Daily music listening associated with 39% reduction in dementia risk — Evidence Review

Listening to music regularly after age 70 is associated with a substantially lower risk of developing dementia, according to a new Monash University study. Most related research generally supports the idea that music engagement—whether listening or active participation—may benefit cognitive health in older adults, though findings on dementia prevention specifically are sometimes mixed.

• Several meta-analyses and reviews indicate that music therapy and musical practice can enhance cognitive function, mood, and quality of life in older adults or people with dementia, providing a context for the observed association between music listening and reduced dementia risk 4 7 10 12.
• Some studies find that music engagement is associated with improvements in specific cognitive domains (e.g., memory, attention), but results for long-term dementia prevention and global cognition are less consistent, with some reviews reporting no significant effect 6 14.
• Personalized or preferred music listening has been shown to influence brain connectivity and behavioral symptoms in dementia, supporting mechanisms by which regular music engagement could help maintain cognitive health 2 3.

Study Overview and Key Findings

Growing numbers of older adults globally face an increasing risk of dementia and age-related cognitive decline, posing significant challenges for families and healthcare systems. As pharmacological treatments for dementia remain limited, identifying accessible, lifestyle-based interventions is an urgent public health priority. The Monash University study is notable for its large sample size and focus on both music listening and active music-making in adults over 70, providing new insights into the potential protective effects of musical engagement in late life.

Property	Value
Organization	Monash University
Journal Name	International Journal of Geriatric Psychiatry
Authors	Emma Jaffa, Joanne Ryan
Population	Older adults
Sample Size	n=10,800
Methods	Observational Study
Outcome	Dementia risk, cognitive impairment, cognitive scores
Results	Listening to music linked to 39% lower dementia risk

Literature Review: Related Studies

To situate these findings in the broader research landscape, we searched the Consensus database, which includes over 200 million papers. The following queries were used to identify relevant studies:

1. music listening dementia risk
2. impact of music on cognitive health
3. music therapy dementia prevention benefits

Below, we organize the literature into major topics and summarize key findings.

Topic	Key Findings
Does music engagement (listening or playing) reduce dementia risk or slow cognitive decline?	- Large-scale and meta-analytic studies suggest that musical practice is associated with enhanced cognitive function and may provide some protection against age-related decline 4 8 10. - Some reviews report no significant effect of music therapy on preventing dementia, though small effects on global cognition are possible 6 14.
What are the cognitive and behavioral effects of music interventions for people with dementia or cognitive impairment?	- Music therapy and individualized listening can improve behavioral symptoms, reduce agitation, and enhance emotional well-being in dementia patients 1 7 11 12. - Effects on cognition are generally small to moderate, with most studies supporting improvements in quality of life and mood 7 12.
Does the type or mode of music engagement (listening vs. playing, active vs. receptive) matter?	- Active participation (playing music) and receptive listening may both confer benefits, but some evidence suggests receptive music therapy is more effective at reducing agitation and behavioral problems 8 11. - Individual differences (such as mental health history) can influence response to personalized music interventions 3.
Are there neurobiological mechanisms underlying music’s effects on the aging brain?	- Listening to preferred music increases functional brain connectivity in Alzheimer’s patients, which may support transient improvements in brain network synchronization 2. - Music engagement may preserve or boost cognitive functions via specific training and compensatory mechanisms 10.

Does music engagement (listening or playing) reduce dementia risk or slow cognitive decline?

The new Monash University study finds a significant association between regular music listening or playing and reduced dementia risk in older adults. This aligns with several large-scale and meta-analytic studies showing that musical practice is linked to better cognitive function and may help protect against age-related decline 4 8 10. However, other systematic reviews and meta-analyses report that, while music-based interventions can have small positive effects on cognition, the evidence for direct prevention of dementia remains limited or inconclusive 6 14.

• Observational research supports the idea that both listening to and making music are associated with better cognitive outcomes in aging populations 8 10.
• Meta-analyses indicate that music engagement may benefit global cognition, but the size of the effect and its durability over time are subject to debate 6 12 14.
• Some studies emphasize the need for longitudinal or randomized controlled trials to establish causation and clarify the preventive potential of music engagement 6 14.
• The new study’s large sample size and focus on late-life music engagement contribute important data, but causality cannot be confirmed due to its observational design 8 10.

