Story-listening shows promise as an intervention for people living with dementia

GettyImages-593316024.jpgBy Emma Young

Listening to a story is known to be cognitively demanding, in part because the listener has to pay close attention to, and remember, plot and character detail in order to understand what’s going on. Attention and memory are both diminished in people living with dementia. Might regularly reading aloud to such patients help, then, to train their attention and memory, and function as a treatment? A new study of people with various kinds of dementia, published in Psychology and Neuroscience, suggests that it could. 

A total of 43 patients with Alzheimer’s, vascular dementia or general cognitive decline, who were living in a nursing home in Perugia, Italy, took part. All these patients had mild to moderate dementia, according to scores on the Clinical Dementia Rating Scale. At the start of the study, they were each assessed by a psychologist using a standard test of attention, language, visuospatial abilities and both immediate and delayed memory. They were then divided into two groups, matched for scores on this test. 

The training took place at a time when the residents would normally be in the common room watching TV. The control group watched TV, as normal. The other group went into another room for the listening activity. Over 40 sessions, run five days a week, Monday through Friday, this group listened to student volunteers from the University of Perugia reading material that became gradually more demanding over time. 

At first, the residents listened for 20 minutes a day to Favole al telefono by Gianni Rodari – a book of short, individual, humorous stories with a simple narrative structure. After a few weeks, the reading shifted up a gear, to 30 minutes a day of traditional fairy tales written by Italo Calvino. This material had a slightly more complex narrative structure and characters, and recurrent motifs. A few weeks after that, the patients started to listen for 40 minutes a day (later upped to 45 minutes a day) to Un Trenzo per la Luna by Cinzia Giuntoli, a novel set in Tuscany during World War 1. To follow this novel, they had to retain memories from earlier instalments. At the beginning and end of each session, the residents were asked to share – if they wanted to – their thoughts on the reading material, and any relevant personal memories. 

At the end of the study period, both groups’ attention, language, visuospatial and immediate and delayed abilities were re-tested. For the listening group, there was an upward trend in their scores on all of these measures, while the control group showed no improvements (and even some decrements). Compared with the control group, those in the listening group now had statistically significant higher scores on immediate memory, attention and delayed memory (though not visuospatial memory). 

A more detailed analysis revealed that people with vascular dementia and Alzheimer’s disease showed improvements in immediate and delayed memory, but only people with vascular dementia got better at tests of language and attention.

This was a small study. And the people in the listening group didn’t just listen to stories. Unlike members of the control group, who were watching TV, they also interacted with the student reader and with each other – and social interaction is cognitively demanding. How much this might have accounted for the attention and memory benefits is unknown because this wasn’t something the researchers looked at. 

Still, the intervention – listening to a story, plus the social interaction and the recall of autobiographical memories – did have significant effects. Given that there’s no cure for Alzheimer’s, anything that can help with memory is surely to be welcomed. 

“The data from this study confirm the effectiveness of the daily narrative training in delaying cognitive decline and maybe in improving the overall quality of life and self-perception of individuals who suffer from mild to moderate cognitive decline,” the researchers write. 

Perhaps, they go on, this kind of training should then be implemented as a non-drug treatment for people with dementia, and explored as a possible prevention tool in healthy older people, or for the millions around the world diagnosed with mild cognitive impairment, which can – but does not always – progress to dementia.

The effect of a narrative intervention program for people living with dementia

Emma Young (@EmmaELYoung) is Staff Writer at BPS Research Digest

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