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A 2025 Cochrane review found music-based therapy probably improves depressive symptoms for people with dementia and may improve overall behavior, while showing little evidence of lasting effects on cognition or agitation. Personalized music may also support moments of comfort and engagement, but it does not reverse or stop dementia.
A 2025 update of a Cochrane review found that music-based therapy probably improves depressive symptoms in people with dementia and may improve overall behavior, but it found little evidence of longer-term changes in cognition or agitation. The findings, reported by Being Patient alongside clinical experience and a small study of personalized playlists, frame music as a possible way to support mood, engagement and connection — not as a treatment that reverses or stops dementia.
The updated review combined results from 30 studies involving 1,720 participants, most of whom were living in care homes. It concluded that music therapy probably improves depressive symptoms and may improve overall behavior. The review found little evidence that it changes cognition or agitation over the longer term, and noted that benefits may fade in the weeks after sessions end. The results point to possible support for day-to-day well-being, rather than a lasting change to the course of dementia.
A separate study of 51 people with dementia attending adult day health centers tested a 20-minute session with a personalized playlist delivered through headphones. Researchers observed increases in joy, eye contact, eye movement, engagement and talkativeness after listening, along with less sleeping. The study measured responses after a brief intervention; it does not establish that music produces lasting effects or works the same way for everyone.
Concetta Tomaino, a music therapist and executive director and co-founder of the Institute for Music and Neurologic Function, described seeing residents with advanced dementia sing familiar songs during her early clinical work. She said that experience led her to investigate how music can remain accessible when other forms of recall and communication are impaired. The mechanisms are not fully understood, and the article stresses that music cannot reverse or stop dementia.
Music’s Role in Daily Dementia Care
The findings matter to families and care workers because familiar music can offer a relatively simple way to create moments of comfort and engagement, even when a person has difficulty communicating. Caregivers described using a favorite song during stressful changes in routine, such as traveling to an appointment, waiting in a clinic, or settling after a family video call. A familiar playlist may also help make a care interaction more personal.
The evidence supports measured expectations. Music may help with mood and behavior, but the review does not show that it changes the underlying disease or reliably improves cognition over time. The study of personalized playlists recorded short-term observations, not proof of long-term benefit. For care settings, the practical implication is to treat music as a possible complement to other support, with attention to the person’s preferences and response.
Music can also affect caregivers and the shared experience of care. A song that a person recognizes may create an opportunity for singing or interaction when conversation is difficult. But responses differ, and a particular song or volume may not be comforting to every person. The report’s emphasis is on individualized use rather than a single playlist or approach for all people with dementia.
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Why Familiar Songs Can Persist
Music engages several brain systems involved in hearing, movement, memory, emotion and reward. Listening activates the auditory cortex; moving along to a rhythm involves coordination systems, including the cerebellum. The hippocampus and amygdala are also involved in memory and emotion, while enjoyable music can engage reward pathways associated with dopamine. These areas do not work in isolation, which may help explain why a song can prompt a response that ordinary conversation does not.
Tomaino told Being Patient that music people love and form attachments to becomes embedded in deeper, subcortical brain networks. She said those networks may remain more resilient as dementia progresses than some functions associated with the brain’s outer cortex. This is a proposed explanation drawn from clinical experience and neuroscience; it is not a complete account of why some musical abilities remain accessible. A person may respond to a song without being able to name it or identify who is playing it.
The article links this clinical perspective with research that has tested music-based interventions. The evidence varies by outcome and duration: findings on mood and behavior are more encouraging than findings on longer-term cognition or agitation. The distinction matters because a visible response during or after a session does not, by itself, show that the disease has changed.
“They not only came to life in the moment, but were able to sing the words.”
— Concetta Tomaino, music therapist and co-founder of the Institute for Music and Neurologic Function
Limits of the Evidence
The review’s overall findings do not establish how long any improvement lasts for an individual, which music-based approaches are most effective, or whether results differ by dementia type or stage. Although the review included 30 studies and 1,720 participants, most participants were in care homes, so the findings may not apply equally to people receiving care at home or in other settings.
The 51-person playlist study found changes after a 20-minute session, but the report does not describe those observations as proof of lasting benefit. It is also unclear from the material provided how much individual responses varied, or whether changes in mood and engagement affected other outcomes over time. Researchers have not fully explained why musical memories can remain accessible when other abilities are impaired.
Music is not a disease-modifying treatment, and the evidence does not show that it prevents dementia or stops its progression. The report also does not provide a single approach that works for everyone. A person’s preferred music, comfort, and response remain relevant, and the possibility of benefit should not be presented as a guaranteed outcome.
Training and Further Research
Dr. Emily Ihara said the results of the personalized-playlist study prompted her team to develop online training for direct care workers in long-term care communities. The report does not state when that training will be available or provide further details about its content.
For researchers, the review’s findings leave questions about the duration and consistency of effects, especially after music sessions stop. Further studies could help clarify which approaches work best, for whom, and whether short-term changes in mood or engagement persist. Until then, music is best described as a possible support for well-being and interaction, with benefits that may vary by person and setting.
Key Questions
Can music treat or stop dementia?
No. The report says music cannot reverse or stop dementia. Evidence suggests possible benefits for depressive symptoms and behavior, but not a treatment for the disease itself.
What did the 2025 review find?
The review pooled 30 studies with 1,720 participants, mostly in care homes. It found that music therapy probably improves depressive symptoms and may improve overall behavior, with little evidence of longer-term changes in cognition or agitation.
What happened in the personalized-playlist study?
In a study of 51 people with dementia at adult day health centers, participants listened to a personalized playlist for 20 minutes. Researchers observed increases in several measures of engagement and joy afterward, but the study does not establish lasting effects.
Why might a familiar song prompt a response?
Music engages brain systems associated with hearing, movement, memory, emotion and reward. Concetta Tomaino has suggested that musical memories may be held in deeper brain networks that can remain accessible as dementia progresses, though the full explanation is not known.
How might caregivers use music?
The report describes caregivers using familiar music during changes in routine, travel, waiting-room visits and other unsettled moments. Responses vary, so the person’s preferences and reaction are important; music should be treated as a possible source of comfort, not a guaranteed solution.
Source: rss
