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<b><i>Introduction:</i></b> Early-onset dementia (EOD), defined as dementia onset before the age of 65 years, is relatively rare, but its social impacts are significant. This study aimed to characterize the diagnosis and clinical and social status of EOD subjects in the 11 dementia centers in Chiba Prefecture, Japan. <b><i>Methods:</i></b> A retrospective 1-year survey was conducted. Collected data included clinical diagnosis, age at onset, age at survey, neuropsychological test, family history, employment, and living status. <b><i>Results:</i></b> We identified 208 EOD subjects, including 123 (59.4%), 24 (11.6%), 21 (10.1%), 17 (8.2%), and 10 (4.8%) with Alzheimer’s disease (AD), vascular dementia, frontotemporal lobar degeneration (FTLD), dementia with Lewy bodies/Parkinson’s disease dementia, and alcohol-related dementia, respectively. The Mini-Mental State Examination (MMSE) score &#x3c;24 was observed in 50–75% of patients and was not correlated with disease duration. Twenty-four (16.4%) subjects had positive family history of EOD. EOD subjects were at risk of early retirement, and 133 subjects lived with their family, in whom 64 (30.8%) lived with their child. <b><i>Conclusion:</i></b> In dementia centers, AD, FTLD, and Lewy body dementia had relatively large proportion. Employment, economy, and social supports are urgently needed for EOD subjects and their family.

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Some patients with dementia repeat stereotypical utterances and/or scream in agitation for several hours. Music therapy is a method known to alleviate the symptoms of dementia. Altshuler explained that a music therapist should first play music that matches the current mood of a patient according to the iso-principle, principle of music therapy. We thought that if certain types of music can calm patients down, a music therapy system that is usable for musical novices could be useful in nursing homes. Therefore, we present a music therapy system, "MusiCuddle," that automatically plays a short musical phrase (tune) in response to a caregiver's simple key entry. This music overlaps with patients' utterances and/or screaming. The first note of the tune is same as the fundamental pitch (F0) of the patient's utterances. We compiled four types of tunes (chords, cadences, Japanese school songs, and phrases created from the patients' utterances) into a database. The cadences were selected from established music scores and began with an unsteady or/and agitated chord in order to resonate with the patient's mental instability. We conducted a case study to investigate how MusiCuddle changes a patient's behaviors. In the case study, the pitches extracted from the patient's utterances were varied and wide-ranging. We thought her level of agitation might be reflected in her pitches. Pitch differences in the first note affect and change the entire mood of the music. Therefore, it may be said that the Mu-siCuddle can play music to resonate with his/her mood by extracting pitch from her utterance in accordance with the iso-principle. Moreover, we recorded the patient's utterances and compared them with vs. without using MusiCuddle to estimate the influence of MusiCuddle. The results suggested that tunes presented by MusiCuddle may give patients an opportunity to stop repeating stereotypical utterances.

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