Musical Intervention in Alzheimer’s Disease 533 Music Perception VOLUME 29, ISSUE 5, PP. 533–541. ISSN 0730-7829, ELECTRONIC ISSN 1533-8312. © 2012 BY THE REGENTS OF THE UNIVERSITY OF CALIFORNIA ALL RIGHTS RESERVED. PLEASE DIRECT ALL REQUESTS FOR PERMISSION TO PHOTOCOPY OR REPRODUCE ARTICLE CONTENT THROUGH THE UNIVERSITY OF CALIFORNIA PRESS’ S RIGHTS AND PERMISSIONS WEBSITE, HTTP:// WWW. UCPRESSJOURNALS. COM/ REPRINTINFO. ASP.DOI: 10.1525/ MP.2012.29.5.533 S YLVAIN CLÉMENT Université de Lille – Nord de France, France AUDREY T ONINI & F ATIHA KHATIR Pôle gériatrique du Centre Hospitalier de Valenciennes, Valenciennes, France L ORIS S CHIARATURA, & S ÉVERINE S AMSON Université de Lille – Nord de France, France IN THIS STUDY, WE EXAMINED SHORT AND LONGER TERM EFFECTS of musical and cooking interventions on emotional well-being of severe Alzheimer’s disease (AD) patients. These two pleasurable activities (i.e., listening to music, tasting sweets) that were collectively performed (i.e., playing music together, collaborative preparation of a cake) were compared in two groups of matched patients with AD ( N = 14). Each intervention lasted four weeks (two sessions per week) and their effects were regularly assessed up to four weeks after the end of the intervention. We repeatedly evaluated the emotional state of both groups before, during, and after the intervention periods by analyzing discourse content and facial expressions from short filmed interviews as well as caregivers’ judgments of mood. The results reveal short-term benefits of both music and cooking interventions on emotional state on all these measures, but long-term benefits were only evident after the music intervention. The present finding suggests that non-pharmacological approaches offer promising methods to improve the quality of life of patients with dementia and that music stimulation is particularly effective to produce long last- ing effects on patients’ emotional well-being. Received January 5, 2011, accepted July 9, 2011. Key words: music, Alzheimer’s Disease, non- pharmacological treatment, emotion, mood A LZHEIMER’S DISEASE (AD) IS THE MOST COMMON neurodegenerative disease and a major world- wide public health problem with a predicted doubling of prevalence every twenty years (Ferri et al., 2005). Although the progression of AD symptoms can be slowed down by pharmacotherapy, the effectiveness of this approach is still limited (Lanctôt & Rajaram, 2009). Therefore, non-drug therapies could be a prom- ising complementary method of assisting AD patients and their caregivers in coping with mood and cognitive symptoms. In addition to cognitive dysfunction characterized by memory and visuospatial disorders (Mendez, Mastri, Sung, & Frey, 1990), emotional and behavioral difficul- ties exist and increase with the spread of AD pathology. Several studies carried out in mild to moderate AD patients reported deficits in emotional judgments using faces (Hargrave, Maddock & Stone, 2002; Kohler et al., 2005; Weiss et al. 2008), voices (Roberts, Ingram, Lamar, & Green, 1996), or body movements (Koff, Zaitchik, Montepare, & Albert, 1999). Social communication was also impaired (Shimokawa et al., 2001). All these emotional disorders seem to be associated with cerebral atrophy and Tau deposition in limbic structures such as the amygdala (Delacourte et al., 1999). In the literature, there is no clear evidence of a specific emotional category deficit in AD. Results of a meta-analysis, however, have revealed age-related changes in the ability to identify specific emotional categories consisting of an increased deficit in the recog- nition of anger or sadness whereas disgust recognition remained unimpaired (Ruffman, Henry, Livingstone, & Phillips, 2008). As pointed out by Henry et al. (2008), this pattern of age-related change was not clearly found in AD patients. Although emotional disorders are frequently present in mild to moderate stages of the disease, they are not common in the earlier stage of AD. Nevertheless, the progressive disruption of cognitive and language functions may disrupt the verbal expression of emotion (Varma et al., 1999). In contrast, nonverbal expressions of emotion seem to remain preserved in later stages of the disease. Patients with severe AD can still express sadness on their face when relatives depart after visiting (Magai, Cogen, Gomberg, Malatesta, & Culver, 1996). They can produce distinguishable facial expressions of joy, anger, or disgust despite a general cognitive S HORT AND L ONGER T ERM E FFECTS OF M USICAL I NTERVENTION IN S EVERE A LZHEIMER ’ S D ISEASE