Abstract
Alzheimer's disease has profound effects on quality of life, affecting not only cognition, but mobility and opportunities for social engagement. Dance is a form of movement that may be uniquely suited to help maintain quality of life for older adults, including those with dementia, because it inherently incorporates movement, social engagement, and cognitive stimulation. Here, we describe the methods and results of the pilot study for the IMOVE trial (NCT03333837, www.clinicaltrials.gov), a clinical trial designed to use improvisational dance classes to test the effects of movement and social engagement in people with mild cognitive impairment (MCI) or early-stage dementia. The pilot study was an 8-week investigation into the feasibility and potential effects of an improvisational dance intervention on people with MCI or early-stage dementia (PWD/MCI) and their caregivers (CG). The pilot aimed to assess changes in quality of life, balance, mood, and functional brain networks in PWD/MCI and their CG. Participants were recruited as dyads (pairs) that included one PWD/MCI and one CG. Ten total dyads were enrolled in the pilot study with five dyads assigned to the usual care control group and five dyads participating in the dance intervention. The intervention arm met twice weekly for 60 min for 8 weeks. Attendance and quality of life assessed with the Quality of Life in Alzheimer's disease (QoL-AD) questionnaire were the primary outcomes. Secondary outcomes included balance, mood and brain network connectivity assessed through graph theory analysis of functional magnetic resonance imaging (fMRI). Class attendance was 96% and qualitative feedback reflected participants felt socially connected to the group. Increases in quality of life and balance were observed, but not mood. Brain imaging analysis showed increases in multiple brain network characteristics, including global efficiency and modularity. Further investigation into the positive effects of this dance intervention on both imaging and non-imaging metrics will be carried out on the full clinical trial data. Results from the trial are expected in the summer of 2022.
Highlights
Alzheimer’s disease (AD) is the most prevalent form of dementia, the most common neurodegenerative disease in older adults, and the 6th leading cause of death in the United States
Emerging evidence suggests that dance may increase brain volumes (Rehfeld et al, 2018; Rektorova et al, 2020), structural connectivity (Burzynska et al, 2017), brain-derived neurotrophic factor (BDNF) (Rehfeld et al, 2018), and functional connectivity (Zilidou et al, 2018; Balazova et al, 2021) in older adults
One dyad in the intervention group identified as Black and the remainder identified as White
Summary
Alzheimer’s disease (AD) is the most prevalent form of dementia, the most common neurodegenerative disease in older adults, and the 6th leading cause of death in the United States. The intervention used the IMPROVment R method, which is grounded in 4 principles of improvisation that shape the tone of the class: non-judgment, non-competitiveness, curiosity, and playfulness (Batson et al, 2016) This method was used in a previous study (Batson et al, 2014), which showed improved balance and mobility in people with Parkinson’s disease, as well as markedly changed functional brain network architecture in the one individual scanned. We further hypothesized that participants in the dance group would show increased connectivity in networks involved with movement and mood, somatomotor regions and the default mode network Results of this pilot study are reported here, but should not be interpreted as definitive outcomes given the extremely limited sample size and the pilot nature of the trial
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