Creativity And Cognitive Health In Brain Disorders

Medically reviewed by Melissa Guarnaccia, LCSW and Corey Pitts, MA, LCMHC, LCAS, CCS
Updated December 7, 2024by BetterHelp Editorial Team

As dementia progresses, it can lead to substantial impairments in mental and physiological functions. However, cognitively stimulating activities may slow this process by promoting a diversity of connections within the brain. Some scientists believe hobbies that engage creativity may be especially effective. 

Expressing yourself through creative media may safeguard against the effects of neurocognitive decline. In various studies, researchers have demonstrated that therapies involving artistic creation or appreciation have positively affected dementia symptoms. These activities may help individuals retain functions like memory, reasoning, mood control, and other cognitive abilities. In some rare cases, people may also experience a startling surge of creativity as dementia changes how their brain processes visual information and language.

Getty/AnnaStills
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Dementia symptoms

Symptoms may vary depending on the specific subtype of dementia, but they commonly involve:

  • Memory loss

  • Diminished executive function (control of behavior, attention, and thinking)

  • Loss of language abilities

  • Impaired orientation in space and time

  • Learning difficulties

  • Challenges with social understanding and interaction

  • Mood and personality changes

  • Impaired perception

  • Loss of motor control

Researchers have found that these symptoms may be delayed and diminished in people with a history of habitual engagement in mentally enriching activities. Current theories suggest these individuals have built up a more complex web of connections between brain cells, making their mental capabilities less vulnerable to atrophy involved in dementia. Their greater diversity in neural pathways might enable them to “route around” damaged areas more effectively.

Cognitive reserve

This increased resilience against the effects of brain atrophy is commonly known as “cognitive reserve” (CR). Deliberately cultivating CR in early life may be an effective strategy for reducing one’s long-term risk of dementia.

Artistic endeavors and cognitive reserve

While there may be many ways to improve the brain’s resistance to dementia symptoms, some research indicates that creative engagement might be particularly effective. Since this process involves thinking of new ways to express ideas and emotions while engaging in various intellectual and technical skills, creativity may be particularly effective at encouraging the brain to form new connections. 

One study published in 2022 reported that regular participation in creative activities significantly reduced cognitive decline, showing more effectiveness than many other approaches. Another paper from 2023 found evidence that making handcrafted art was linked to distinctive benefits in cognitive function among older adults, including better working memory and non-verbal reasoning. Music therapy has also been beneficial in slowing the decline in the brain and improving cognitive function. 

These benefits appear to apply to many creative pursuits. A study following adults aged 85 and older found that they were 73% less likely to develop cognitive impairment if they participated in painting, drawing, or sculpture over four years. Meanwhile, other researchers have found that literary activities like journaling and letter writing can have similar effects. 

Artistic enjoyment in dementia

Stretching one’s creative muscles may not be the only way art can help people stave off neurocognitive deficits. Some evidence suggests that engagement with the arts as an audience member can also have beneficial effects. 

For instance, a study with more than 3400 participants found that those who regularly saw theatrical performances, visited art galleries, attended exhibitions, or participated in other cultural enrichment activities showed less decline in cognitive function. A 2023 paper concluded that active and receptive artistic engagement was associated with better mental health, well-being, and improved quality of life in older adults.

Benefits of dementia art activities

Enabling people living with dementia to enjoy creative works may benefit both them and their caregivers. Investigations into the effects of art therapy have found that it can improve mood, decrease agitation, and boost self-esteem for individuals while reducing emotional stress in those caring for them. 

Visual art may not be the only type of creative engagement helpful for people with dementia. Music also appears to be powerfully connected to memory in a way that may resist the effects of neurocognitive disorders. People with dementia listening to a favorite song may suddenly recall details of their lives and relationships that previously appeared to be lost.  

An elderly man stands outside with an easel and paits on a canvas on a sunny day.
Getty/yacobchuk

Art therapy for dementia

Based on findings from the studies above, clinicians are exploring the possibility of using art-based therapies to support mental functioning and subjective well-being in people with dementia or cognitive impairment. These therapeutic modalities may take many forms but often involve instructors guiding participants in creative activities like:

  • Drawing

  • Painting

  • Expressive writing

  • Crafting activities 

  • Sculpture

  • Creating music 

Some art therapy programs also include an art appreciation component, in which clients are encouraged to view and evaluate works of visual art.

