Preserved musical instrument playing in dementia

[Extract]
The ability to play a musical instrument can remain despite significant cognitive
impairment in the severe stage of dementia. Such observations illustrate
a striking dissociation between musical and non- musical memory and
skill within this population. What are the psychosocial implications of such
a complex skill being preserved in the face of an otherwise devastating cognitive
impairment? We propose that playing a musical instrument allows
a unique form of access to two crucial domains: memory and the self. This
notion was first raised by Matthews (2015), who described music as a “tool
of access— access to memory of music and access to a past social self ” in
people with dementia (p. 576). We expand this notion by considering musical
instrument playing as a means of accessing specific types of memory
and maintaining a strong sense of self. In particular, certain procedural, semantic, and episodic, including autobiographical, memories may be preserved
through the act of playing an instrument, even in the severe stage of
dementia. Such memories are not easily elicited by non- music stimuli (e.g.,
verbal and visual reminders), but playing a musical instrument has a unique
capacity to enable the expression of these preserved forms of memory. In
doing so, it can provide access to one’s past and continuing self, and can be
considered a form of self- preservation and expression in musicians with
dementia.