Dance Intervention to Improve Executive Function and Physical Performance in Older Adults With Cognitive Impairment

Official title

A Pilot Study of Dance Intervention for Enhancing Executive Function and Physical Performance in Cognitively Impaired Older Adults

Overview

This pilot study investigates the effects of a music-based dance intervention on executive function and physical performance in middle-aged and older adults with cognitive impairment. Dance, as a form of dual-task training, integrates music, rhythmic movement, and cognitive-motor coordination. When combined with group interaction and partner-guided physical cues, it has the potential to enhance both cognitive and motor functions simultaneously. The intervention features a simple, structured dance sequence designed to stimulate rhythm, attention, and coordination through music-based movement. This study aims to evaluate the feasibility and preliminary efficacy of this approach in improving executive function and lower limb physical performance among individuals with cognitive impairment.

Detailed description

Mild Cognitive Impairment (MCI) is an age-related condition that affects memory, judgment, and motor performance, often leading to reduced independence and quality of life. Recent studies have emphasized the interrelationship between cognitive and motor functions, particularly in individuals with neurodegenerative conditions. Interventions that incorporate dual-task training, such as dance, have shown promise in enhancing both domains by combining rhythmic movement, memory recall, physical coordination, and social interaction.

Dance-based interventions, especially those integrating music, external cues, and partner interaction, engage multiple brain regions including the frontal cortex, cerebellum, and hippocampus. These programs stimulate sensory-motor integration and executive control, potentially improving attention, gait, balance, and cognitive flexibility. Existing evidence supports that rhythm- and music-based movement, when combined with cognitive tasks, can enhance brain function, promote emotional regulation, and improve daily functioning in cognitively impaired populations.

This study aims to examine the effects of a structured, music-based dance intervention on executive function and physical performance in middle-aged and older adults with cognitive impairment. The program integrates fixed dance routines with perceptual-motor training and social interaction.

A total of 50 middle-aged and older adults receiving outpatient rehabilitation at a medical center in northern Taiwan were recruited and randomly assigned to either the music-based dance intervention group (n = 25) or the control group (n = 25). The intervention group participated in a nine-week group-based program involving rhythmic movement, mutual physical guidance, and social interaction. The control group completed a nine-week lower limb intermittent exercise program guided by non-musical instructional videos.

Assessments were conducted at three time points: pre-intervention, mid-intervention, and post-intervention. Evaluation tools included:Four-Square Step Test (FSST), Functional Reach Test (FRT), Timed Up and Go - Cognitive (TUG-Cognitive), Montreal Cognitive Assessment (MoCA), Stroop Color and Word Test (SCWT), Modified Borg Rating of Perceived Exertion (RPE), Course feedback questionnaire. Descriptive statistics were used to summarize participant demographics. Repeated measures analysis of variance (ANOVA) was used to examine within-group and between-group differences over time. Statistical analyses were performed using SPSS Statistics 26.0, with the significance level set at α \< 0.05.

Interventions

• Behavioral Music-based dance
  The dance routines emphasized perceptual-motor training through mutual physical guidance, spatial coordination, and social interaction among participants. The intervention aimed to enhance executive function, balance, and lower limb mobility by incorporating dual-task elements that challenge memory, attention, and physical control in a dynamic, enjoyable setting.
• Behavioral Control
  The training content is delivered through standardized, non-musical instructional videos. Participants in the control group follow fixed video demonstrations to perform functional lower limb exercises. The movement components include independent lower limb strength training and balance training.

Primary outcome measures

• Montreal Cognitive Assessment [Time frame: Baseline, mid-intervention (week 5), and one week post-intervention (week 10)]

Secondary outcome measures (5)

• Four-Square Step Test [Time frame: Baseline, mid-intervention (week 5), and one week post-intervention (week 10)]
• Timed Up and Go - Cognitive [Time frame: Baseline, mid-intervention (week 5), and one week post-intervention (week 10)]
• Functional Reach Test [Time frame: Baseline, mid-intervention (week 5), and one week post-intervention (week 10)]
• Stroop Color and Word Test [Time frame: Baseline, mid-intervention (week 5), and one week post-intervention (week 10)]
• Course Feedback Questionnaire [Time frame: One week post-intervention (week 10)]

Eligibility criteria

Inclusion criteria

• Subjective Cognitive Decline (SCD) with a score ≥5 on the SCD-Q9 questionnaire, or Mild Behavioral Impairment (MBI) with a score ≥7 on the MBI-Checklist, with symptoms persisting for more than three months.
• Ability to follow instructions.
• Ability to stand unsupported or with assistive devices for at least 10 minutes.
• Ability to walk at least 10 meters, either unsupported or with assistive devices.

