Multishell Diffusion MRI Reflects Improved Physical Fitness Induced by Dance Intervention

Moving Towards a Medicine of Dance: A Scoping Review of Characteristics of Dance Interventions Targeting Older Adults and a Theoretical Framework

Background

Dance combines cultural and aesthetic elements with behaviors important for brain health, including physical activity, social engagement, and cognitive challenge. Therefore, dance could positively impact public health given the rapidly aging population, increasing incidence of Alzheimer's disease and related dementias, and lack of uptake of exercise in many older adults. Despite a high volume of literature, existing literature does not support evidence-based guidelines for dance to support healthy aging.

Objective

To conduct a scoping review of the dance intervention literature in older adults and provide information to facilitate a more consistent approach among scientists in designing dance interventions for older adults that stimulate physical and neurocognitive health adaptations.

Methods

Study characteristics (sample size, population, study design, outcomes, intervention details) were ascertained from 112 separate studies of dance reported in 127 papers that reported outcomes important for brain health (cardiorespiratory fitness, balance and mobility, cognition, mood, and quality of life).

Results

High heterogeneity across studies was evident. Class frequency ranged from < 1 to 5 classes per week, class length from 30-120 minutes, and intervention duration from 2 weeks to 18 months. Studies often did not randomize participants, had small (< 30) sample sizes, and used varied comparator conditions. Over 50 tests of cognition, 40 dance forms, and 30 tests of mobility were identified.

Conclusions

Based on these results, important future directions are establishing common data elements, developing intervention mapping and mechanistic modeling, and testing dosing parameters to strengthen and focus trial design of future studies and generate evidence-based guidelines for dance.

The effect of dance on physical health and cognition in community dwelling older adults: a systematic review and meta-analysis

BACKGROUND

Dancing is an attractive form of exercise among older adults and may positively influence physical and psychosocial health. The aim of this systematic review was to synthesize the evidence examining the dance prescription and effectiveness of dance in community dwelling older adults.

METHODS

Eight databases were searched to identify randomized controlled trials that evaluated the effectiveness of dance programs on community-dwelling older adults from 2007 to December 2020. Data regarding participants, dance programs and outcomes of interest were extracted and narratively synthesized. A meta-analysis was performed on the outcome data where possible.

RESULTS

Twenty-two studies met the inclusion criteria, of those 15 were deemed to be fair quality and 7 high quality using the PEDro scale. Nineteen studies included in the meta-analysis found that dancing can improve mobility and endurance compared to no intervention and afforded equivalent outcomes compared to other exercise programs.

CONCLUSION

The findings suggest that dance is an effective, safe and viable activity for community-dwelling older adults..

Effects of a 5-Year Exercise Intervention on White Matter Microstructural Organization in Older Adults. A Generation 100 Substudy

Aerobic fitness and exercise could preserve white matter (WM) integrity in older adults. This study investigated the effect on WM microstructural organization of 5 years of exercise intervention with either supervised moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), or following the national physical activity guidelines. A total of 105 participants (70–77 years at baseline), participating in the randomized controlled trial Generation 100 Study, volunteered to take part in this longitudinal 3T magnetic resonance imaging (MRI) study. The HIIT group (n = 33) exercised for four intervals of 4 min at 90% of peak heart rate two times a week, the MICT group (n = 24) exercised continuously for 50 min at 70% peak heart rate two times a week, and the control group (n = 48) followed the national guidelines of ≥30 min of physical activity almost every day. At baseline and at 1-, 3-, and 5-year follow-ups, diffusion tensor imaging (DTI) scans were performed, cardiorespiratory fitness (CRF) was measured as peak oxygen uptake (VO_2peak) with ergospirometry, and information on exercise habits was collected. There was no group*time or group effect on any of the DTI indices at any time point during the intervention. Across all groups, CRF was positively associated with fractional anisotropy (FA) and axial diffusivity (AxD) at the follow-ups, and the effect became smaller with time. Exercise intensity was associated with mean diffusivity (MD)/FA, with the greatest effect at 1-year and no effect at 5-year follow-up. There was an association between exercise duration and FA and radial diffusivity (RD) only after 1 year. Despite the lack of group*time interaction or group effect, both higher CRF and exercise intensity was associated with better WM microstructural organization throughout the intervention, but the effect became attenuated over time. Different aspects of exercising affected the WM metrics and WM tracts differently with the greatest and most overlapping effects in the corpus callosum. The current study indicates not only that high CRF and exercise intensity are associated with WM microstructural organization in aging but also that exercise’s positive effects on WM may decline with increasing age.

Dance Intervention Impact on Brain Plasticity: A Randomized 6-Month fMRI Study in Non-expert Older Adults

Background: Dance is a complex activity combining physical exercise with cognitive, social, and artistic stimulation.

Objectives: We aimed to assess the effects of dance intervention (DI) on intra and inter-network resting-state functional connectivity (rs-FC) and its association to cognitive changes in a group of non-demented elderly participants.

Methods: Participants were randomly assigned into two groups: DI and life as usual (LAU). Six-month-long DI consisted of supervised 60 min lessons three times per week. Resting-state fMRI data were processed using independent component analysis to evaluate the intra and inter-network connectivity of large-scale brain networks. Interaction between group (DI, LAU) and visit (baseline, follow-up) was assessed using ANOVA, and DI-induced changes in rs-FC were correlated with cognitive outcomes.

