Review: Physical benefits of dancing for older adults

Physical Benefits of Dancing for Healthy Older Adults: A Review. 2009. Justin W.L. Keogh, Andrew Kilding, Philippa Pidgeon, Linda Ashley, and Dawn Gillis. Journal of Aging and Physical Activity, 2009, 17, 1-23.

Abstract: “Dancing is a mode of physical activity that may allow older adults to improve their physical function, health, and well-being. However, no reviews on the physical benefits of dancing for healthy older adults have been published in the scientific literature. Using relevant databases and keywords, 15 training and 3 cross-sectional studies that met the inclusion criteria were reviewed. Grade B–level evidence indicated that older adults can significantly improve their aerobic power, lower body muscle endurance, strength and flexibility, balance, agility, and gait through dancing. Grade C evidence suggested that dancing might improve older adults’ lower body bone-mineral content and muscle power, as well as reduce the prevalence of falls and cardiovascular health risks. Further research is, however, needed to determine the efficacy of different forms of dance, the relative effectiveness of these forms of dance compared with other exercise modes, and how best to engage older adults in dance participation.

“Keywords: dance, exercise, falls, functional ability”

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Dementia prevention review

Dementia Prevention: Methodological Explanations for Inconsistent Results. Nicola Coley, Sandrine Andrieu, Virginie Gardette, Sophie Gillette-Guyonnet, Caroline Sanz, Bruno Vellas, and Alain Grand. (2008). Epidemiol Rev 30 (1): 35-66.

Abstract: “The prevention of neurodegenerative dementias, such as Alzheimer disease, is a growing public health concern, because of a lack of effective curative treatment options and a rising global prevalence. Various potential risk or preventive factors have been suggested by epidemiologic research, including modifiable lifestyle factors, such as social contacts, leisure activities, physical exercise, and diet, as well as some preventive pharmacologic strategies, such as hormone replacement therapy, nonsteroidal antiinflammatory drugs, and Ginkgo biloba. […] The aim of this paper is to review the epidemiologic data linking potential protective factors to dementia or cognitive decline and to discuss the methodological limitations that could explain conflicting results. A thorough review of the literature suggests that, even if there are consistent findings from large observational studies regarding preventive or risk factors for dementia, few randomized controlled trials have been designed specifically to prove the protective effects of interventions based on such factors on dementia incidence. Because of the multifactorial origin of dementia, it appears that multidomain interventions could be a suitable candidate for preventive interventions, but designing such trials remains very challenging for researchers.”

Below are excerpts from the section “Social contacts, leisure activities, and physical exercise.” (Dance integrates all of these aspects: social engagement, leisure and cognitive activity, and physical exercise).

Prospective longitudinal studies
“Social contacts and social engagement. Fourteen studies have found an inverse relation between the level of late-life social contacts or engagement and the risk of dementia/Alzheimer disease (76–82) or cognitive decline (83–89). Midlife social engagement was assessed by one of these studies (82) but was not found to be related to dementia risk.
Two studies (90, 91) found only certain measures of social engagement to be associated with better cognitive function, and four studies found no association between participation in social activities (92, 93) or social network or support measures (91, 94) and cognition.

“Cognitive activities in late life. Twelve studies have demonstrated a relation between increased participation in cognitive activities in late life and a decreased risk of dementia (76–78, 95), Alzheimer disease (95–98), vascular dementia (95), or cognitive decline or impairment (87, 92, 93, 97,99, 100). No studies were identified that failed to find an association between cognitive activities and outcomes, although the positive effects in one of the above-mentioned studies (87) were seen only in some specific cognitive domains.

“Physical exercise. An increased frequency or intensity of physical exercise or activities in late life was associated with a decreased risk of dementia/Alzheimer disease (76, 77, 95, 101–107) or cognitive decline/impairment in 19 studies (87, 104, 108–115). However, nine studies found no association with dementia/Alzheimer disease (78, 96,97, 116, 117) or cognitive decline/impairment (92, 118–120). Two studies examined the effects of midlife physical exercise on the risk of dementia in late life and found conflicting results (121, 122).”