What are the cognitive and behavioral effects of music interventions for people with dementia or cognitive impairment?

Research demonstrates that music therapy and individualized music listening can improve behavioral and psychological symptoms in people with dementia, including reductions in agitation, anxiety, and depressive symptoms 1 7 11 12. While effects on cognition are generally small to moderate, improvements in quality of life and mood are consistently reported.

• Meta-analyses show that music therapy has moderate effects on disruptive behaviors and anxiety in dementia patients, with small positive effects on cognitive functioning 7 12.
• Systematic reviews highlight that music-based interventions may reduce depressive symptoms, though effects on cognition and behavioral problems may be limited 14.
• Individualized or personalized music interventions appear to be especially effective in improving emotional responses and behavioral symptoms 1 3.
• The new study extends these findings by focusing on the potential for music engagement to reduce the risk of developing dementia, not just manage symptoms 4 12.

Does the type or mode of music engagement (listening vs. playing, active vs. receptive) matter?

The Monash study examined both music listening and active music-making, finding substantial risk reductions for both. Related research suggests that receptive music therapy (listening) may be more effective than interactive or active interventions for reducing agitation and behavioral symptoms 11. However, active participation, such as playing an instrument, is also associated with better cognitive outcomes in some studies 8 10.

• Receptive music therapy is easier to implement and has demonstrated efficacy in reducing behavioral problems in dementia 11.
• Active musical practice may protect a broader range of cognitive domains and enhance domain-general cognitive processes in aging 10.
• Individual factors, such as mental health history and symptom profiles, can alter the emotional and cognitive impact of music interventions 3.
• The combined or synergistic effects of listening and playing music on cognitive health in aging remain an area for further research 8.

Are there neurobiological mechanisms underlying music’s effects on the aging brain?

Neuroimaging and experimental studies indicate that music listening can increase functional connectivity in brain networks, particularly in people with Alzheimer’s disease 2. These changes may underpin the observed benefits in cognitive function and emotional well-being. Mechanistic theories suggest that music engagement supports compensatory processes and preserves cognitive functions vulnerable to aging 10.

• Listening to preferred music activates brain regions involved in memory and increases network synchronization, which may transiently improve cognitive function in dementia 2.
• Musical practice may enhance both specific and general cognitive processes through repeated engagement of sensory, motor, and executive functions 10.
• Some researchers argue for the importance of starting musical engagement early but suggest benefits can also accrue in late life 10 13.
• More research is needed to clarify the duration and long-term impact of these neurobiological changes 2 13.

Future Research Questions

While the current study provides valuable evidence of an association between late-life music engagement and reduced dementia risk, further research is needed to address causality, mechanisms, and optimal intervention strategies. Key gaps include the need for randomized controlled trials, exploration of individual differences in response to music, and greater understanding of long-term outcomes.

Research Question	Relevance
Does music listening causally reduce dementia risk in older adults?	Establishing causality is critical, as most current evidence is observational and cannot rule out confounding factors 6 8 14. Randomized controlled trials would clarify whether music engagement directly lowers risk.
What are the neurobiological mechanisms underlying music engagement and cognitive health in aging?	Understanding brain changes associated with music listening or playing could inform targeted interventions and explain observed behavioral and cognitive benefits 2 10.
Does combining music listening and active music-making offer greater cognitive benefits than either alone?	The new study suggests both activities are beneficial, but it is unclear if there is an additive or synergistic effect; clarifying this could improve intervention design 8 10 11.
How do individual differences (e.g. depression, apathy, music preference) affect response to music interventions for cognitive health?	Personalized responses to music interventions may vary based on mental health and cognitive profiles; understanding these factors could guide more effective, individualized approaches 3 12.
What is the optimal frequency, duration, and type of music engagement for maintaining cognitive health?	Research is needed to determine how often and in what ways older adults should engage with music to maximize cognitive benefits and reduce dementia risk 4 10.