Enhancing postural, sensorimotor and cognitive performance in elderly people

Six months of dance intervention enhances postural, sensorimotor, and cognitive performance in elderly without affecting cardio-respiratory functions. 2013. Kattenstroth JC, Kalisch T, Holt S, Tegenthoff M, Dinse HR. Frontiers in Aging Neuroscience. 2013 Feb 26; 5:5.

Abstract: “During aging, sensorimotor, cognitive and physical performance decline, but can improve by training and exercise indicating that age-related changes are treatable. Dancing is increasingly used as an intervention because it combines many diverse features making it a promising neuroplasticity-inducing tool. We here investigated the effects of a 6-month dance class (1 h/week) on a group of healthy elderly individuals compared to a matched control group (CG). We performed a broad assessment covering cognition, intelligence, attention, reaction time, motor, tactile, and postural performance, as well as subjective well-being and cardio-respiratory performance. After 6 months, in the CG no changes, or further degradation of performance was found. In the dance group, beneficial effects were found for dance-related parameters such as posture and reaction times, but also for cognitive, tactile, motor performance, and subjective well-being. These effects developed without alterations in the cardio-respiratory performance. Correlation of baseline performance with the improvement following intervention revealed that those individuals, who benefitted most from the intervention, were those who showed the lowest performance prior to the intervention. Our findings corroborate previous observations that dancing evokes widespread positive effects. The pre-post design used in the present study implies that the efficacy of dance is most likely not based on a selection bias of particularly gifted individuals. The lack of changes of cardio-respiratory fitness indicates that even moderate levels of physical activity can in combination with rich sensorimotor, cognitive, social, and emotional challenges act to ameliorate a wide spectrum of age-related decline.”
“KEYWORDS: VO2max; balance; cognition; dance therapy; enriched environment; intervention; sensorimotor; successful aging”

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Amateur dancing & superior sensory, motor and cognitive performance in elderly individuals

Superior Sensory, Motor, and Cognitive Performance in Elderly Individuals with Multi-Year Dancing Activities. 2010. Jan-Christoph Kattenstroth, Izabella Kolankowska, Tobias Kalisch, and Hubert R. Dinse. Frontiers in Aging Neuroscience. 2010; 2: 31.

Abstract: “Aging is associated with a progressive decline of mental and physical abilities. Considering the current demographic changes in many civilizations there is an urgent need for measures permitting an independent lifestyle into old age. The critical role of physical exercise in mediating and maintaining physical and mental fitness is well-acknowledged. Dance, in addition to physical activity, combines emotions, social interaction, sensory stimulation, motor coordination and music, thereby creating enriched environmental conditions for human individuals. Here we demonstrate the impact of multi-year (average 16.5 years) amateur dancing (AD) in a group of elderly subjects (aged 65–84 years) as compared to education-, gender- and aged-matched controls (CG) having no record of dancing or sporting activities. Besides posture and balance parameters, we tested reaction times, motor behavior, tactile and cognitive performance. In each of the different domains investigated, the AD group had a superior performance as compared to the non-dancer CG group. Analysis of individual performance revealed that the best participants of the AD group were not better than individuals of the CG group. Instead, the AD group lacked individuals showing poor performance, which was frequently observed for the CG group. This observation implies that maintaining a regular schedule of dancing into old age can preserve cognitive, motor and perceptual abilities and prevent them from degradation. We conclude that the far-reaching beneficial effects found in the [amateur dancing] group make dance, beyond its ability to facilitate balance and posture, a prime candidate for the preservation of everyday life competence of elderly individuals.”

“Keywords: aging, dance, successful aging, plasticity, neurotrophic factors, intervention, seniors, enriched environment”

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).”

Promoting successful cognitive aging

Enrichment effects on adult cognitive development; Can the functional capacity of older adults be preserved and enhanced?. Hertzog, C., Kramer, A. F., Wilson, R. S., & Lindenberger, U. (2008). Psychological Science in the Public Interest, 9(1), 1-65.

Some excerpts from the abstract:

“We begin with a theoretical framework that emphasizes the potential of behavior to influence levels of cognitive functioning. According to this framework, the undeniable presence of age-related decline in cognition does not invalidate the view that behavior can enhance cognitive functioning.

“We conclude that, on balance, the available evidence favors the hypothesis that maintaining an intellectually engaged and physically active lifestyle promotes successful cognitive aging.

“The longitudinal evidence consistently shows that engaging in intellectually stimulating activities is associated with better cognitive functioning at later points in time. Other studies show that meaningful social engagement is also predictive of better maintenance of cognitive functioning in old age. These longitudinal findings are also open to important rival explanations, but overall, the available evidence suggests that activities can postpone decline, attenuate decline, or provide prosthetic benefit in the face of normative cognitive decline, while at the same time indicating that late-life cognitive changes can result in curtailment of activities.

“Third, there is a parallel literature suggesting that physical activity, and aerobic exercise in particular, enhances older adults’ cognitive function. Unlike the literature on an active lifestyle, there is already an impressive array of work with humans and animal populations showing that exercise interventions have substantial benefits for cognitive function, particularly for aspects of fluid intelligence and executive function. Recent neuroscience research on this topic indicates that exercise has substantial effects on brain morphology and function, representing a plausible brain substrate for the observed effects of aerobic exercise and other activities on cognition.”

Lower risk of dementia

Leisure Activities and the Risk of Dementia in the Elderly. Joe Verghese, M.D., Richard B. Lipton, M.D., Mindy J. Katz, M.P.H., Charles B. Hall, Ph.D., Carol A. Derby, Ph.D., Gail Kuslansky, Ph.D., Anne F. Ambrose, M.D., Martin Sliwinski, Ph.D., and Herman Buschke, M.D. (2003). New England Journal of Medicine, 348: 2508-2516.

In the study of 469 people, “Dancing was the only physical activity associated with a lower risk of dementia.”

Participants were interviewed starting in 1980 about their participation in “6 cognitive activities (reading books or newspapers, writing for pleasure, doing crossword puzzles, playing board games or cards, participating in organized group discussions, and playing musical instruments) and 11 physical activities (playing tennis or golf, swimming, bicycling, dancing, participating in group exercises, playing team games such as bowling, walking for exercise, climbing more than two flights of stairs, doing housework, and babysitting).” (Table of the various activities).

The study found that “There was no association between physical activity and the risk of dementia. Exercise is said to have beneficial effects on the brain by promoting plasticity, increasing the levels of neurotrophic factors in the brain, and enhancing resistance to insults. Cognitive and physical activities overlap, and therefore it is not surprising that previous studies have disagreed on the role of physical activities. Although physical activities are clearly important in promoting overall health, their protective effect against dementia remains uncertain.” (See the footnotes in the article for references for each of those sentences.)