Pilot Randomized‐Controlled Trial of Social Ballroom Dancing in Dementia‐At‐Risk Older Adults

Abstract

AbstractBackgroundExecutive functions (EF) such as planning, problem‐solving, and organization are often impaired in Alzheimer’s disease (AD). This pilot trial examined the safety and efficacy of social ballroom dancing for improving EF in older adults at increased risk for AD and related dementias. We hypothesized that the added social and cognitive demands of ballroom dancing would lead to greater intervention‐related changes in EF than a traditional aerobic activity (treadmill‐walking) – because it furthers neuroplasticity.MethodA single‐blind pilot randomized controlled trial (clinicaltrials.gov: NCT03475316) contrasted 6‐months (90 minutes twice a week) of social ballroom dancing with 6 months (90 minutes twice a week) of treadmill walking in dementia‐at‐risk older adults. Dementia‐at‐risk was defined as a memory impairment screen score of ≥3 and ≤6, and/or an AD‐8 dementia screening interview score of ≥1. A composite EF score generated from digit‐symbol substitution (DSST), flanker interference, and walking‐while‐talking tasks was the primary outcome. Functional neuroplasticity during fMRI‐adapted versions of these EF tests were secondary outcomes. The intention‐to‐treat principle was applied to all linear‐mixed effects analyses.ResultTwenty‐five participants were randomized between June 2019 and March 2020. The mean age was 76.45 years. 66% were women, 48% White/Caucasian, 24% Black/African‐American and 20% Hispanic/Latino. Sixteen participants (8 in each study arm) completed the intervention prior to study termination due to COVID‐19. The most common (mild) adverse event was falls (social dancing = 4; treadmill walking = 1), but no falls occurred during intervention sessions. No serious study‐related adverse events were reported. No between‐group differences were observed on the composite EF measure – although social dancing generated greater improvements on DSST than treadmill walking (6.57 correct items more; SE = 2.77, 95% CI = .46; 12.67, p = .02. No between‐group differences were observed in functional activation/deactivation patterns during EF tasks. Hippocampal volume, however, showed less atrophy following social dancing arm than treadmill walking (SE = 109.42; 95% CI = 58.29; 487.22, p = .01).ConclusionSocial ballroom dancing is a safe intervention for dementia‐at‐risk older adults. This clinical trial provides preliminary evidence that social dancing improves performance on one test of EF (DSST), and promotes hippocampal neuroplasticity – but these findings need to be confirmed in larger clinical trials.