Preserved musical instrument playing in dementia: a unique form of access to memory and the self

The ability to play a musical instrument can remain in people with dementia, despite their cognitive impairment in other non-music domains. Case studies of people with Alzheimer’s Dementia (AD) or Behavioural variant Frontotemporal dementia (Bv-FTD) have reported preserved musical instrument playing even in the severe stage and, in some cases, the ability to learn a musical instrument after the onset of dementia. We propose that playing a musical instrument allows a unique form of access to two crucial domains, memory and the self. It enables the expression of preserved forms of memory, namely procedural, semantic, and episodic, including autobiographical memories. 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. Four new cases of preserved musical instrument playing in people with AD and Bv-FTD are described to illustrate our proposal.