If you’ve ever felt the electricity of joining with others in song, you’ll understand the appeal of choir. In fact, one national survey found choral singing to be among Canada’s most popular pastimes, with 3.5 million Canadians (that’s 10 percent of our population) having sung in a choir during the survey year (2017). 

               Dr.Debra Sheets

“Choirs are natural communities,” says Dr. Debra Sheets, lead researcher and founder of Victoria’s intergenerational Voices in Motion choir. For people living with dementia and their care partners, choirs such as Voices in Motion function as ideal creative outlets since “you've got support, nothing you can do is wrong, and you can just enjoy yourself. The focus isn't on dementia,” says Sheets, who is also an Associate Professor of Nursing at University of Victoria.

Choirs may even provide a defence against further cognitive and mental decline. Not because the progressive neural pathology of a disease like Alzheimer’s can be stopped—it can’t—but because the positive impact of social singing may mitigate some comorbidities of living with dementia. These include depression, negative affect, poor sleep, elevated stress and anxiety, says Dr. Stuart MacDonald, Associate Professor of Lifespan Development and Aging at the University of Victoria, and a research advisor to Voices in Motion.

By reducing the impact of these comorbidities, “you can see boosts in cognitive function because the cognitive resources that all of those comorbidities are drawing upon can be better utilized,” says MacDonald. “If you can limit depressive symptoms, signs and stress, you can make better use of your available neural resources. And you see all sorts of residual benefits in terms of affect and psychological well-being, but also in terms of cognitive health.” 

The beauty of choir is that it allows all members to participate as creative equals. While people with dementia may struggle with episodic memory due to damage to the entorhinal cortex and the hippocampus, music draws from the brain’s emotional and procedural centres, which tend to be better preserved. As with riding a bike or playing an instrument, odds are good that even if someone has dementia, they will recognize familiar songs.

“Music is drawing upon systems that are spared rather than impaired and it really is allowing individuals with dementia to be on an equal footing [as choir members] in many respects,” says MacDonald.

People can still participate and contribute, creatively engaging with other people in a collaborative way.

– Dr. Debra Sheets

      Dr. Stuart MacDonald

Participants also learn new songs, including those in other languages, under the guidance of a choir director, says Dr. Sheets, who believes the program “reduces the stigma of dementia by challenging perceptions that people may have that once you have dementia, it's all about decline. People can still participate and contribute, creatively engaging with other people in a collaborative way.”

For Voices in Motion’s high school members, participation provides a valuable counterpoint to stereotypes. “They become less fearful of dementia, and they can see the potential and possibilities that remain,” notes Sheets, adding that choir participation has facilitated many student/senior friendships, and even inspired one former high school member—now a medical student at UBC—to pursue a career working with older adults. 

  Gracia Seal (centre) and other participants practice with the Voices in Motion intergenerational choir project led by UVic researchers.

The mental health benefits of choir aren’t limited to participants with dementia, says MacDonald. His research found moderate to high levels of caregiver distress among Voices in Motion care partners, markers for which were measurably reduced across the program’s three-and-a-half month choral season. 

MacDonald credits both the joyful act of group singing (shown to release the “love hormone” oxytocin) as well as the social supports provided by the program and interaction with other caregivers for this reduction. 

Sheets, meanwhile, notes that in England, doctors write social prescriptions so patients can join creative arts programs with the cost covered by the government. Given the positive health impacts of programs like Voices in Motion, perhaps a broader conversation around funding for cultural programming is overdue in Canada.