Denial of Desire for Death in Dementia: Why Is Dementia Excluded from Australian Voluntary Assisted Dying Legislation?

Euthanasia in the form of Voluntary Assisted Dying (VAD) is legal in all Australian States, but current eligibility criteria preclude access to people with dementia. This article discusses Australian VAD eligibility criteria that are problematic for people with dementia: (1) time until death within 12 months, (2) decision-making capacity for VAD, and (3) determination of intolerable suffering. Legislation in the Netherlands allows VAD for people with dementia.

Can music enhance awareness in unresponsive people with severe dementia? An exploratory case series using behavioral, physiological and neurophysiological measures.

In five people with severe dementia, we measured their behavioral and physiological responses to familiar/unfamiliar music and speech, and measured ERP responses to subject's own name (SON) after exposure to familiar/unfamiliar music or noise. We observed more frequent behavioral responses to personally-significant stimuli than non-personally-significant stumuli, and higher skin temperatures for music than non-music conditions. The control group showed typical ERPs to SON, regardless of auditory exposure.

Why is music therapeutic for neurological disorders? The Therapeutic Music Capacities Model.

Music has cognitive, psychosocial, behavioral and motor benefits for people with neurological disorders such as dementia, stroke, Parkinson's disease (PD) and Autism Spectrum Disorder (ASD). Here we discuss seven properties or 'capacities' of music that interact with brain function and contribute to its therapeutic value. Specifically, in its various forms, music can be engaging, emotional, physical, personal, social and persuasive, and it promotes synchronization of movement.

Music evoked autobiographical memories in people with behavioural variant frontotemporal dementia.

Music is highly efficient at evoking autobiographical memories in both healthy and neurological populations. Music evoked autobiographical memories (MEAMs) are preserved in people with Alzheimer's Dementia (AD), and occur at the same frequency as in healthy people. To date there has been no investigation of the integrity of MEAMs in people with non-AD dementia.

Does collaboration with an intimate partner support memory performance? An exploratory case series of people with epilepsy or acquired brain injury.

Background: Intimate couples can become cognitively interdependent over time. If one member of the couple has a neurological condition with associated cognitive impairments, their partner can support or 'scaffold' their cognitive functioning through collaboration.

Objective: We explored the phenomenon of 'collaborative memory' in a case series of 9 couples in which one member had a neurological condition, specifically an acquired brain injury (ABI; n = 7) or epilepsy (n = 2).

A 'Music, Mind and Movement' Program for People With Dementia: Initial Evidence of Improved Cognition.

Background: Music is being increasingly used as a therapeutic tool for people with dementia. Research has uncovered several qualities of music that are responsible for its beneficial effects. Based on the identification of seven therapeutic capacities of music, we devised the (MMM) program and evaluated whether it had therapeutic benefit for people with dementia (various types) in the areas of cognition, mood, identity, and motor fluency.

Characterization of Music and Photograph Evoked Autobiographical Memories in People with Alzheimer's Disease.

Background: Music evoked autobiographical memories (MEAMs) have been documented in people with Alzheimer's disease (AD), but it is unclear whether music is more effective than other familiar stimuli at evoking memories.

Objective: To explore the frequency and specificity of memories in response to famous songs compared with photographs of famous events (photograph evoked autobiographical memories, PEAMs), and whether stimuli from the period of the reminiscence bump (10-30 years of age) were more likely to elicit memories.

Methods: 10 participants with AD and 10 aged-matched healthy elderly people reported memories following exposure to 2 songs (longest time at number one in Australian music charts) and 2 photographs (of prominent famous events) from each decade from 1930 to 2010.

Novel cognitive insights from the first year after bi-thalamic infarct.

Neuropsychological consequences of bi-thalamic damage are scarcely known. This case study documents cognitive (in particular memory and executive) functioning in a man with a medial bi-thalamic infarct in the first year (8 and 12 months) post injury. NG showed persistent memory (including autobiographical) impairment, but improved executive functions at one year post injury.

The Impact of Music on the Self in Dementia.

In this review, we consider how the onset and progression of dementia can disrupt one's sense of self, and propose that music is an ideal tool for alleviating this distressing symptom. Various aspects of the self can be impaired in people with dementia, depending on how the self is defined. There are anecdotal reports that music can 'bring people back to themselves' in the face of dementia, but there have been scarce empirical investigations of this topic.

A nonmusician with severe Alzheimer's dementia learns a new song.

The hallmark symptom of Alzheimer's Dementia (AD) is impaired memory, but memory for familiar music can be preserved. We explored whether a non-musician with severe AD could learn a new song. A 91 year old woman (NC) with severe AD was taught an unfamiliar song.

Group singing and health-related quality of life in Parkinson's disease.

Objective: Parkinson's disease (PD) has a negative impact on health-related quality of life (HRQoL). Previous studies have shown that participating in group singing activities can improve quality of life in some patient populations (e.g.

Does music training facilitate the mnemonic effect of song? An exploration of musicians and nonmusicians with and without Alzheimer's dementia.

