Effects of Dance Movement Intervention on Elderly with Early Dementia: Preliminary Results of a Randomized Controlled Trial

Abstract

Background: Dementia describes a clinical syndrome that encompasses difficulties in memory, language, and impairments in daily activities, often accompanied by anxiety and depression symptoms. The primary objective of non-pharmacological interventions is to minimize psychosocial disturbances and slow disease progression. This study aims to examine the effects of dance movement intervention which combines psychotherapeutic elements with the well-established benefits of physical activity on elderly with early dementia. Methods: A total of 204 Chinese elderly with early dementia, defined as individuals aged 65 or above with clinical dementia rating (CDR) of 0.5 to 1, were randomised into dance-movement therapy (DMT), physical exercises (EX) and waitlist control (Control). Both DMT and EX groups received a 12-week semiweekly intervention, with each session lasting for one hour. Cognitive functioning was measured via cognitive tests (Digit Span Test, Fuld Object Memory Evaluation and Trail Making Test) whereas psychosocial well-being and daily functioning were measured using self-reported scales (Abbreviated Geriatric Depression Scale, de Jong Gierveld Loneliness Scale, Visual Analogue Scale, and Lawton Instrumental Activities of Daily Living). Neuropsychiatric symptoms were measured via an informant reported scale (Neuropsychiatric Inventory). Assessments were performed before randomization, post-intervention (3-month), at 6-month, and at 12-month. Preliminary data from baseline and 3-month were analysed using linear mixed-model (LMM), to preserve intention-to-treat principle using maximum likelihood estimation. Results: The mean age of the sample was 79.1 years old and the majority of them were female (82%), widowed (54%), with no formal education (36%). Using a linear mixed model with Subjects as random effects, significant Group X Time effects were found in depressive symptoms [F(2, 195)= 3.76, p= .025], loneliness [F(2, 196)= 6.28, p= .002], daily functioning [F(2, 197)= 4.39, p= .014], and negative mood [F(2, 196)= 3.18, p= .044]. Pairwise comparisons using Bonferroni test set at p<.016 showed significant improvements in depressive symptoms, loneliness and daily functioning but not negative mood in the DMT group compared to the Control group. The improvement in loneliness of the DMT group was also significantly greater than the EX group. None of the changes of the EX group were significantly different from the Control group. No significant Group X Time effects were found in cognitive functioning. Discussion: The preliminary findings suggested that DMT may have therapeutic effects in elderly with dementia in comparison to Control, particularly on psychosocial well-being and daily functioning. This study is still ongoing. Follow-up data will be collected from the participants to study the long-term effects of DMT and EX on the progression of dementia.