Effectiveness of a Combined Dance and Relaxation Intervention on Reducing Anxiety and Depression and Improving Quality of Life among the Cognitively Impaired Elderly

Life-long music and dance relationships inform impressions of music- and dance-based movement therapies in individuals with and without mild cognitive impairment

Background

No effective therapies exist to prevent degeneration from Mild Cognitive Impairment (MCI) to Alzheimer's disease. Therapies integrating music and/or dance are promising as effective, non-pharmacological options to mitigate cognitive decline.

Objective

To deepen our understanding of individuals' relationships (i.e., histories, experiences and attitudes) with music and dance that are not often incorporated into music- and dance-based therapeutic design, yet may affect therapeutic outcomes.

Methods

Eleven older adults with MCI and five of their care partners/ spouses participated (4M/12F; Black: n=4, White: n=10, Hispanic/ Latino: n=2; Age: 71.4±9.6). We conducted focus groups and administered questionnaires that captured aspects of participants' music and dance relationships. We extracted emergent themes from four major topics, including: (1) experience and history, (2) enjoyment and preferences, (3) confidence and barriers, and (4) impressions of music and dance as therapeutic tools.

Results

Thematic analysis revealed participants' positive impressions of music and dance as potential therapeutic tools, citing perceived neuropsychological, emotional, and physical benefits. Participants viewed music and dance as integral to their lives, histories, and identities within a culture, family, and/ or community. Participants also identified lifelong engagement barriers that, in conjunction with negative feedback, instilled persistent low self-efficacy regarding dancing and active music engagement. Questionnaires verified individuals' moderately-strong music and dance relationships, strongest in passive forms of music engagement (e.g., listening).

Conclusions

Our findings support that individuals' music and dance relationships and the associated perceptions toward music and dance therapy may be valuable considerations in enhancing therapy efficacy, participant engagement and satisfaction for individuals with MCI.

Effect of Dancing Interventions on Depression and Anxiety Symptoms in Older Adults: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis (PROSPERO CRD42023428105) investigated the effect of dancing on depression and anxiety symptoms in older adults. Conducted up to October 2023, the search across seven databases and gray literature yielded 5020 records. Only randomized trials that analyzed dance interventions for depression and/or anxiety in older adults were included. Nineteen randomized trials, involving 508 participants in dance classes lasting 5 weeks to 18 months, were included and 16 were subjected to meta-analysis. Risk of bias was assessed using the Cochrane tool. The meta-analysis showed a statistically significant reduction in depression among older adults participating in dance interventions (p < 0.01). A decrease in depressive symptoms was significant compared to that in those involved in no other intervention (p = 0.02) but not compared to that achieved with other interventions in control groups (p = 0.96). Subgroup analysis showed no significant differences in depression scores for those with mild cognitive impairment (p = 0.47). These conclusions are associated with moderate bias and very low certainty. Due to heterogeneity and the small number of studies, conclusions for anxiety outcomes could not be drawn. These results underscore the potential clinical relevance of integrating dance into mental health interventions for older adults, thereby highlighting a promising avenue for enhancing the mental well-being of this demographic.

Efficacy of aquatic exercise in chronic musculoskeletal disorders: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Aquatic exercise (AE) is becoming ever more popular as a physical therapy, while it is unclear what precise improvements it will produce and how effective it will be in comparison with other non-surgical therapies. The study aimed to assess whether AE positively impacts chronic musculoskeletal disorder patients in terms of pain, physical function, and quality of life.

METHODS

PRISMA guidelines were followed, and our study protocol was published online at PROSPERO under registration number CRD42023417411. We searched PubMed, Embase, Web of Science, and Cochrane library databases for English-language articles published before April 11, 2023, including studies from all relevant randomized controlled trials (RCTs). After screening, we ultimately included 32 RCTs with a total of 2,200 participants. We also performed subgroup analyses for all included studies. This meta-analysis calculated standardized mean difference (SMD) with 95% confidence interval (CI), and the variance was estimated using a random-effects model. The quality of the included studies was assessed by using the Cochrane collaborative "risk of bias" assessment tool (version 2.0). Thus ensuring that the literature included is of high quality.

RESULTS

This meta-analysis included 32 trials with 2,200 participants; these patients were all between the ages of 38-80. The study showed that compared to the no exercise (NE) group, patients in the AE group experienced a remarkable reduction in pain (SMD: -0.64, P < 0.001), a significant increase in physical function (SMD: 0.62, P < 0.001), and a statistically significant improvement in quality of life (SMD: -0.64, P < 0.001). When compared to land-based exercise (LE), AE significantly relieves patients' pain (SMD: -0.35, P = 0.03).

CONCLUSIONS

This is the first systematic review and meta-analysis to study whether AE could improve chronic musculoskeletal disorders. The evidence suggests that AE benefits pain, physical function, and quality of life in adults with chronic musculoskeletal conditions compared to NE. Furthermore, when compared to LE, AE continues to provide a better improvement in patient pain. More long-term clinical trials are needed to confirm AE's positive effects and improvement mechanisms and the more existential advantages compared to LE.

The effectiveness of dance movement interventions for older adults with mild cognitive impairment, Alzheimer's disease, and dementia: A systematic scoping review and meta-analysis

OBJECTIVES

To synthesize evidence and summarize research findings related to the effectiveness and feasibility of dance movement intervention (DMI) in older adults with mild cognitive impairment (MCI), Alzheimer's disease (AD), and dementia; to systemically map existing research gaps and research directions for future practice.

METHODS

A systematic search was conducted using six electronic databases: Web of Science, PubMed, PsycINFO, MEDLINE, ScienceDirect, and Cochrane Central Register of Controlled Trials. The methodological quality of included studies was assessed using the Cochrane Risk of Bias Tool for Randomized Trials (RoB 2) and The Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I).

RESULTS

29 dance intervention studies (13 RCT studies) were included in the scoping review: 62% of MCI, 10% of AD, and 28% of dementia; a total of 1708 participants (Female=1247; Male=461) aged from 63.8 ( ± 5.24) to 85.8 ( ± 5.27) years old. Eight RCT studies were included in the meta-analysis; results indicated that dance interventions had a significant effect on global cognition, memory, balance, and significantly decreased depression. No significant effects were found for executive function.

CONCLUSIONS

Dance is a non-pharmacological, effective, affordable, and engaging intervention that can be used as a complementary treatment for older adults with MCI, AD, and dementia.

