In a recent meta-analysis of 33 randomized controlled trials, Zhang et al. (2025) found that music therapy produced significant improvements in global cognition, memory, and executive function in older adults, with standardized mean differences ranging from 0.25 to 0.40 across domains. The authors conclude that “music therapy has small to moderate beneficial effects on cognitive function and may serve as an effective non-pharmacological strategy for older adults with cognitive impairment” (The Gerontologist).
Similarly, in a large longitudinal study using data from the Health and Retirement Study, Chen et al. (2023) reported that “older adults who engaged in both active and passive music activities had significantly higher baseline episodic memory scores and experienced a slower rate of cognitive decline over time” (p. 4). Over a 12-year period, those involved with music declined at a slower rate—by 0.043 points per visit—compared to non-engagers (Journal of Gerontology Series B).
In a cross-sectional analysis of nearly 4,600 older adults, Wall et al. (2021) observed that “both listening to music and actively playing or singing were independently associated with better episodic memory performance,” after controlling for demographic and health variables (Aging & Mental Health).
Neuroimaging findings offer biological support for these associations. In a structural MRI study, Zhang et al. (2021) demonstrated that “higher self-reported musical sophistication was significantly correlated with increased gray matter volumes in the parahippocampus, insula, and inferior frontal gyrus—regions involved in memory, emotional processing, and executive function” (Brain Sciences).
While not all intervention studies are U.S.-based, similar benefits have been observed in programs involving 10-week piano training, which significantly improved verbal memory among older adults, suggesting that “even late-life musical training can produce measurable cognitive benefits” (Biasutti & Mangiacotti, 2021, Int. J. Aging & Human Development).
Taken together, these studies suggest a consistent link between musical engagement and cognitive function, especially episodic memory, in older adults..
Music has also demonstrated substantial effects on emotional health. In a meta-analysis of 19 RCTs focused on depression in older adults, Chan et al. (2020) found that “music therapy combined with standard treatment significantly reduced depressive symptoms, with an effect size exceeding one standard deviation” (International Journal of Geriatric Psychiatry).
A broader meta-analysis of 55 RCTs by Koger & Brotons (2021) found that both active and receptive musical interventions significantly reduced depression and anxiety in older adults, with “music medicine” (passive listening) producing particularly large reductions in depressive symptoms (SMD = –1.33) (Psychology of Music).
In a classic U.S.-based trial, Hanser and Thompson (1994) evaluated a psychoeducational music intervention for older adults with depression and found that “both therapist-guided and self-administered music sessions led to sustained reductions in depressive symptoms, distress, and improved self-esteem,” effects that were maintained for up to 9 months post-intervention (The Gerontologist).
Studies on older adults with dementia or Alzheimer’s disease show mixed but promising results. For example, Li et al. (2024) reviewed nine RCTs and noted that “while not all studies reached statistical significance, several demonstrated large reductions in anxiety and modest reductions in depressive symptoms in dementia patients receiving music therapy” (Aging & Mental Health).
More broadly, Aalbers et al. (2024) argue that the therapeutic efficacy of music arises not only from sound stimulation but also from “the formation of emotional bonds, the stimulation of autobiographical memory, and the provision of a safe space for expression” (BJPsych Advances).
Overall, the emotional benefits of music in later life—especially in reducing depression and anxiety—are among the most consistently supported outcomes in the literature.
Several studies have raised questions about the persistence of music’s effects over time. For example, Chen et al. (2023) observed that while memory scores remained higher in music-engaged individuals over many years, other studies suggest that “emotional or cognitive improvements may fade within weeks after the intervention ends, particularly in individuals with more advanced dementia.”
Effectiveness often depends on baseline cognitive status and the type of intervention. As Zhang et al. (2025) noted, “Active interventions tend to produce greater gains in cognitive domains, while passive listening appears especially effective for mood regulation.” They also emphasized the need for personalization: “Familiar or preferred music consistently outperforms unfamiliar selections in improving outcomes.”
In terms of generalizability, Wall et al. (2021) cautioned that “current evidence is primarily based on urban, White, and middle-class samples,” making it difficult to extrapolate results to more diverse older adult populations.
Thus, while benefits of music for memory and mood are promising, they appear to be moderate in size, sometimes short-lived, and dependent on individual and contextual factors.