Chorus Gives Voice to Those With Alzheimer’s

THURSDAY, Dec. 22 (HealthDay News) — Late December wouldn’t be
the same without the uplifting sound of holiday choirs, but there’s a
unique chorus in New York City, called “The Unforgettables,” that’s
bringing new harmony to singers and audiences alike.

That’s because the chorus’ 22 members include 11 men and women
diagnosed with early to middle-stage dementia, including dementia linked
to Alzheimer’s disease, paired up with 11 of their caregivers — a spouse,
child or friend.

Each practice and recital is an act of togetherness and renewed
strength in the face of illness, one of the chorus’ founders said.

“The pleasure this process has given participants was clear from the
start,” said researcher Mary S. Mittelman, who spearheaded the choir’s
inauguration back in June, along with colleagues from the NYU Langone
Medical Center’s Center of Excellence on Brain Aging. “The chorus has
proven to be a wonderful place to be, where no one feels stigmatized.”

Organizers say this is the first choir of its kind in the United
States. Patients and caretakers were initially recruited through outreach
that involved a number of local organizations, including the New York City
chapter of the Alzheimer’s Association and Langone. The chorus currently
includes people diagnosed with either Alzheimer’s disease or another form
of dementia called Lewy body disease.

Chorus members meet once a week to practice and are joined by musicians
who serve as conductor-directors. They’re taught standard techniques to
enhance breathing, vocalization and performance, just like any other
choir, Mittelman said.

To date, two public performances have been staged: The first, in
September, featured 18 songs ranging from classical to folk to pop; the
second, which took place just last week, was filled with holiday
favorites.

“There’s a certain camaraderie,” noted Howard Smith, a choral member
who cares for his wife, Lois, diagnosed with Alzheimer’s about two years
ago. “Lois is there with people with the same problems. And it’s
comforting for her and the other patients, and even for the caregivers.
Because it means we’re not alone.”

That sense of inclusiveness is key, Mittelman agreed. Too often, she
said, the typical caregiver is “afraid to go to a normal event with a
person with dementia. And so he ends up being discounted, or discounts
himself, as people exclude him from social events and he has less and less
activities to participate in and becomes more and more isolated.”

That means that a group such as The Unforgettables becomes “very
important,” said Smith, a painter and CUNY professor who commutes from the
Hudson River Valley to join rehearsals with his wife each week. “Here you
get a group like this together and it’s not threatening.”

Could the choir experience have therapeutic value, too? Mittelman says
that’s not been proven, but she hopes music may be an “unexplored
opportunity” for improving cognitive function.

“Who’s to say that singing in this chorus isn’t having a really
positive effective on mental function?” she asked, pointing to prior
research that’s indicated that exposure to music may elicit profound motor
responses in every region of a patient’s brain, stimulating the release of
neurotransmitters and endorphins while triggering musical and emotional
memory.

Delving further, Mittelman said she’s now incorporated The
Unforgettables into, “a research project with structured assessments
before, in the middle and after the concert, as well as focus groups, to
assess the benefits of participating.”

One outside expert believes it may be worth studying. This kind of
choral project, “may very well have a profound impact on the quality of
life of both patient and family,” said Dr. Robert Friedland, chair of
neurology at the University of Louisville School of Medicine, in
Kentucky.

“I actually believe it has a wonderful potential to be an Alzheimer’s
therapy,” he said. “First, it involves physical activity, which is good
for the brain and the heart. You have to get up and go. You can’t
participate in the activity if you stay home. And then singing involves
emotional and social relationships, which are stimulating. And it provides
purpose, so it’s a meaningful activity and a very vigorous one. And it
also would be a valuable approach to dealing with depression, which often
accompanies dementia.”

“That’s not to say,” Friedland cautioned, “that it’s proven that
singing in itself is effective as a therapy. But there’s every reason to
believe that it may very well be.”

For his part, Smith says he doesn’t need a study to know that the
chorus is improving the quality of life for members, allowing them to
regain their dignity.

“For example, there’s a guy in the group, Chester, who is rather
advanced in terms of his situation,” Smith said. “Now this is a man who
worked for IBM. He was very, very bright and educated. But when he was
asked to [join the chorus], even clapping was very difficult for him. And
yet now he is performing a solo in the concert from ‘Fiddler on the
Roof.'”

“I think there is a realization that the participants with dementia
still have some behavioral skills working,” he explained. “One watches
loved ones or friends unable to accomplish tasks, having difficulty
processing or retaining thoughts, or just experiencing confusion. And all
of a sudden [in the chorus] they are functioning in a group setting and
succeeding in singing words and melody.”

More information

There’s more on how music impacts dementia care at the Alzheimer’s Association.

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