Well-being and dance movement therapy interventions (including dance improvisation)

Specific dance movement therapy interventions – which are successful? An intervention and correlation study.
Iris Bräuninger. The Arts in Psychotherapy, Available online 19 August 2014, In Press, Accepted Manuscript. *Article does not have free open access.

“Highlights

•Specific DMT [Dance Movement Therapy] interventions could be identified that relate to the improvement of well-being.
•Dance Improvisation, Spatial and Effort Synchrony, and working with a Focus were effective individual DMT interventions.
•Improvement of QOL [Quality of Life], coping, stress with Psychodynamic, Chace DMT, directive-non-directive Leading and Interpersonal Closure.
•A small number of specific DMT interventions should be used cautiously until further research proves their effectiveness.
•970 intervention checklists on individual and 120 on group DMT interventions were analyzed.”

Abstract: “This intervention study examines the correlation between specific DMT interventions and the improvement in quality of life, stress management, and stress reduction. Dance therapists (N = 11) filled out 970x Intervention Checklist 1 (specific interventions at the individual level) and 120x Intervention Checklist 2 (specific interventions at the group level) while leading 10 sessions. Individual level therapists’ scoring of the Intervention Checklists were correlated with individual level clients’ scoring from the standardized questionnaires of the treatment group (n= 97). Therapists worked successfully when applying a self-selected approach and mixing in-depth DMT approaches and specific interventions. The findings show that a relationship exists between clients’ improvement in Quality of Life, coping, reduction of Stress and the use of Psychodynamic-oriented DMT, Chace approach, a combination of a Directive/Non-Directive Leadership Style, and an Interpersonal Closure. Clients’ Daily Life improved and Somatization symptoms decreased when Dance Improvisation, Spatial Synchrony, Synchrony in Efforts and working with a Focus were used. Results indicate that specific DMT interventions could be identified that relate to the improvement of well-being while some single DMT interventions should be used cautiously until further research proves their effectiveness. There is a continuing need to identify successful specific DMT interventions in future studies.”

Physical activity in preventing and managing Alzheimer’s disease

The Role of Physical Activity in the Prevention and Management of Alzheimer’s Disease—Implications for Ontario. Ontario Brain Institute. (2013).

“Approach: To better understand how physical activity can contribute to the prevention and management of Alzheimer’s disease, 871 research articles were reviewed. After closer inspection and quality scoring, 24 randomized control trials and 21 prospective cohort studies examining physical activity and Alzheimer’s disease were selected for further analysis.

“Results: Within older adults with Alzheimer’s disease, regular physical activity improved quality of life (QOL), activities of daily living (ADL), and decreased the occurrence of depression. In older adults without Alzheimer’s disease, those who were very physically active were almost 40% less likely to develop Alzheimer’s disease as those who were inactive. At the population level, it was observed that more than 1 in 7 cases of Alzheimer’s disease could be prevented if everyone who is currently inactive were to become physically active at a level consistent with current activity recommendations. On this basis, potential cost-savings (~$88 to $970 million CDN per year) in healthcare for community-dwelling older adults with Alzheimer’s disease are substantial.” (page 2)

Review of dance therapy for schizophrenia

Dance therapy for schizophrenia. 2013. Juanjuan Ren, Jun Xia. Editorial Group: Cochrane Schizophrenia Group. Published Online: 4 OCT 2013; Assessed as up-to-date: 10 JUL 2012.

 

Plain Language Summary written by Ben Gray:

“The first line of treatment of schizophrenia is usually antipsychotic drugs. Usually, these drugs are more effective in treating the ‘positive symptoms’ than ‘negative symptoms’ of schizophrenia. Moreover, antipsychotic drugs have debilitating side-effects such as weight gain, shaking, tremors and muscle stiffness.