The Impact of Rhythmic Physical Activity on Mental Health and Quality of Life in Older Adults with and without Cognitive Impairment: A Systematic Review and Meta-Analysis

(1) Background: Nowadays, it is essential to implement new non-pharmacological strategies, such as rhythmic physical activity, to improve mental health and quality of life in both individuals experiencing normal brain aging and those with cognitive impairment. Therefore, the objective of this study is to identify the effects of rhythmic physical activity interventions on mental health and quality of life in older adults, with or without mild cognitive impairment; (2) Methods: We conducted a systematic review with a meta-analysis, searching the Pubmed, Scopus, Web of Science, and Cochrane Plus databases using specific keywords. We selected studies that included rhythmic physical activity as the primary intervention for patients aged 65 and above, with or without cognitive impairment. We assessed the methodological quality of the articles using the PEDro scale; (3) Results: Out of 961 identified studies, we included 11 in this review, all of which employed rhythmic physical activity as an intervention. The selected studies consistently measured depression, anxiety, and quality of life; (4) Conclusions: This review demonstrates that rhythmic physical activity can effectively improve depression, anxiety, and quality of life in older adults, whether or not they have mild cognitive impairment. However, it is worth noting that while we have identified beneficial outcomes, the evidence supporting the use of rhythmic physical activity in enhancing depression, anxiety, and quality of life in older adults with or without mild cognitive impairment remains somewhat limited.

A comparative study on the effects of Mitchell and Benson relaxation techniques on quality of life of the old people in nursing homes: a quasi- experimental study

BACKGROUND

There is slight evidence on the effectiveness of relaxation techniques to improve quality of life of the old people, and no comparative studies have particularly investigated this population. Hence, the present study was conducted to examine the effect of Mitchell relaxation versus Benson relaxation technique to improve quality of life of the old people.

METHODS

In the present quasi-experimental study, 96 eligible old people in a nursing home were selected by available sampling method. Afterwards, they were assigned to three groups: Mitchell's Relaxation Technique, Benson Relaxation Technique, and control (each of 32 participants) using the random block sampling method. The intervention groups received relaxation for 8 weeks and 3 sessions of 20 min each week. However, the control group did not receive any relaxation. Data was gathered by questionnaires (SF-36) and (CASP-19) before (week 0) and after the intervention (week 8) and were analyzed using the SPSS software version 26.

RESULTS

The results indicated that both Benson and Mitchell relaxation had improved the quality of life (SF-36) and (CASP-19) and their sub-scales in the participants compare to the control group (P < 0.001). Accordingly, the median (quartile 25, 75) of the specific quality of life of the participants before the intervention was 21 (18.25, 25.75) in the Benson group, 20.5 (16, 24) in the Michel group, and 21 (16.25, 24) in the control group. However, after the intervention they reached 35(26.25, 38.75), 34.5(26.75, 42.25), and 17 (14, 21) respectively. There was no statistically significant difference between the Benson and Michel relaxation groups.

CONCLUSIONS

Based on the results, Benson and Mitchell relaxation techniques improve the quality of life of the old people. If the results be confirmed in other studies, the education of each of them, especially for the old people living in nursing homes and their caregivers, is suggested as routine care.

The Effects of Dance Interventions on Depression in Older Adults: A Meta-Analysis

Meta-analyses of the effects of dance on depressive symptoms in older adults have shown contradictory results, but few primary studies were included (5 and 8 studies). We aimed to examine the effects of dance on depressive symptoms in older adults aged 60 years and older and to examine the moderator effects of the source, participants, methods, and intervention characteristics. We included 23 primary studies that compared depressive symptoms across dance and comparison/control groups of older adults (72 ± 6.7 years old) and were written in English (N = 1,398) participants. Dance groups showed significantly less depressive symptoms post-intervention than comparison groups (ES = 0.66, 95% CI [0.42, 0.91], p < .001, I2 = 76.80%). South America and Australia showed the greatest effects. Using quasi-experimental designs showed significant effect sizes compared to using randomized designs. Only one quality indicator, intention-to-treat, influenced effect size. Dance might be used as an alternative treatment to improve depression.

Effect of Music Interventions on Cognitive Function in Older Adults With Mild Cognitive Impairment: A Systematic Review

The purpose of the current systematic review was to examine the effects of music interventions on cognitive function in older adults with mild cognitive impairment (MCI). A systematic search of CINAHL, PubMed, PsycINFO, and Web of Science databases was performed. Studies examining the effects of music interventions on cognitive function in older adults with MCI were included. Narrative synthesis for cognitive outcomes postintervention was performed. A total of 11 articles met inclusion criteria. Music interventions significantly improved global cognitive function, verbal fluency, executive function, and spatial function in older adults with MCI. Included studies were heterogeneous in terms of the type of intervention, cognitive assessment tool, and intervention duration. Six studies were at risk of bias due to missing data and confounding factors. Our findings suggest that music interventions can be an effective strategy to improve cognitive function for older adults with MCI. However, findings should be interpreted with caution. More rigorous studies with various types of music interventions investigating cognitive domain-specific effects are needed. [Research in Gerontological Nursing, 16(5), 259-268.].

Effect of multimodal exercise training on physical fitness indices, cognitive status, and depressive symptoms in Alzheimer's disease

In Alzheimer's disease (AD) patients, low levels of physical fitness (PF) and cognitive status are associated with high rates of depression. However, this condition can be improved through physical training.

Objective

The aim of the present study was to investigate the effect of multimodal exercise training (MET) on aerobic endurance, muscular strength, agility, dynamic balance, cognitive status, and depressive symptoms in men with mild-to-moderate AD.

Methods

A total of 25 elderly men with a diagnosis of mild-to-moderate AD were randomly categorized into an MET or a control group. The subjects in the MET group participated in a 12-week, three sessions per week MET program that included resistance, balance, and aerobic exercises. While the participants in the control group did not perform any regular exercise training during this period. Patients' cognitive status and depressive symptoms were assessed by Mini-Mental State Examination and the Geriatric Depression Scale-15 (GDS-15) questionnaires. PF indicators such as aerobic endurance, muscular strength, agility, and dynamic balance, as well as cognitive status and depressive symptoms, were taken from all the subjects before and after MET.

Results

The participants in the MET group improved handgrip, upper and lower body strength, agility, dynamic balance, and depressive symptoms (p<0.05). The intervention had no significant effect on aerobic endurance and cognitive status (p>0.05).

Conclusions

MET is an effective strategy to improve muscular strength, agility, dynamic balance, and depressive symptoms in men with mild-to-moderate AD. It is recommended for AD patients to engage in this type of exercise to reduce AD complications.

Integrating social support into interventions among the elderly in nursing homes: a scoping review

OBJECTIVES

This study aimed to understand the evidence related to integration of social support into interventions, to identify literature gaps related to social support interventions, and to clarify dimensions of supportive functions, outcomes, and providers among the elderly in nursing homes.

DESIGN

This scoping review followed the approach by Arksey and O'Malley. The Mixed Methods Appraisal Tool V.2018 was used for quality assessment of the studies.