Exclusion Criteria:-Age below 55 years.

• Severe visual or hearing impairment.
• Score <16 on the Montreal Cognitive Assessment (MoCA).
• Emotional or anxiety symptoms caused by psychiatric medications that significantly impair the ability to perform study-related motor tasks.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Non-randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Taiwan · 1 center

• Taipei Medical University Shuang Ho Hospital — New Taipei City

Publications

• Woods B, Rai HK, Elliott E, Aguirre E, Orrell M, Spector A. Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev. 2023 Jan 31;1(1):CD005562. doi: 10.1002/14651858.CD005562.pub3. PMID 39804128
• Wang RY, Huang YC, Zhou JH, Cheng SJ, Yang YR. Effects of Exergame-Based Dual-Task Training on Executive Function and Dual-Task Performance in Community-Dwelling Older People: A Randomized-Controlled Trial. Games Health J. 2021 Oct;10(5):347-354. doi: 10.1089/g4h.2021.0057. Epub 2021 Sep 1. PMID 34491113
• Tsai JC, Chen CW, Chu H, Yang HL, Chung MH, Liao YM, Chou KR. Comparing the Sensitivity, Specificity, and Predictive Values of the Montreal Cognitive Assessment and Mini-Mental State Examination When Screening People for Mild Cognitive Impairment and Dementia in Chinese Population. Arch Psychiatr Nurs. 2016 Aug;30(4):486-91. doi: 10.1016/j.apnu.2016.01.015. Epub 2016 Jan 21. PMID 27455923
• Sanprakhon P, Suriyawong W, Longphasuk N, Khatichop N, Arpaichiraratana C, Wongwiseskul S, Rattanaselanon P, Pipatpiboon N, Thaipisuttikul P. Effects of traditional Thai folk dance combined with cognitive stimulation program on behavior and cognition among older adults with cognitive decline: A randomized controlled trial. J Prev Alzheimers Dis. 2025 Apr;12(4):100066. doi: 10.1016/j.tjpad.2025.100 PMID 39824702
• Outermans JC, van Peppen RP, Wittink H, Takken T, Kwakkel G. Effects of a high-intensity task-oriented training on gait performance early after stroke: a pilot study. Clin Rehabil. 2010 Nov;24(11):979-87. doi: 10.1177/0269215509360647. Epub 2010 Aug 18. PMID 20719820
• McGirr A, Nathan S, Ghahremani M, Gill S, Smith EE, Ismail Z. Progression to Dementia or Reversion to Normal Cognition in Mild Cognitive Impairment as a Function of Late-Onset Neuropsychiatric Symptoms. Neurology. 2022 May 24;98(21):e2132-e2139. doi: 10.1212/WNL.0000000000200256. Epub 2022 Mar 29. PMID 35351783
• Lazarou I, Parastatidis T, Tsolaki A, Gkioka M, Karakostas A, Douka S, Tsolaki M. International Ballroom Dancing Against Neurodegeneration: A Randomized Controlled Trial in Greek Community-Dwelling Elders With Mild Cognitive impairment. Am J Alzheimers Dis Other Demen. 2017 Dec;32(8):489-499. doi: 10.1177/1533317517725813. Epub 2017 Aug 25. PMID 28840742
• Ilardi CR, Federico G, La Marra M, Amato R, Iavarone A, Soricelli A, Santangelo G, Chieffi S. Deficits in reaching movements under visual interference as a novel diagnostic marker for mild cognitive impairment. Sci Rep. 2025 Jan 14;15(1):1901. doi: 10.1038/s41598-025-85785-7. PMID 39805990

Identifiers

NCT: NCT07105800 · TMU-JIRBN202507032

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