Effectiveness of dementia art therapy

While research into this type of treatment is still relatively new, early results suggest that these interventions may produce significant benefits. A randomized controlled trial from 2018 found that people experiencing mild cognitive impairment (an early stage of functional decline that can be a precursor to dementia) showed sustained improvements in cognitive ability as a result of art therapy.

Effective forms of art therapy

A meta-analysis comparing various forms of art therapy identified several types with stronger evidence of effectiveness, including: 

  • Calligraphy therapy

  • Art-assisted reminiscence therapy

  • Horticultural therapy

Creativity may be resistant to dementia

Studying dementia may provide insights into how various functions of healthy brains operate — including creativity. Several studies have reported evidence that creative tendencies may be less vulnerable than other cognitive capabilities to age and cognitive decline. 

Deficits may hamper certain aspects of creative expression in motor control, language use, and other effects of dementia. However, overall creative ability is often stable across one’s lifespan, even for people experiencing neurocognitive decline.

Dementia-prompted creativity

There have been cases where dementia incites an unexpected burst of creativity. This effect is most commonly seen in frontotemporal dementia (FTD), a relatively rare dementia subtype involving degeneration of the brain’s frontal and temporal lobes. This condition is often associated with a loss of self-control or difficulties with communication. Still, it can also produce surges in visual creativity, even among those who previously had little interest in art. 

Artwork of clients with frontotemporal dementia

A 2023 study found examples of artwork produced by clients with FTD that included “painting, quilting, jewelry making, sculpture, pottery, and montage making.” These works of art often included bold colors and visual styles but lacked certain symbolic features, such as realistic facial expressions or accurate details of particular animals. This loss of specificity tended to increase as patients’ conditions advanced.

What researchers say about patients with frontotemporal dementia artwork

Researchers found that this unexpected creativity was most common in people who had experienced significant deterioration in specific regions of the left temporal lobe. These areas are heavily involved in language and seem to inhibit parts of the occipital cortex, an area at the rear of the brain involved in visual processing. Decreased activity in the temporal lobe may allow these previously suppressed regions of the visual cortex to become hyperactive, causing a spontaneous increase in the urge to create art. 

Some researchers have suggested that FTD-related creative pursuits might represent an individual’s attempt to convey aspects of their inner world. As their ability to use words diminishes, the brain may shift to visual “language” instead. 

How art can help following a dementia diagnosis

A diagnosis of dementia can be a scary, life-changing event, but taking up hobbies related to the arts might be a helpful response. Participating in creative activities or artistic appreciation might help individuals preserve brain function and slow disease progress. Those with mild cognitive impairment that hasn’t fully progressed to dementia might find that art helps them regain some of the functioning they’ve lost.

Creativity is not limited to visual arts

Creativity may not necessarily be limited to visual arts. Other forms of creative engagement, such as reading and writing or playing and listening to music, can lead to similar benefits. Taking up a new form of artistic engagement that an individual is unfamiliar with may be particularly effective since it may prompt the brain to form new connections. 

An elderly woman with glasses stands in her home and smiles down at a peice of paper in her hand.
Getty/JGI:Tom Grill
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Other ways to stay cognitively healthy besides doing arts

Art therapy by itself may not address all symptoms and functional impairments that accompany cognitive impairment and dementia. Individuals may also benefit from making some healthy lifestyle adjustments such as eating nutritious foods, getting regular exercise, getting enough sleep, and quitting smoking or alcohol use. 

Online mental health care

Addressing mental health difficulties like depression could also help individuals preserve the long-term health of the brain. However, making therapy work with a busy schedule can be difficult, particularly if cognitive symptoms make driving or using public transportation inaccessible. Online mental health care through a platform like BetterHelp could help clients get around this issue due to the lack of a commute. Therapists who offer services over the internet also tend to have flexible scheduling options that make the experience more convenient than traditional counseling. 

Effectiveness of web-based therapy

Although it’s a newer form of treatment, Internet-based care has repeatedly demonstrated useful results in clinical trials. In one notable experiment from 2018, clients showed substantial improvements in depressive symptoms after attending online cognitive-behavioral therapy. Researchers concluded that web-based therapy is an effective treatment approach that can achieve extensive effect sizes. 

Takeaway

Creative expression may persist in the face of dementia and cognitive decline. For some, it may have a defensive  effect on brain function, helping them hold onto cognitive skills that their disease would otherwise make challenging. Art therapy may also improve self-esteem, self-expression, and overall quality of life for people with neurocognitive ailments.
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