DATA SOURCES

Searches were conducted of the PubMed, ScienceDirect, Public Library of Science, SocioHub, Wiley Online Library and PsycINFO databases for publications from 2010 to 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

We searched for primary studies and heterogeneous study designs published in English. Eligible studies took place in nursing and care homes and had study populations of elderly adults (older adults, geriatrics, ageing, seniors, older people and those aged 60 years and older).

DATA EXTRACTION AND SYNTHESIS

A data extraction form based on Joanna Briggs Institute's recommendations for scoping reviews was used. Two reviewers independently extracted data and performed quality assessment of the studies. Then, extracted data and quality assessment reports were discussed by all authors.

RESULTS

Thirty-one eligible studies were included in this review. 54.8% of the studies provided interventions for cognitively impaired residents. The top-three outcomes were neuropsychiatric symptoms, physical function and quality of life, respectively. The interventions were performed by nursing home staff (83.9%), other persons with specific qualifications (58.1%) and health volunteers (6.5%). Most studies (90.3%) depicted the integration of emotional and instrumental supportive functions into interventions.

CONCLUSION

The appropriate dimensions of supportive function, mainly emotional and instrumental support, are important to integrate into the social care of elderly people living in nursing homes.

Effects of acceptance and commitment therapy on cognitive function: A systematic review

Cognitive function is essential for daily activities. Acceptance and commitment therapy (ACT) may improve cognitive function by enhancing psychological flexibility, but the underlying mechanism is unknown. This systematic review evaluated the effectiveness of ACT on cognitive function. Seven research databases (PubMed, ProQuest Dissertations and Theses, Web of Science, EBSCOhost, CNKI, Scopus, Wanfang) were searched to collect articles with trials published in English and Chinese. After applying inclusion and exclusion criteria, we identified 12 studies published between 1994 and 2022 that included a combined total of 904 participants. Among the included studies were within-group (N = 3) and randomized controlled trial (RCT, N = 9) study designs. Outcome measures included cognitive scales and behavioral measurements. Of the 12 articles, 10 studies showed improvements in certain domains of cognitive function due indirectly to ACT intervention. We found that the ability of ACT intervention to promote psychological flexibility is due to its transdiagnostic nature. Also, the effects of the ACT intervention were observed in multiple cognitive domains: attention, subjective cognitive function, executive function, and memory. In conclusion, cognitive trainers could consider practicing ACT as part of their strategy to enhance an individual's psychological flexibility and cognitive function.

Recent advances on the molecular mechanisms of exercise-induced improvements of cognitive dysfunction

Physical exercise is of great significance for maintaining human health. Exercise can provide varying degrees of benefits to cognitive function at all stages of life cycle. Currently, with the aging of the world's population and increase of life expectancy, cognitive dysfunction has gradually become a disease of high incidence, which is accompanied by neurodegenerative diseases in elderly individuals. Patients often exhibit memory loss, aphasia and weakening of orientation once diagnosed, and are unable to have a normal life. Cognitive dysfunction largely affects the physical and mental health, reduces the quality of life, and causes a great economic burden to the society. At present, most of the interventions are aimed to maintain the current cognitive level and delay deterioration of cognition. In contrast, exercise as a nonpharmacological therapy has great advantages in its nontoxicity, low cost and universal application. The molecular mechanisms underlying the effect of exercise on cognition are complex, and studies have been extensively centered on neural plasticity, the direct target of exercise in the brain. In addition, mitochondrial stability and energy metabolism are essential for brain status. Meanwhile, the organ-brain axis responds to exercise and induces release of cytokines related to cognition. In this review, we summarize the latest evidence on the molecular mechanisms underlying the effects of exercise on cognition, and point out directions for future research.

Uplifted by Dancing Community: From Physical Activity to Well-Being

The aim of the article is to present the dancing experience of older adult women who increase their well-being through dancing. That aim was realized through conducting qualitative research in accordance with COREQ among the members of a dance group "Gracje" from Wrocław. In the article, we show that senior women dance as a form of physical activity in the pursuit of health, enabling them to maintain the level of physical ability that allows them to fully enjoy different aspects of life. Thus, health is not only attempting to avoid illnesses, but, first of all, experiencing well-being, i.e., satisfaction with life in its physical, mental (cognitive) and social aspects. That satisfaction touches, in particular, such spheres as acceptance of an aging body, a need for personal growth and entering into new social relationships. Increasing that sense of satisfaction and agency (subjectivity) in each of those spheres as a consequence of organized dancing activity should be treated as one of the most important factors responsible for improving the quality of life of older adult women.

Using Machine Learning to Predict Cognitive Impairment Among Middle-Aged and Older Chinese: A Longitudinal Study

Objective: To explore the predictive value of machine learning in cognitive impairment, and identify important factors for cognitive impairment. Methods: A total of 2,326 middle-aged and elderly people completed questionnaire, and physical examination evaluation at baseline, Year 2, and Year 4 follow-ups. A random forest machine learning (ML) model was used to predict the cognitive impairment at Year 2 and Year 4 longitudinally. Based on Year 4 cross-sectional data, the same method was applied to establish a prediction model and verify its longitudinal prediction accuracy for cognitive impairment. Meanwhile, the ability of random forest and traditional logistic regression model to longitudinally predict 2-year and 4-year cognitive impairment was compared. Results: Random forest models showed high accuracy for all outcomes at Year 2, Year 4, and cross-sectional Year 4 [AUC = 0.81, 0.79, 0.80] compared with logistic regression [AUC = 0.61, 0.62, 0.70]. Baseline physical examination (e.g., BMI, Blood pressure), biomarkers (e.g., cholesterol), functioning (e.g., functional limitations), demography (e.g., age), and emotional status (e.g., depression) characteristics were identified as the top ten important predictors of cognitive impairment. Conclusion: ML algorithms could enhance the prediction of cognitive impairment among the middle-aged and older Chinese for 4 years and identify essential risk markers.

Dance therapy and cognitive impairment in older people: A review of clinical data

ABSTRACT The growing interest for nonpharmacological treatment alternatives to older people with mild cognitive impairment or dementia has increased exponentially for the past few years; in this context, dance therapy is an effective therapeutic tool in improving the cognition of older people. The aim of this study was to verify whether dance therapy is a viable tool in promoting benefits with regard to the cognition and mood of older people with cognitive impairment. A database search covering the past 10 years was carried out. Result: The search found 193 papers; after title, abstract, and duplicity analysis, 14 of those were selected, of which 10 were fully revised. The studies showed positive results regarding the improvement of cognitive function after dance stimulations, as well as beneficial effects on the mood of older people with cognitive impairment.