Introduction: The efficacy of using sung words as a mnemonic device for verbal memory has been documented in persons with probable Alzheimer's dementia (AD), but it is not yet known whether this effect is related to music training. Given that music training can enhance cognitive functioning, we explored the effects of music training and modality (sung vs. spoken) on verbal memory in persons with and without AD.

Music and dementia.

There is an increasing incidence of dementia in our aging population, and consequently an urgent need to develop treatments and activities that may alleviate the symptoms of dementia. Accumulating evidence shows that persons with dementia enjoy music, and their ability to respond to music is potentially preserved even in the late or severe stages of dementia when verbal communication may have ceased. Media interest in this topic has contributed to the public perception that music abilities are an "island of preservation" in an otherwise cognitively impaired person with dementia.

Selective preservation of the beat in apperceptive music agnosia: a case study.

Introduction: Music perception involves processing of melodic, temporal and emotional dimensions that have been found to dissociate in healthy individuals and after brain injury. Two components of the temporal dimension have been distinguished, namely rhythm and metre. We describe an 18 year old male musician 'JM' who showed apperceptive music agnosia with selectively preserved metre perception, and impaired recognition of sad and peaceful music relative to age and music experience matched controls after resection of a right temporoparietal tumour.

Mirror neuron system involvement in empathy: a critical look at the evidence.

It has been proposed that the human mirror neuron system (MNS) plays an integral role in mediating empathy. In this review, we critically examine evidence from three bodies of research that have been cited as supporting this notion: (1) behavioral studies that have examined the relationship between imitation and empathy, (2) findings from functional neuroimaging studies that report a positive correlation between MNS activation and self-report on an empathy questionnaire, and (3) observations of impaired imitation and empathy in autism spectrum disorders (ASD). In addition, we briefly review lesion studies of the neural correlates of imitation and empathy.

The relationship of lyrics and tunes in the processing of unfamiliar songs: a functional magnetic resonance adaptation study.

The cognitive relationship between lyrics and tunes in song is currently under debate, with some researchers arguing that lyrics and tunes are represented as separate components, while others suggest that they are processed in integration. The present study addressed this issue by means of a functional magnetic resonance adaptation paradigm during passive listening to unfamiliar songs. The repetition and variation of lyrics and/or tunes in blocks of six songs was crossed in a 2 x 2 factorial design to induce selective adaptation for each component.

Memory for music in Alzheimer's disease: unforgettable?

The notion that memory for music can be preserved in patients with Alzheimer's Disease (AD) has been raised by a number of case studies. In this paper, we review the current research examining musical memory in patients with AD. In keeping with models of memory described in the non-musical domain, we propose that various forms of musical memory exist, and may be differentially impaired in AD, reflecting the pattern of neuropathological changes associated with the condition.

Psychological factors in retrograde amnesia: self-deception and a broken heart.

We explored potential contributing psychological factors in a patient ('XF') with focal retrograde amnesia, within the framework proposed by Kopelman (2000, Cognitive Neuropsychology, 17, 585). In particular, we investigated the psychological trait of self-enhancement. We constructed a self-report questionnaire measure of self-enhancement and compared XF's score on this measure with the scores of 61 control participants.

Social and emotional functions in three patients with medial frontal lobe damage including the anterior cingulate cortex.

Introduction: The aim of this study was to explore social and emotional functions in patients with medial frontal damage including the anterior cingulate cortex (ACC).

Methods: Three patients with medial frontal lobe lesions primarily involving the ACC performed tasks on motivational decision making, emotional facial expression recognition, and social cognition, including theory of mind (ToM). Their performance on these tasks was compared with age and education matched healthy controls.

Neurological control of human sexual behaviour: insights from lesion studies.

We review the human literature examining the effects of neurological insult on human sexual behaviour. We provide a synthesis of the findings to date, and identify key brain regions associated with specific aspects of human sexual behaviour. These include subcortical and cortical regions, with the mesial temporal lobe and the amygdala in particular being a crucial structure in the mediation of human sexual drive.

Cognitive functioning after medial frontal lobe damage including the anterior cingulate cortex: a preliminary investigation.

Two patients with medial frontal lobe damage involving the anterior cingulate cortex (ACC) performed a range of cognitive tasks, including tests of executive function and anterior attention. Both patients lesions extended beyond the ACC, therefore caution needs to be exerted in ascribing observed deficits to the ACC alone. Patient performance was compared with age and education matched healthy controls.

The amygdala and sexual drive: insights from temporal lobe epilepsy surgery.

The aim of this study was to explore the relationship between the amygdala and human sex drive. We compared amygdalar volume in groups of patients with or without sexual changes after temporal lobe resection and in age-matched neurologically normal subjects. Forty-five patients with intractable temporal lobe epilepsy who underwent surgical resection in the Comprehensive Epilepsy Program at the Austin and Repatriation Medical Centre completed a semistructured interview and questionnaire relating to sexual outcome after surgery.

Hypersexuality after Temporal Lobe Resection.

Hypersexuality has occasionally been reported in patients with temporal lobe epilepsy following temporal lobe resection. The mechanism underlying this phenomenon is poorly understood. We describe seven patients who spontaneously reported dramatic postoperative changes in sexual behavior after unilateral temporal lobe resection.