Art programs for people living with dementia have existed for years in museums and art institutions around the world, including at New York’s Museum of Modern Art (MoMA) and Studio Museum in Harlem. While there’s a is a growing recognition among researchers that art programs have the ability to improve quality of life for people living with dementia, few are the studies that have tested the cognitive and physiological impact of these initiatives. But now, a medical study based on saliva samples collected from participants in a program at the National Gallery of Australia (NGA) in Canberra found concrete evidence of visual art’s ability to ease symptoms of dementia.
The NGA’s Art and Dementia program provides discussion-based tours wherein participants discuss and engage with artworks from the museum’s collection in six weekly one-hour-long tours. The program, which was initially launched as a pilot project in 2007, is informed by MoMA’s “Meet Me at MoMA,” a monthly program for individuals with dementia and their family members or caregivers. As people living with dementia often suffer from social isolation, the activities offered by these programs give them a sense of inclusion, mind stimulating activity, and a chance to express emotions and summon back memories.
Dementia is a broad term used to describe a number of diseases and conditions, the most common of which is Alzheimer’s. Definitions of dementia include a list of cognitive deficits that cause a progressive decline in a person’s functioning such as loss of memory, aphasia, deteriorating social skills and reasoning, and the inability to plan and initiate complex behavior. These symptoms manifest themselves differently among different patients. While symptoms may improve with treatment, many of the diseases that cause them are incurable.
In Australia, dementia is the leading cause of death of women and the second leading cause of death of all Australians, according to the Causes of Death 2018 report released by the Australian Bureau of Statistics (in the United States, Alzheimer’s ranks sixth among the leading causes of death).
Nathan M. D’Cunha, a PhD Candidate at the University of Canberra, led a group of researchers — Andrew J. McKun, Stephen Isbel, Jane Kellet, and Nenad Naumovski from the University of Canberra, and Ekavi N. Georgousopoulou from Australian National University in Canberra — in a study that monitored 28 participants of the NGA’s Art and Dementia program before, during, and after the program. During that period, saliva samples were collected from participants to determine levels of cortisol, best known as the “stress hormone,” which plays an important role in dementia symptoms.
Elevated cortisol levels are associated with greater cognitive impairment, brain shrinkage, and a more rapid decline in cognitive function. According to the study, normal cortisol levels are usually high upon waking, then decrease during the day and drop significantly at bedtime. But in people living with dementia, this rhythm is disrupted, causing increased frailty, stress, agitation, and decreased cognitive performance.
“After the six-week intervention, we found the rhythm of salivary cortisol across the day to be improved,” D’Cunha told Hyperallergic in an email interview. “We also found the intervention improved some aspects of well-being. We think if both these physiological and psychological benefits could be sustained for long periods, it could help to improve quality of life.”
A major highlight of the study is that nearly half of the participants were able to remember the artworks they discussed in the program six weeks after it ended.
“Of the 25 participants who completed data collection, 12 remembered specific aspects of the Art and Dementia program,” D’Cunha said. “For example, some were able to describe certain works of art with some detail and what they did or didn’t like about it.” D’Cunha added that some of the participants anecdotally reported a decrease in sundowning, otherwise known as “Late-day confusion.”
D’Cunha’s interest in the study goes beyond his academic research. “I have a strong personal connection with dementia,” he told Hyperallergic. “I spent three years working at an aged care facility, and both of my grandmothers and my mother were diagnosed within less than ten years of one another.” The researcher stressed that the study’s results are preliminary and that long-term testing of cortisol levels is needed.
“Nathan’s study revealed in a significant way, what educators observe anecdotally, that visiting a gallery and participating in a regular facilitated program has social impact,” Adriane Boag, Program Producer of Public Programs with Responsibility for Access Inclusion at the NGA, told Hyperallergic in an email.
Boag, a trained artist and art historian, has been overseeing the Art and Dementia program since its inception. “The program supports the imagination of participants and provides a pathway for individuals to create a positive vision of their ability,” she wrote in her email. “It encourages learning and creates a sense of achievement.”
The art viewed in the program includes works by Salvador Dalí, Roy Lichtenstein, and Australian artists Martin Sharp, Eric Wilson, and John Olsen.
Dalí’s “Lobster Telephone,” in which a lobster made from plaster is mounted over a rotary phone, is one of 11 that British poet and wealthy art collector Edward James commissioned from the artist in 1936. This peculiar artwork, according to D’Cunha, was one of the more popular pieces among participants. “Several participants remembered the hilarious conversation that ensued as they tried to speculate as to why the artist would create such a work!” he wrote.
“[Dalí’s] work contains surprise and humour, it upsets our expectations of a useful object and tickles the imagination,” Boag explained. “The work introduces the focus on communication and the effects of dementia on word finding, delayed pathways of processing information and the recognition of objects when they are made unfamiliar.”
That, however, might not be the way Dalí himself would have interpreted this specific artwork, which is alternatively titled “Aphrodisiac telephone.” Lobsters and telephones, which are both recurrent motifs in Dalí’s work, had strong sexual connotations for the artist. It’s by no coincidence that the lobster’s tail, where its sexual organ is located, is placed directly over the phone’s mouthpiece.
Another work that has sparked the imagination of participants was American painter Robert Ryman’s “Arena” (1977). As in many of his works, the painting is a clean slate of white paint. “Over the course of 20 minutes, skepticism among the group was replaced by a grudging admiration and enjoyment of the playful and challenging nature of a painting in which there is ostensibly nothing to see,” Boag wrote.
D’Cunha explained that while arts-based discussion and participatory art activities cannot be considered a treatment, it is a perfect way to keep the brain active and to challenge new ways of thinking through trying to interpret art. “We noticed that several participants would remember things from the past while looking at the art, and in some cases, become quite emotional,” he added.
Feedback from participants has been overwhelmingly positive, according to testimonies collected over the program’s 12-year run. “I feel like me again,” said Judith, one of the participants. “It is good coming here because we all know we have the same problem so we are accepting when people … forget. I feel as though I belong somewhere.”
Wendy, another participant, wrote, “The only time I feel the purple cloud of my diagnosis lift is when I visit the Gallery.”
George, who wrote “I feel as though I am disappearing” at the beginning of the program, ended it reporting: “It has been so positive, I feel intelligent again.”