Mix-and-Match or Mismatch? Exploring the Perspectives of Older Adults About Zumba Dance and Its Potential Utilization for Dual-Task Training

Despite the popularity of Zumba dancing, research is scarce about its impact on older adults. Meanwhile, the integration of cognitive tasks with physical exercises, also known as dual tasking, is an evolving strategy to facilitate activities for older adults. This study investigated the perceptions of persons aged ≥55 years on Zumba and its potential to be incorporated into a dual-task program. We conducted a descriptive-qualitative study involving 44 Filipino older adults. Using content analysis, four themes were identified: moving toward match or mismatch, balancing benefits with burdens, dual tasking as innovative yet potentially challenging, and overcoming barriers with enablers. Although Zumba was perceived as an inclusive and beneficial activity, individual and contextual limitations could hinder its suitability. Moreover, dual tasking in Zumba was considered an innovative approach, although challenges should be addressed to promote its feasibility. Several strategies could enable the design and implementation of age-appropriate Zumba and dual-tasking programs for older adults.

Acceptability and feasibility of public square dancing for community senior citizens with mild cognitive impairment and depressive symptoms: A pilot study

Objectives

To explore the acceptability and feasibility of public square dancing among community residents with mild cognitive impairment (MCI) and depressive symptoms.

Methods

This mixed-method study consisted of a quantitative and a qualitative phase. From January to July 2018, a total of 241 community-dwelling senior citizens who complained of memory loss in one community in the Haidian District in Beijing were approached and screened, and 41 qualified for the study. Among them, 35 senior citizens participated in the public square dancing intervention. By the end of the three-month follow-up, 31 senior citizens completed the whole study. The Subjective Exercise Experience Scale (SEES) was used to survey senior citizens at the end of the three-month public square dancing intervention and follow-up to measure the participants' subjective exercise experience. Then 15 senior citizens were interviewed to collect attitudes, opinions, and suggestions related to the intervention.

Results

During the intervention, 90.6% of senior citizens met the requirement for defined hours. All senior citizens continued to dance at the three-month follow-up, and 32.3% met the requirement for defined hours. The scores of psychological well-being (11.03 ± 2.82 vs. 14.87 ± 3.93, P < 0.001) and fatigue (11.00 [8.00, 12.00] vs. 14.00 [9.00, 18.00], P < 0.001) increased at the end of the three-month follow-up. Qualitative research results extracted four major themes: increased confidence and a sense of accomplishment; easy to learn, close to real life, and sense of belonging; promotes physical and mental health; future expectations include music selection, reduced weather disruption, and self-organizing workouts.

Conclusion

Public square dancing proved to be an acceptable, viable, and valuable intervention for MCI residents with depressive symptoms, which could be carried out by nursing staff in the community. Future studies should consider the appropriate population, intensity, and frequency of public square dancing and its effect on specific cognitive functions.

Effects of Dance Interventions on Cognition, Psycho-Behavioral Symptoms, Motor Functions, and Quality of Life in Older Adult Patients With Mild Cognitive Impairment: A Meta-Analysis and Systematic Review

Background: Dance interventions are considered beneficial for older patients with mild cognitive impairment in many aspects. We conducted a comprehensive systematic review and meta-analysis to assess the effects of dance on different aspects (cognitive function, emotions, physical function, and quality of life) of this population. Methods: A systematic search of PubMed, Web of Science, the Cochrane Central Register of Controlled Trials, Embase, American Psychological Association PsycInfo, ProQuest, Scopus, Cumulative Index to Nursing and Allied Health Literature, the Chinese BioMedical Literature Database, the VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang Data database was performed. Two reviewers independently assessed the study quality. Results: Fourteen studies were retrieved from the databases for analysis. The pooled results showed that dance interventions significantly improved global cognition (standardized mean difference [SMD] = 0.73, 95% confidence interval [CI]: 0.47 to 0.99, P < 0.00001), rote memory (mean difference [MD] = -2.12, 95% CI: -4.02 to -0.21, P = 0.03), immediate recall (SMD = 0.54, 95% CI: 0.30 to 0.78, P < 0.0001), delayed recall (SMD = 0.56, 95% CI: 0.26 to 0.86, P = 0.0002) and attention (SMD = 0.38, 95% CI: 0.13 to 0.64, P = 0.003). No significant improvement was found in executive function, language, depression, anxiety, dementia-related behavioral symptoms, motor function, and quality of life. Conclusion: Dance interventions benefit most aspects of cognitive functions. The evidence for the effects of dance on psycho-behavioral symptoms, motor function and quality of life remains unclear. More trials with rigorous study designs are necessary to provide this evidence.

Effects of dance intervention on agitation and cognitive functioning of people living with dementia in institutional care facilities: Systematic review

INTRODUCTION

Agitation and impaired cognitive functioning are common symptoms of dementia, which require costly medication regimens that are associated with adverse effects. This study investigates the effects of dance interventions on agitation and cognitive function in people living with dementia in institutional care facilities.

METHODS

Five electronic databases were searched for eligible studies on dance interventions for people living with dementia published between 2002 and 2021. Standard deviation and post mean values were extracted. Within-group Hedges' g was computed for individual studies.

RESULTS

Six randomised controlled trials and three non-randomised studies of satisfactory quality, with a total of 610 participants, were included. Statistical analysis found significant improvements in agitation and cognitive functioning with dance interventions.

DISCUSSION

This review provided favourable evidence on the effects of dance interventions on agitation and cognitive functions in people with dementia. However, given the limited evidence, more studies are needed to confirm the effects.

Effects of nurse-led square dancing on older patients with mild cognitive impairment combined with depressive symptoms: A pilot study

OBJECTIVE

The present study aimed to verify the feasibility and preliminary effects of nurse-led square dancing designed to improve older adults' cognitive function and depressive symptoms who with MCI.

METHODS

A quasi-experimental pilot study design was adopted for the present study. Screening for cognitive function was conducted among older adults (≥ 60 years old) living in two communities in Beijing who complained of memory loss. A total of 107 older patients with MCI and depressive symptoms were diagnosed after obtaining informed consent. Thirty-five patients selected from each community were included in the study as control and intervention groups, respectively. The two groups of patients received health education while the intervention group participated in a square dance intervention program led by nurses three times per week for 60 min per session over a period of three months. The Montreal Cognitive Assessment-Peking version (MoCA-P) and Geriatric Depression Scale (GDS-30) were used to assess the cognitive function and depressive symptoms of patients in the two groups at three time intervals; before intervention, at the end of the three-month intervention period, and over a three-month follow-up period after the end of intervention.

RESULTS

Feasibility of the intervention was established with a high completion rate of 90%. Data collection for 63 out of 70 patients enrolled for the study was completed after six months. MoCA-P and GDS-30 scores of the intervention group were significantly different after the intervention when compared with the control group. A significant improvement in cognition was observed in the intervention group, and depressive symptoms decreased after intervention and follow-up when compared with the control group. During the intervention and follow-up phases, the MoCA-P score of the intervention group increased gradually with time. Furthermore, the MoCA-P and GDS-30 scores of the control group remained unchanged.