Results: Data were analyzed in 68 participants (DI; n = 36 and LAU; n = 32). A significant behavioral effect was found in the attention domain, with Z scores increasing in the DI group and decreasing in the LAU group (p = 0.017). The DI as compared to LAU led to a significant rs-FC increase of the default mode network (DMN) and specific inter-network pairings, including insulo-opercular and right frontoparietal/frontoparietal control networks (p = 0.019 and p = 0.023), visual and language/DMN networks (p = 0.012 and p = 0.015), and cerebellar and visual/language networks (p = 0.015 and p = 0.003). The crosstalk of the insulo-opercular and right frontoparietal networks were associated with attention/executive domain Z-scores (R = 0.401, p = 0.015, and R = 0.412, p = 0.012).

Conclusion: The DI led to intervention-specific complex brain plasticity changes that were of cognitive relevance.

An Overview on Cognitive Function Enhancement through Physical Exercises

This review is extensively focused on the enhancement of cognitive functions while performing physical exercises categorized into cardiovascular exercises, resistance training, martial arts, racquet sports, dancing and mind-body exercises. Imaging modalities, viz. functional magnetic resonance imaging (fMRI), functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG), have been included in this review. This review indicates that differences are present in cognitive functioning while changing the type of physical activity performed. This study concludes that employing fNIRS helps overcome certain limitations of fMRI. Further, the effects of physical activity on a diverse variety of the population, from active children to the old people, are discussed.

Dynamic Functional Connectivity Signifies the Joint Impact of Dance Intervention and Cognitive Reserve

Research on dance interventions (DIs) in the elderly has shown promising benefits to physical and cognitive outcomes. The effect of DIs on resting-state functional connectivity (rs-FC) varies, which is possibly due to individual variability. In this study, we assessed the moderation effects of residual cognitive reserve (CR) on DI-induced changes in dynamic rs-FC and their association on cognitive outcomes. Dynamic rs-FC (rs-dFC) and cognitive functions were evaluated in non-demented elderly subjects before and after a 6-month DI (n = 36) and a control group, referred to as the life-as-usual (LAU) group (n = 32). Using linear mixed models and moderation, we examined the interaction effect of DIs and CR on changes in the dwell time and coverage of rs-dFC. Cognitive reserve was calculated as the residual difference between the observed memory performance and the performance predicted by brain state. Partial correlations accounting for CR evaluated the unique association between changes in rs-dFC and cognition in the DI group. In subjects with lower residual CR, we observed DI-induced increases in dwell time [t(58) = -2.14, p = 0.036] and coverage [t(58) = -2.22, p = 0.030] of a rs-dFC state, which was implicated in bottom-up information processing. Increased dwell time was also correlated with a DI-induced improvement in Symbol Search (r = 0.42, p = 0.02). In subjects with higher residual CR, we observed a DI-induced increase in coverage [t(58) = 2.11, p = 0.039] of another rs-dFC state, which was implicated in top-down information processing. The study showed that DIs have a differential and behaviorally relevant effect on dynamic rs-dFC, but these benefits depend on the current CR level.

Impact of cognitive reserve on dance intervention-induced changes in brain plasticity

Dance is a complex sensorimotor activity with positive effects on physical fitness, cognition, and brain plasticity in the aging population. We explored whether individual levels of cognitive reserve (CR) proxied by education moderate dance intervention (DI)-induced plasticity assessed by resting-state functional connectivity (rs-FC) changes of the sensorimotor network (SMN), and between the dorsal attention network (DAN) and anterior default mode network (aDMN). Our cohort consisted of 99 subjects, randomly assigned to either a DI group who underwent a 6-month intervention (n = 49, M_age = 69.02 ± 5.40) or a control group (n = 50, M_age = 69.37 ± 6.10). Moderation analyses revealed that CR moderated DI-induced increase of the SMN rs-FC with significant changes observed in participants with ≥ 15 years of education (b = 0.05, t(62) = 3.17, p = 0.002). Only DI alone was a significant predictor of the DAN-aDMN crosstalk change (b = 0.06, t(64) = 2.16, p = 0.035). The rs-FC increase in the SMN was correlated with an improved physical fitness measure, and changes in the DAN-aDMN connectivity were linked to better performance on figural fluency. Consistent with the passive CR hypothesis, we observed that CR correlated only with baseline behavioral scores, not their change.

Development of Creative Intelligence in Physical Education and Sports Science Students through Body Expression

Body expression can enhance movement creativity and at the same time promote the growth of creative intelligence in college age. The aim of this study was to analyze the influence of an intervention in body expression classes on the creative intelligence of university students. The 49 participants aged 19 to 38 years engaged in the body expression course for seven weeks, 3 h per week. The Creative Intelligence test (CREA) was applied as an evaluative method to obtain the initial data and after the intervention the test was reapplied. Pre- and post-test results were analyzed and compared by gender and type of sporting background (team or individual sports). The results indicate an overall improvement in creative intelligence with a significant difference between the two evaluations (p < 0.001). Women started with a higher score than men, and although an improvement in their final mean score could be observed, it was not significant. Men, on the other hand, had noted a significant increase (p < 0.001) of these values in the post-test. Regarding the type of sports, at the beginning of the study, both groups had similar results; however, in the final test, the team sports players obtained better scores. In conclusion, body expression, thanks to its content focused on artistic-creative development, has been shown to be useful in the general progression of creative intelligence in college age.