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”

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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).”

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.”

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)

Young adults with autism spectrum mirroring in movement

Fixing the mirrors: A feasibility study of the effects of dance movement therapy on young adults with autism spectrum disorder. Sabine C Koch, Laura Mehl, Esther Sobanski, Maik Sieber, Thomas Fuchs. (2014). Autism . 02/2014 (E-pub ahead of print).

ABSTRACT: “From the 1970s on, case studies reported the effectiveness of therapeutic mirroring in movement with children with autism spectrum disorder. In this feasibility study, we tested a dance movement therapy intervention based on mirroring in movement in a population of 31 young adults with autism spectrum disorder (mainly high-functioning and Asperger’s syndrome) with the aim to increase body awareness, social skills, self-other distinction, empathy, and well-being. […] After the treatment, participants in the intervention group reported improved well-being, improved body awareness, improved self-other distinction, and increased social skills. The dance movement therapy-based mirroring approach seemed to address more primary developmental aspects of autism than the presently prevailing theory-of-mind approach. Results suggest that dance movement therapy can be an effective and feasible therapy approach for autism spectrum disorder, while future randomized control trials with bigger samples are needed.”

“Keywords: autism spectrum disorder, embodiment, dance movement therapy, mirroring, clinical controlled trial, treatment manual, intersubjectivity, social competence, empathy, well-being, self-other distinction, body awareness”

Dance-movement therapy with unhoused men

In Search of a Voice: Working with Homeless Men. Judith Ginzberg. (1991). American Journal of Dance Therapy Spring/Summer 1991, Volume 13, Issue 1, pp 33-48.

From the abstract: “The process of establishing dance/movement therapy in two shelters [in New York City] is described. The initial goals delineated are: establishing trust, reducing tension, enhancing self-esteem, facilitating self-expression and creativity, and promoting group interaction and understanding among the homeless men. The importance of being able to work with large groups of 50 to 200 individuals in order to transform the environment and effect the greatest numbers is posited, and the methods are discussed. Ritual, rhythm, and the use of appropriate music, as well as the occasional use of props are cited as important factors.”

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.)