Abstract
A physically active lifestyle has the potential to prevent cognitive decline and dementia, yet the optimal type of physical activity/exercise remains unclear. Dance is of special interest as it complex sensorimotor rhythmic activity with additional cognitive, social, and affective dimensions. To determine whether dance benefits executive function more than walking, an activity that is simple and functional. Two-arm randomized controlled trial among community-dwelling older adults. The intervention group received 1 h of ballroom dancing twice weekly over 8 months (~69 sessions) in local community dance studios. The control group received a combination of a home walking program with a pedometer and optional biweekly group-based walking in local community park to facilitate socialization. Executive function tests: processing speed and task shift by the Trail Making Tests, response inhibition by the Stroop Color-Word Test, working memory by the Digit Span Backwards test, immediate and delayed verbal recall by the Rey Auditory Verbal Learning Test, and visuospatial recall by the Brief Visuospatial Memory Test (BVST). One hundred and fifteen adults (mean 69.5 years, SD 6.4) completed baseline and delayed baseline (3 weeks apart) before being randomized to either dance (n = 60) or walking (n = 55). Of those randomized, 79 (68%) completed the follow-up measurements (32 weeks from baseline). In the dance group only, "non-completers" had significantly lower baseline scores on all executive function tests than those who completed the full program. Intention-to-treat analyses showed no group effect. In a random effects model including participants who completed all measurements, adjusted for baseline score and covariates (age, education, estimated verbal intelligence, and community), a between-group effect in favor of dance was noted only for BVST total learning (Cohen's D Effect size 0.29, p = 0.07) and delayed recall (Cohen's D Effect size = 0.34, p = 0.06). The superior potential of dance over walking on executive functions of cognitively healthy and active older adults was not supported. Dance improved one of the cognitive domains (spatial memory) important for learning dance. Controlled trials targeting inactive older adults and of a higher dose may produce stronger effects, particularly for novice dancers. Australian and New Zealand Clinical Trials Register (ACTRN12613000782730).
Highlights
A physically active lifestyle has the potential to prevent cognitive decline and dementia, yet the optimal type of physical activity/exercise remains unclear
Complex motor skills cannot be mastered in a single practice session as they involve unpredictable and changing environments where the person and/ or object are in motion, such as ball sports, dance, and martial arts (Gentile, 1972; Kraft et al, 2015)
Retention to study end was slightly lower in the dance group (66%) than the walking group (69%) due to the greater number of participants lost to follow-up in that group
Summary
A physically active lifestyle has the potential to prevent cognitive decline and dementia, yet the optimal type of physical activity/exercise remains unclear. Dance is of special interest as it complex sensorimotor rhythmic activity with additional cognitive, social, and affective dimensions. Focusing only on measures of fitness to assess the impact of exercise on cognition is not sensitive to the fact that physical activities vary considerably in the degree of sensorimotor complexity, cognitive demand, and social interaction that they entail. These factors may significantly modify the effects of physical activity on the aging brain regardless of changes in fitness. Complex motor skills cannot be mastered in a single practice session as they involve unpredictable and changing environments where the person and/ or object are in motion, such as ball sports, dance, and martial arts (Gentile, 1972; Kraft et al, 2015)
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