Social Dancing Intervention for older adults at high risk of Alzheimer's disease and other dementias: A pilot study

Dancing is a complex sensorimotor rhythmic activity integrating physical, cognitive and social elements with the potential to ameliorate a wide range of physiological and cognitive impairments in older individuals at risk of Alzheimer?s disease and related dementias. Despite its popularity, there is a paucity of studies that have systematically examined social dancing?s role in preventing or delaying cognitive decline as well as Alzheimer?s disease and related dementia. We propose to conduct a pilot six-month single-blind randomized controlled trial (RCT) of social (ballroom) dancing and active control (walking) interventions in 32 older adults at risk for Alzheimer?s disease and related dementias. Dementia risk status is defined using established cognitive screeners. Our overall hypothesis is that social dancing in vulnerable older adults will induce neuroplasticity that will enhance cognitive processes such as executive function, speed of processing, and attention; reducing dementia risk as well as improving everyday behaviors. Our objective for this pilot trial is to examine feasibility as well as obtain preliminary data on intervention effects (trajectory and asymptote) on executive function to design a full-scale RO1. We will examine post- intervention changes in executive function, attention and processing speed measured using a battery of conventional standardized (Digit symbol substitution test), computerized (Flanker test), and cognitive-motor (Walking While Talking) tests to capture different facets of this broad cognitive domain (that would not be possible with a single test). Executive functions is an umbrella term for the management of cognitive processes, including working memory, reasoning, task flexibility, and problem solving, which is central to planning, goal-directed action, and coordination of complex locomotion and other everyday behaviors. Impairment of executive functions and related processes such as speed of processing and attention is seen early in the course of Alzheimer?s disease and related dementias, and is associated with difficulty in performing daily activities and increased risk of adverse events such as falls. Encouragingly, aerobic exercise has been reported to enhance cognitive performance, especially executive function. However, participation rates in exercise is very low among American seniors; warranting examination of other sustainable physical leisure activities. We will also examine improvement on other cognitive processes, mobility measures, quality of life, mood and falls to inform the design of future studies to prevent Alzheimer?s disease and related dementias. Our secondary aim is to explore functional and structural neuroplasticity for cognitive benefits of social dancing in seniors at risk for dementia. To investigate neuroplasticity in structural connectivity patterns, we will use diffusion-weighted imaging, which are responsive to social dancing and physical interventions. Social dancing appeals to older adults, has intrinsic value and high potential for long-term sustainability. This RCT will provide the evidence base to support prescription of this enjoyable intervention to prevent age related cognitive and mobility decline in older adults at high risk of Alzheimer?s disease and related dementias.