but no significant benefits on cognitive function were observed (p = 0.7).

Music therapy interventions, especially singing and instrument playing were associated with various benefits towards dementia symptoms such as an improvement in the patient’s quality of life, cognitive function, and mental health. Additional research investigating the long-term effects of music therapy on dementia symptoms may provide an avenue for complementary therapy.