CONCLUSION

This study has revealed that square dance intervention exerts a positive impact on cognitive function and depressive symptoms among older patients suffering from MCI and depressive symptoms. The results of this study support the feasibility and preliminary effects of square dancing on relieving cognitive decline and depressive symptoms. Square dancing is a recommended type of intervention that can be applied to the local Chinese population because of its simplicity, convenience, and suitability for the older adults.

Effect of progressive muscle relaxation on adaptation to old age and quality of life among older people in a nursing home: a randomized controlled trial

BACKGROUND

Changes occurring in the aging process, the presence of decline in physical and cognitive functions, and the limitations of participation in activities affect adaptation to old age and the quality of life. This study aimed to examine the effect of progressive muscle relaxation (PMR) exercises on adaptation to old age and the quality of life of older people.

METHODS

A randomized controlled trial design was used. The sample consisted of 45 older residents (21 intervention subjects, 24 controls) from a nursing home in a city of Turkey. The intervention group received progressive muscle-relaxation sessions twice weekly for 8 weeks, while the control group received routine care. All PMR exercises were led by the researcher. All participants were evaluated at baseline and after 8 weeks using the Assessment Scale of Adaptation Difficulty for the Elderly and the Nottingham Health Profile.

RESULTS

As a result of PMR exercises performed for 8 weeks, the Assessment Scale of Adaptation Difficulty for the Elderly and Nottingham Health Profile total mean scores of the intervention group improved significantly (P < 0.001). No statistically significant difference was observed, however, when comparing the intervention and control groups in terms of the level of adjustment to old age and health-related quality of life, either at baseline or following the intervention (P > 0.05).

CONCLUSION

The results of this study indicate that progressive muscle relaxation can increase adaptation to old age and the quality of life and of older people in a nursing home.

The effect of dance interventions on cognition, neuroplasticity, physical function, depression, and quality of life for older adults with mild cognitive impairment: A systematic review and meta-analysis

BACKGROUND

Mild cognitive impairment is an age-related cognitive disorder which is associated with frequent memory lapses, impaired judgement, and progressive functional decline. If untreated early, 39.2% of people with mild cognitive impairment could progress to develop dementia. However, there are currently no approved pharmacological interventions to treat the condition, which lead researchers to explore non-pharmacological options, such as dance therapy.

OBJECTIVES

This systematic review aimed to examine the effectiveness of dance interventions on cognition, neuroplasticity, physical function, depression, and quality of life in older adults with mild cognitive impairment.

METHODS

Seven databases were systematically searched from their respective inception dates to 31 March 2020. Relevant randomized controlled trials (RCTs) were screened and assessed for risk of bias. Eight RCTs evaluating dance interventions were included.

RESULTS

Results showed that dance interventions had a significant moderate effect on global cognition (SMD=0.54, Z = 3.55, p<0.001), significantly improved memory (SMD=0.33, Z = 3.97, p<0.001), visuospatial function (SMD=0.42, Z = 2.41, p = 0.02), and language (SMD=0.39, Z = 2.69, p = 0.007). We found that dance interventions produced a significant moderate effect on physical function (SMD=0.55, Z = 3.43, p<0.001), and a significant effect on quality of life (SMD=0.93, Z = 5.04, p<0.0.001).

CONCLUSION

Dance is a non-pharmacological and inexpensive intervention that can be implemented for older adults on a large scale. It can slow down the cognitive deterioration of older adults with mild cognitive impairment. However, the findings should be interpreted with caution due to the heterogeneity in intervention designs. Rigorous design studies with long-term follow-ups, neuroimaging, biological markers, and comprehensive neuropsychological assessment are required to understand the mechanism of dance interventions and demonstrate its efficacy for older adults with mild cognitive impairment. The protocol was registered on PROSPERO (CRD42020173659).

Promoting wellbeing and health through active participation in music and dance: a systematic review

Purpose: This review aims to reveal how music and dance participation relates to key social determinants of health, and acts as population wellbeing and health promotion and preventive tools for people without pre-existing health issues in diverse social groups.

Methods: A qualitative systematic literature review addresses the questions: 1) How might music and dance cultural practices relate to social determinants of health?; 2) What gaps exist in the current body of research examining how healthy individuals/populations maintain and promote good health and wellbeing through music and dance participation?; 3) What are the implications of the current body of literature for healthcare, policy and research?

Results: Music and dance relate to key social determinants of health, from social and cultural, and physical and mental health perspectives. A number of gaps in the literature exist, including underrepresentation of middle aged participants, men, and Indigenous, LGBTQIAP+, and migrant populations. There is a lack of consistency in theoretical and methodological approaches, and a language for effective communication across arts and health audiences.

Conclusions: A significant opportunity exists for cross-disciplinary collaboration to advance healthcare and arts policy, generate cost-effective approaches to preventive healthcare practice, and enhance the wellbeing and health of large and diverse populations.

Preventing dementia? Interventional approaches in mild cognitive impairment

Mild cognitive impairment (MCI) is defined as an intermediate state between normal cognitive aging and dementia. It describes a status of the subjective impression of cognitive decline and objectively detectible memory impairment beyond normal age-related changes. Activities of daily living are not affected. As the population ages, there is a growing need for early, proactive programs that can delay the consequences of dementia and improve the well-being of people with MCI and their caregivers. Various forms and approaches of intervention for older people with MCI have been suggested to delay cognitive decline. Pharmacological as well as non-pharmacological approaches (cognitive, physiological, nutritional supplementation, electric stimulation, psychosocial therapeutic) and multicomponent interventions have been proposed. Interventional approaches in MCI from 2009 to April 2019 concerning the cognitive performance are presented in this review.

Influence of an Aquatic Therapy Program on Perceived Pain, Stress, and Quality of Life in Chronic Stroke Patients: A Randomized Trial

Pain and depressive states may have a negative impact on the quality of life of individuals with stroke. The aim of this study was to evaluate the effects of a program of Ai Chi aquatic therapy on pain, depression, and quality of life in a sample of people with stroke. Forty-five participants received physiotherapy treatment on dry land (control group), an experimental group received aquatic Ai Chi therapy, and a combined therapy group received alternating sessions of physiotherapy on dry land and aquatic Ai Chi therapy. The Visual Analog Scale (VAS) scale for pain, the resilience scale, and the SF-36 quality of life scale were used as outcome measures. Statistically significant differences were found in the experimental group and the combined intervention group for post treatment pain and resilience (p < 0.001). Concerning the SF-36, statistically significant changes (p < 0.01) were found in the experimental group and the combined therapy group for all items except general health, vitality, and social function, where no between group differences were observed (p = 0.001). In conclusion, physical exercise performed in water has positive effects on several factors that contribute towards improving the mood and quality of life of people with acquired brain injury.

