The use of music in older people with advanced dementia is possible because perception, sensitivity, emotion, and memory of music may remain intact after other types of memory disappear. Previous literature is controversial about stress biomarkers response to music introduction in therapy routines for people with severe cognitive impairment and neural-behavioural disorders. Particularly, for these patients, it is possible that they feel lower pleasure levels with music-based therapies.

To characterize the immediate physiological effects of listening to music during psychomotor stimulation in an old participant with combined dementia and depression disorder and in a participant with a dementia diagnosis.

Two study cases with dementia diagnosis participated in this study (P1: 84yrs; male Parkinson; FAB=9; P2: 85 yrs; female; Alzheimer; FAB=11; depression diagnosis) and were submitted to psychomotor stimulation (2 sessions). The first 20 min. of each session was dedicated to psychomotor stimulation without music (A), followed by 20 minutes with music (B). Heart rate was monitored (H10 Polar sensor) in a continuous mode. Cortisol levels were collected at the beginning of the session (T0) and then repeated at periods A and B (μg/dL). The range between minimum and maximum HR values (beats per minute- bpm) and mean values for cortisol levels were considered for the stress response analysis.

Salivary cortisol levels were higher at T0 for P1 (0.393 vs 0.203). During period A, the P1 slightly decreased their values (↓0,076) and P2 had no changes. After introducing music, both P1 and P2 increased cortisol levels (↑0,085; 0,162↑). For both P1 and P2, a wide range of HR was detected during period B (P1: 13 vs 23 bpm) vs (P2: 15 vs 41 bpm).

Immediate responses to the music inclusion in a psychomotor intervention caused an augmented stress response in elderly participants with dementia, especially in P2. In specific, the depression diagnosis in this participant may be associated with a low capacity to handle emotions during new experiences, causing a higher stress response.