alzheimer's disease and music Her hands clasped primly in her lap, the elderly woman listened to the strumming of the guitar and the words of the poem. It was about embracing your heritage, and the sentiment struck a chord.

''You should!" exclaimed Betty Barton, an 88-year-old with mid-stage Alzheimer's disease. ''Good for you!"

Around the room, a snug library in a Hopkinton assisted living facility for people with Alzheimer's, several others clapped or nodded. The guitarist then played a medley of American standards, and the familiar tunes appeared to spark glimmers of recognition. Some tapped their legs to the rhythm; a few sang along a little bit.

Sometimes even patients who struggle to remember their names can sing words to old songs, said Carol Cahill, the program director.

Artists visit Hearthstone Alzheimer Care periodically as part of an innovative program that uses art and music as therapy to help patients cope with the disease. The program, offered in Hearthstone centers in New York and Massachusetts, brings in artists to perform and allows patients to create art themselves.

Hearthstone officials have also been working with the Museum of Modern Art in New York City on holding specialized tours for people with Alzheimer's this fall.

While the disease, which affects more than 4 million Americans, steals short-term memory, some researchers believe that the earliest, hard-wired memories remain intact. Music and art can help tap into those memories, drawing previously unreachable thoughts and feelings to the surface.

Dr. John Zeisel, president of Hearthstone, said art therapy cannot check or reverse the disease. But it provides stimulation that can awaken a patient's mind and spirit.

''This touches the part of the brain that still works," he said. ''It wakes them up to themselves."

The program revolves around the belief that Alzheimer's patients are ''still with us," Zeisel said.

Alzheimer's disease, the most common form of dementia, is a degenerative brain disease that gradually impairs the ability to think, remember, and communicate. The cause is unclear, and no cure has been found. The number of Alzheimer's patients is expected to surge as the baby boom generation ages.

Dr. Gene Cohen, a geriatric psychiatrist who directs the Center on Aging, Health & Humanities at George Washington University, said art therapy can help tap into ''pockets of memory" that remain intact.

''There's no intervention that will stop or reverse the disorder," he said. ''But there are interventions that can alleviate symptoms that come from Alzheimer's. This provides people that have lost so much control an opportunity for a sense of mastery."

For 72-year-old Patricia Coughlin, the poem reminded her of ''stained glass" and a painting by her son of the woods in autumn. The memories brought a smile to her face.

''If he were here right now," she said, ''we'd all be laughing."

Later, Coughlin looked at a replica of Andrew Wyeth's famous painting ''Christina's World." An art therapist asked her what the painting made her think of, and Coughlin replied, ''She's climbing up the ground trying to get somewhere." Indeed, the subject of the painting was paralyzed in the lower body, forcing her to drag herself along the ground to her house.

Barton offered a contemplative reaction.

''The lady is thinking," she mused. ''Thinking about what she's going to do next. She wants to choose the right thing."

To Cohen and other art therapy proponents, such insights undermine the perception that Alzheimer's patients have little left to offer creatively.

''There's a nihilism to Alzheimer's care," he said. ''Often, more is getting through than you realize."

Jeanette Rosa-Brady of the Massachusetts chapter of the Alzheimer's Association, said that Alzheimer's patients who can no longer speak can sometimes sing a familiar song.

Music touches part of the brain that is still working silently, behind the veil of the disease, she said.

''It speaks to what's left," she said.

By Peter Schworm, Globe Staff | May 5, 2005