The emotional dance with depression: A longitudinal investigation of OULA® for depression in women

The primary purpose of this pilot study was to evaluate OULA®, a dance fitness program with a strong emphasis on processing emotions through dance, as an intervention for depression in women diagnosed with major or persistent depressive disorders. 53 women were eligible for participation. Women attended OULA® for 12 weeks and then abstained from OULA® during week 13. For the primary outcome, depression severity was measured using the Hamilton Depression Rating Scale (HAM-D), and secondary outcomes were measured using the Beck Anxiety Index (BAI) and the Subjective Happiness Scale (SHS). After the abstinence week, women were offered 3-months of optional additional OULA®. HAM-D, BAI and SHS scores were collected at weeks 2, 4, 5-14 and at the end of the 3-month optional OULA® phase. Results from linear mixed effects repeated models show that during the 12-week intervention period and at week 26, HAM-D scores significantly decrease each week compared to baseline. Further, BAI scores significantly decrease starting at week 5 and through the end of the intervention period and at week 26. Moreover, SHS scores increased significantly for four of the weeks during the intervention period and at week 26. The results from this study suggest that OULA® may be a useful intervention for decreasing depression and anxiety severity in women with depression but may not be helpful for improving subjective happiness.

Dance for Health: the impact of creative dance sessions on older people in an acute hospital setting

Background: This service evaluation examined the impact of Dance for Health, a programme of weekly group dance sessions for older patients, which took place on wards in an acute hospital setting.Methods: Qualitative and quantitative observations using the ArtsObs scale were undertaken of 64 dance sessions over a 12-week period involving seven different hospital wards encompassing 313 patient attendances.Results: Statistically significant improvements were observed in the mood of the majority of patients taking part. People engaged mentally and physically with the activity were distracted from their medical condition and from what was happening on the ward. Patients appeared relaxed and were willing to express themselves creatively.Conclusion: The Dance for Health programme had a positive impact on group participants, promoting movement and physical activity for older patients. It is a meaningful and enjoyable activity, which encourages social interaction and provides respite from the medical environment.

Effects of Dance Movement Therapy and Dance on Health-Related Psychological Outcomes. A Meta-Analysis Update

Background: Dance is an embodied activity and, when applied therapeutically, can have several specific and unspecific health benefits. In this meta-analysis, we evaluated the effectiveness of dance movement therapy(DMT) and dance interventions for psychological health outcomes. Research in this area grew considerably from 1.3 detected studies/year in 1996-2012 to 6.8 detected studies/year in 2012-2018. Method: We synthesized 41 controlled intervention studies (N = 2,374; from 01/2012 to 03/2018), 21 from DMT, and 20 from dance, investigating the outcome clusters of quality of life, clinical outcomes (with sub-analyses of depression and anxiety), interpersonal skills, cognitive skills, and (psycho-)motor skills. We included recent randomized controlled trials (RCTs) in areas such as depression, anxiety, schizophrenia, autism, elderly patients, oncology, neurology, chronic heart failure, and cardiovascular disease, including follow-up data in eight studies. Results: Analyses yielded a medium overall effect (d = 0.60), with high heterogeneity of results (I 2 = 72.62%). Sorted by outcome clusters, the effects were medium to large (d = 0.53 to d = 0.85). All effects, except the one for (psycho-)motor skills, showed high inconsistency of results. Sensitivity analyses revealed that type of intervention (DMT or dance) was a significant moderator of results. In the DMT cluster, the overall medium effect was small, significant, and homogeneous/consistent (d = 0.30, p < 0.001, I 2 = 3.47). In the dance intervention cluster, the overall medium effect was large, significant, yet heterogeneous/non-consistent (d = 0.81, p < 0.001, I 2 = 77.96). Results suggest that DMT decreases depression and anxiety and increases quality of life and interpersonal and cognitive skills, whereas dance interventions increase (psycho-)motor skills. Larger effect sizes resulted from observational measures, possibly indicating bias. Follow-up data showed that on 22 weeks after the intervention, most effects remained stable or slightly increased. Discussion: Consistent effects of DMT coincide with findings from former meta-analyses. Most dance intervention studies came from preventive contexts and most DMT studies came from institutional healthcare contexts with more severely impaired clinical patients, where we found smaller effects, yet with higher clinical relevance. Methodological shortcomings of many included studies and heterogeneity of outcome measures limit results. Initial findings on long-term effects are promising.

Music Therapy and Physical Activity to Ease Anxiety, Restlessness, Irritability, and Aggression in Individuals With Dementia With Signs of Frontotemporal Lobe Degeneration

The purpose of the current study was to evaluate whether a combined intervention of physical activity and music therapy could reduce anxiety, restlessness, irritability, and aggression among individuals with severe dementia. An exploratory design was used to evaluate a combined intervention of physical activity, music therapy, and daily walking. Interventions were systematically implemented for 8 weeks. Target groups were individuals with dementia with frontal lobe symptoms in institutional care. Primary outcome measure was the Brøset Violence Checklist (BVC). Four men and two women (mean age = 84.3 years) and their primary caretakers (n = 6) participated. The most prominent symptoms among participants at baseline were confusion, irritability, and verbal threats. The individual BVC total scores indicated significant improvements (p = 0.03). Implementation of individualized music therapy combined with increased physical activity for 8 weeks was a feasible intervention that reduced anxiety, restlessness, irritability, and aggression in the current study. [Journal of Psychosocial Nursing and Mental Health Services, 57(5), 29-37.].

Creative Arts Interventions to Address Depression in Older Adults: A Systematic Review of Outcomes, Processes, and Mechanisms

Depression experienced by older adults is proving an increasing global health burden, with rates generally 7% and as high as 27% in the USA. This is likely to significantly increase in coming years as the number and proportion of older adults in the population rises all around the world. Therefore, it is imperative that the effectiveness of approaches to the prevention and treatment of depression are understood. Creative arts interventions, including art, dance movement, drama, and music modalities, are utilized internationally to target depression and depressive symptoms in older adults. This includes interventions led by trained arts therapists as well as other health and arts professionals. However, to date there has not been a systematic review that reports effects and examines the processes (why) and mechanisms (how) of creative arts interventions are used to address depression in this older age group. This systematic review of studies on creative arts interventions for older adults experiencing depression examined: outcomes of four creative arts modalities (art, dance movement, drama, and music); with particular attention paid to processes documented as contributing to change in each modality; and mechanisms considered to result from these processes. Our analysis of 75 articles (17 art, 13 dance, 4 drama, and 41 music) indicates mostly significant quantitative or positive qualitative findings, particularly for interventions led by creative arts therapists. Mechanisms of change gleaned from the studies that were common across modalities include physical (e.g., increased muscle strength; neurochemical effects, such as endorphin release), intra-personal (e.g., enhanced self-concept, strengthened agency and mastery; processing and communication of emotions), cultural (e.g., creative expression, aesthetic pleasure), cognitive (e.g., stimulation of memory), and social (e.g., increased social skills and connection), that were all considered to contribute to reduced depression and symptoms. Recommendations for future research includes stronger focus on testing of processes and mechanisms.