“Dance therapy (also known as dance movement therapy, DMT) uses movement and dance to explore a person’s emotions in a non-verbal way (without language or words). The therapist helps the individual to interpret their dance and movement and link them with people’s personal feelings. Dance has been used as a healing ritual since earliest human history, but the establishment of dance therapy as a profession is quite recent. Dance therapy can be used with people of all ages, races and genders. It can be effective in the treatment of people with medical, social, developmental, physical and psychological impairments. The review included one study with 45 participants. The aim was to compare dance therapy with standard care or other interventions. The one included study compared dance therapy plus routine care with routine care alone. In the main, there was no difference between those who engaged in dance therapy versus those who did not (for outcomes such as satisfaction with care, mental state, leaving the study early, quality of life). However, those who engaged in dance therapy showed significant improvement in negative symptoms. 

“Overall, because of the small number of participants, the findings are limited. There is little evidence to support or refute the use of dance therapy. Larger studies and trials are needed that focus on important outcomes (such as rates of relapse, quality of life, admission to hospital, leaving the study early, cost of care and satisfaction with treatment). Further research would help clarify whether dance therapy is an effective and holistic treatment for people with schizophrenia, especially in terms of helping people cope with negative symptoms that do not respond so well to antipsychotic drugs.

“This summary was written by a consumer Ben Gray (Benjamin Gray, Service User and Service User Expert Rethink Mental Illness, Email:ben.gray@rethink.org).”

Physical and psychological benefits of dance

The Value of Arts and Culture to People and Society: an evidence review. Arts Council England. (2014).

The report references other reports, including:

• Keep Dancing: The health and well-being benefits of dance for older people, BUPA, 2011.
• What do we know about the role of arts in the delivery of social care?, Consilium, 2013, Skills for Care.
• Dancing toward well-being in the Third Age: Literature review on the impacts of dance on health and well-being among older adults, Trinity Laban Conservatoire of Music and Dance, 2011.

“The [Consilium] report (2013) concluded that the use of art, when delivered effectively, has the power to both facilitate social interaction and enable those in receipt of social care to pursue creative interests. The review highlights the benefits of dance for reducing loneliness and alleviating depression and anxiety among people in social care environments. Dance has the ability to promote creativity and social integration and allow nonverbal stimulation and communication. The review evidence demonstrates the considerable physical and psychological benefits of using arts with people in receipt of social care.” (page 26)

“In 2011 BUPA published the Keep Dancing report which highlighted a number of issues relating to old people and exercise, and identified the key benefits of dance. Trinity Laban Conservatoire of Music and Dance (TLCMD) published a literature review on the impact of dance on health and wellbeing in older people, also in 2011, called Dancing towards wellbeing in the Third Age.

“TLCMD’s literature review (2011) makes a distinction between dance therapy (a psychotherapeutic activity focusing more on therapeutic than artistic outcomes) and dance interventions and focuses on studies looking at dance interventions. They acknowledge that this boundary is sometimes blurred and included some therapy-weighted studies that are relevant to a dance and health research context.

“The reports from BUPA and TLCMD shared key findings relating to the physical and psychological benefits of dance. Many featured studies focused on activities that were specific to particular conditions such as arthritis, Parkinson’s, dementia and depression. The benefits of dance in relation to the prevention of falls were also evidenced (BUPA, 2011). Alongside evidenced benefits related to particular conditions, overall physical improvements include increased cardio vascular, strength and flexibility and improved balance and gait. These physical benefits vary depending on the individual participant and style of dance undertaken.

“Evidenced psychological benefits include quicker reaction times and cognitive performance”… “The physical benefits when contrasted with sports or other exercises are bolstered by the social and creative aspects which can enhance overall wellbeing. Dance activities create a sense of community and can help counter feelings of isolation. ” (page 29)

“Dance is a key component of many cultures and traditional dance activities can present a more relevant choice of activity for individuals in particular communities. Both reports reference pieces of research that highlight the value of culturally specific dance.” (page 30)