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

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

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.

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.

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.