Effects of aquatic exercise on mental health, functional autonomy and oxidative stress in depressed elderly individuals: A randomized clinical trial

OBJECTIVES

The aim of this study was to investigate the effects of aquatic exercise on mental health, functional autonomy and oxidative stress parameters in depressed elderly individuals.

METHODS

Initially, ninety-two elderly individuals were included in the study and were allocated into the depression group (n=16) and nondepression group (n=14). Both groups engaged in the aquatic exercise program for 12 weeks, including two weekly sessions (45 min/session) at a low intensity (between 50% and 60% of maximal heart rate or Borg scale scores of 13 to 14) throughout the intervention. All outcomes were evaluated at baseline and 12 weeks later.

RESULTS

The patients were 63.5±8.8 years old. The following scores were decreased after training in the depressed group: depression (53%), anxiety (48%), and Timed Up & Go (33%). The following scores increased: Berg Balance Scale (9%) and flexibility (44%). Regarding the blood-based parameters, there were decreases in protein carbonylation (46%) and nitric oxide (60%) and increases in glutathione (170%) and superoxide dismutase (160%) in the depression group (p<0.005).

CONCLUSIONS

The aquatic exercise program reduces depression and anxiety, improves functional autonomy and decreases oxidative stress in depressed elderly individuals.

Effects of Mind-Body Exercise on Cognitive Function in Older Adults With Cognitive Impairment: A Systematic Review and Meta-analysis

To quantify the effects of mind-body exercise on cognitive function in older adults with cognitive impairment, we systematically searched five databases. Findings were analyzed according to the mean change of global cognition, memory, and executive function. Subgroup analyses were conducted based on the level of cognitive impairment and types of exercise. Thirteen studies were included. Analyses revealed that mind-body exercise was effective in promoting global cognition in individuals with cognitive impairment (standardized mean difference [SMD] = 0.61; 95% confidence interval, 0.21-1.00; p = 0.003), as well as in individuals with mild cognitive impairment (SMD = 0.46; 95% confidence interval, 0.06-0.85; p = 0.02) or dementia; dance was effective in promoting global cognition (SMD = 0.84; 95% confidence interval, 0.23-1.46; p = 0.007) and memory (SMD = 0.27; 95% confidence interval, 0.02-0.52; p = 0.04) in individuals with cognitive impairment, but tai chi was not. Nevertheless, additional well-designed randomized clinical trials are further needed.

Effects of Physical Exercise on Depressive Symptoms in Patients With Cognitive Impairment: A Systematic Review and Meta-Analysis

We aimed to evaluate the efficacy of physical exercise in ameliorating depressive symptoms in patients with cognitive impairment. The databases of PubMed, EMBASE, Web of Science, the Cochrane Library, PsycINFO, China National Knowledge Infrastructure, WanFang, and WeiPu (VIP) were searched to identify randomized controlled trials (RCTs) that involved physical exercise for patients with cognitive impairment. A random effects model and a fixed effects model were used to calculate the pooled effect size. Twenty-one studies were identified. The meta-analysis showed that physical exercise significantly ameliorated depressive symptoms (standardized mean difference [SMD] = -0.23; 95% confidence interval [CI], -0.39 to -0.07; p = 0.004). In addition, beneficial improvements in neuropsychiatric symptoms (mean difference, -4.62; 95% CI, -9.07 to -0.16, p = 0.04), quality of life (SMD = 0.23; 95% CI, 0.01-0.46; p = 0.04), and activities of daily living (SMD = 0.27; 95% CI, 0.12-0.43; p = 0.0005) were observed in our study. No significant improvements were found in anxiety or apathy. Nevertheless, further high-quality, multicenter RCTs are needed to identify the clinical value of our results.

Effects of a specially designed aerobic dance routine on mild cognitive impairment

Background

Mild cognitive impairment (MCI) is known as a transitional stage or phase between normal aging and dementia. In addition, it is associated with an increased risk of dementia. Research has shown that moderate-intensity exercise is associated with a decreased risk of cognitive impairment. Two recent studies demonstrated that dance interventions are associated with improved cognitive function in the elderly with MCI.

Purpose

We evaluated the effect of a moderate-intensity aerobic dance routine on the cognitive function in patients with MCI.

Patients and methods

This is a single-blind randomized controlled trial. Sixty MCI patients were randomized to receive either treatment (aerobic dance routine + usual care) or control (usual care only) for 3 months. All patients received usual care for an additional 3 months thereafter. The aerobic dance routine was a specially designed dance routine which involved cognitive effort for patients to memorize the complex movements. Wechsler memory scale-revised logical memory (WMS-R LM) and event-related evoked potentials (ERPs) P300 latency were used to assess patients’ cognitive function at baseline, 3 months, and 6 months.

Results

Twenty-nine patients received exercise therapy and 31 patients received usual care. Patients in the treatment group showed a greater improvement in memory (difference in WMS-R LM changes over 3 months 4.6; 95% CI 2.2, 7.0; p<0.001) and processing speed (difference in P300 latency changes over 6 months −20.0; 95% CI=−39.5, −0.4; p<0.05) compared to control.

Conclusion

This dance routine improves cognitive function, especially episodic memory and processing speed, in MCI patients and merits promotion in communities.

An Internet-based survey of the dance fitness program OULA

Background:

OULA is a high-energy dance workout to top 40 hits that is inspired by yoga and non-impact aerobics. Created in Missoula, Montana, the program has been gaining national and international popularity. To understand the demographic composition, reasons for attending OULA, and experiences with depression/anxiety, we conducted an Internet-based survey.

Methods:

A pilot descriptive cross-sectional Internet-based survey was created in Qualtrics and distributed through social media and flyers.

Results:

The 38-item survey received responses from 302 participants. Current OULA participants chose “exercise” as the primary reason for attending (40.2%, 95% confidence interval: 33.3–48.2), followed by “stress relief/improve mood” (28.8%, 95% confidence interval: 23.0–35.6). Participants listed “stress relief/improve mood” as the most common secondary (35.6%, 95% confidence interval: 29.0–43.2) and tertiary (38.6%, 95% confidence interval: 31.7–46.7) reason for attending OULA. A majority of the participants said that OULA makes them feel like part of a community (93.2%, 95% confidence interval: 82.5–105.1) and increases their energy outside of class (80.1%, 95% confidence interval: 70.2–91.1). In our sample, 12.5% (95% confidence interval: 8.8–17.1) and 9.0% (95% confidence interval: 5.9–12.9) were currently taking antidepressants and anxiolytics, respectively.

Conclusion:

These results suggest that current OULA participants are already using the program to relieve stress or improve mood. Further research should be conducted to understand the relationship between OULA and depression/anxiety.

A Novel and Intelligent Home Monitoring System for Care Support of Elders with Cognitive Impairment

BACKGROUND

Assistive technology, in the form of a smart home environment, is employed to support people with dementia.

OBJECTIVES

To propose a system for continuous and objective remote monitoring of problematic daily living activity areas and design personalized interventions based on system feedback and clinical observations for improving cognitive function and health-related quality of life.

METHODS

The assistive technology of the proposed system, including wearable, sleep, object motion, presence, and utility usage sensors, was methodically deployed at four different home installations of people with cognitive impairment. Detection of sleep patterns, physical activity, and activities of daily living, based on the collected sensor data and analytics, was available at all times through comprehensive data visualization solutions. Combined with clinical observation, targeted psychosocial interventions were introduced to enhance the participants' quality of life and improve their cognitive functions and daily functionality. Meanwhile, participants and their caregivers were able to visualize a reduced set of information tailored to their needs.

RESULTS

Overall, paired-sample t-test analysis of monitored qualities revealed improvement for all participants in neuropsychological assessment. Moreover, improvement was detected from the beginning to the end of the trial, in physical condition and in the domains of sleep. Detecting abnormalities via the system, for example in sleep quality, such as REM sleep, has proved to be critical to assess current status, drive interventions, and evaluate improvements in a reliable manner.

CONCLUSION

It has been proved that the proposed system is suitable to support clinicians to reliably drive and evaluate clinical interventions toward quality of life improvement of people with cognitive impairment.

International Ballroom Dancing Against Neurodegeneration: A Randomized Controlled Trial in Greek Community-Dwelling Elders With Mild Cognitive impairment

BACKGROUND

Many studies have highlighted the positive effects of dance in people with neurodegenerative diseases.

OBJECTIVES

To explore the effects of International Ballroom Dancing on cognitive function in elders with amnestic mild cognitive impairment (aMCI).

METHODS

One-hundred twenty-nine elderly patients with aMCI diagnosis (mean age 66.8 ± 10.1 years) were randomly assigned into 2 groups: intervention group (IG, n = 66) and control group (CG, n = 63). The IG exercised systematically for 10 months, and both groups were submitted to extensive neuropsychological assessment prior and after the 10-month period.

RESULTS

According to the independent sample t test at the follow-up, significant differences between groups were found in benefit of the IG while the CG showed worse performance in the majority of neuropsychological tests. According to the Student t test, better performance is detected in IG in contrast with CG, which had worse performance almost in all scales.

CONCLUSION

Dance may be an important nonpharmacological approach that can benefit cognitive functions.

The Dancing Brain: Structural and Functional Signatures of Expert Dance Training

Dance - as a ritual, therapy, and leisure activity - has been known for thousands of years. Today, dance is increasingly used as therapy for cognitive and neurological disorders such as dementia and Parkinson's disease. Surprisingly, the effects of dance training on the healthy young brain are not well understood despite the necessity of such information for planning successful clinical interventions. Therefore, this study examined actively performing, expert-level trained college students as a model of long-term exposure to dance training. To study the long-term effects of dance training on the human brain, we compared 20 young expert female Dancers with normal body mass index with 20 age- and education-matched Non-Dancers with respect to brain structure and function. We used diffusion tensor, morphometric, resting state and task-related functional MRI, a broad cognitive assessment, and objective measures of selected dance skill (Dance Central video game and a balance task). Dancers showed superior performance in the Dance Central video game and balance task, but showed no differences in cognitive abilities. We found little evidence for training-related differences in brain volume in Dancers. Dancers had lower anisotropy in the corticospinal tract. They also activated the action observation network (AON) to greater extent than Non-Dancers when viewing dance sequences. Dancers showed altered functional connectivity of the AON, and of the general motor learning network. These functional connectivity differences were related to dance skill and balance and training-induced structural characteristics. Our findings have the potential to inform future study designs aiming to monitor dance training-induced plasticity in clinical populations.

Alternative Treatment Modalities and Its Effect in Older Populations

Aging is an inevitable multifactorial process. Advances in health care and technology have led to an increase on expected life span that can reach an average of 90 years in the next few decades. Lifestyle changes that include activity, nutrition, stress management, and alternatives low-impact exercises like yoga and tai chi can help us modify some of these age-related changes and lead to an increase in the health span and quality of life of the older adults.

Pilot of a Tailored Dance Intervention to Support Function in People With Cognitive Impairment Residing in Long-Term Care: A Brief Report

Older adults who live in long-term care settings are at risk for functional decline, which may be mitigated by regular exercise. Using a single-group repeated measures design, this pilot study explored the feasibility, acceptability, and preliminary effects of a Waltz-based dance intervention delivered to 13 Canadian, English-speaking, long-term care residents with mild to moderate cognitive impairment. The findings supported intervention feasibility, based on a high completion rate (93%), level of attendance (M = 7.15 of 10 sessions) and level of engagement during dance sessions (M = 1.75 to 1.97 out of 2.00). On average, residents perceived dance sessions positively, and staff and family participants (N = 26) rated them as somewhat acceptable overall (M = 2.37, 0 to 4 scale). Additional research is needed to assess intervention efficacy in a larger sample.

White Matter Integrity Declined Over 6-Months, but Dance Intervention Improved Integrity of the Fornix of Older Adults

Degeneration of cerebral white matter (WM), or structural disconnection, is one of the major neural mechanisms driving age-related decline in cognitive functions, such as processing speed. Past cross-sectional studies have demonstrated beneficial effects of greater cardiorespiratory fitness, physical activity, cognitive training, social engagement, and nutrition on cognitive functioning and brain health in aging. Here, we collected diffusion magnetic resonance (MRI) imaging data from 174 older (age 60–79) adults to study the effects of 6-months lifestyle interventions on WM integrity. Healthy but low-active participants were randomized into Dance, Walking, Walking + Nutrition, and Active Control (stretching and toning) intervention groups (NCT01472744 on ClinicalTrials.gov). Only in the fornix there was a time × intervention group interaction of change in WM integrity: integrity declined over 6 months in all groups but increased in the Dance group. Integrity in the fornix at baseline was associated with better processing speed, however, change in fornix integrity did not correlate with change in processing speed. Next, we observed a decline in WM integrity across the majority of brain regions in all participants, regardless of the intervention group. This suggests that the aging of the brain is detectable on the scale of 6-months, which highlights the urgency of finding effective interventions to slow down this process. Magnitude of WM decline increased with age and decline in prefrontal WM was of lesser magnitude in older adults spending less time sedentary and more engaging in moderate-to-vigorous physical activity. In addition, our findings support the anterior-to-posterior gradient of greater-to-lesser decline, but only in the in the corpus callosum. Together, our findings suggest that combining physical, cognitive, and social engagement (dance) may help maintain or improve WM health and more physically active lifestyle is associated with slower WM decline. This study emphasizes the importance of a physically active and socially engaging lifestyle among aging adults.