Social Dance Therapy for Early Alzheimer's Disease

Overseen By Madeleine Hackney, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Emory University

Must be taking: Aricept, Anticholinesterase inhibitors

Must not be taking: Antipsychotics, Opioids, Stimulants, others

Disqualifiers: Stroke, Uncontrolled hypertension, Diabetes, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 56

66 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial requires that participants are not on medications that could negatively affect cognition, such as antipsychotics, opioids, stimulants, and certain drugs for Parkinson's and multiple sclerosis. Participants must also be on stable doses of medications like Aricept or Namenda for at least 3 months before joining the study.

What data supports the effectiveness of the treatment Social Dance Therapy for Early Alzheimer's Disease?

Research shows that rhythmic auditory cues and music therapy can improve walking speed and stride length in Alzheimer's patients, and dance-based treatments like Biodanza and Salsa have been effective in reducing agitation and improving balance and gait. Combining music and physical rehabilitation has also shown positive effects on cognitive and motor functions in Alzheimer's patients. ^{1 2 3 4 5}

Is social dance therapy safe for people with Alzheimer's disease?

Research shows that social dance therapy, including programs like Salsa dance and music-cued gait training, is generally safe for people with Alzheimer's disease. Studies found no adverse events, and participants reported high satisfaction with the activities. ^{1 2 3 6 7}

How is the Social Dance Therapy treatment for early Alzheimer's disease different from other treatments?

Social Dance Therapy, including Partnered Rhythmic Rehabilitation (PRR), is unique because it combines movement, social interaction, and cognitive stimulation, which can improve mood and behavior in people with early Alzheimer's disease. Unlike traditional drug treatments, this non-pharmacological approach focuses on enhancing quality of life through dance and social engagement. ^{2 7 8 9 10}

What is the purpose of this trial?

Interventions that affect many different aspects of human ability rather than just one aspect of human health are more likely to be successful in preventing and treating Alzheimer's disease (AD). Functional decline in AD is severely impacted by impaired ability to do physical actions while having to make decisions and concentrating, something scientists call motor-cognitive integration. Combined motor and cognitive training has been recommended for people with early AD, thus this study will use partnered, rhythmic rehabilitation (PRR), as an intervention to simultaneously target cardiovascular, social and motor-cognitive domains important to AD. PRR is moderate intensity, cognitively-engaging social dance that targets postural control systems, involves learning multiple, varied stepping and rhythmic patterns, and fosters tactile communication of motor goals between partners, enhancing social interaction's effect on cognition. Previous research demonstrates that PRR classes are safe and result in no injurious falls. This study is a 12-month long Phase II single- blind randomized clinical trial using PRR in 66 patients with early AD. Participants with early AD will be randomly assigned to participate in PRR or a walking program for three months of biweekly sessions, followed by nine months of weekly sessions of PRR or walking. The overarching hypothesis is that PRR is safe, tolerable and associated with improved motor-cognitive function, and brain (neuronal), vascular (blood vessels) and inflammatory biomarkers that might affect function.

Research Team

Madeleine Hackney, MD

Principal Investigator

Emory University

Eligibility Criteria

This trial is for individuals with early Alzheimer's Disease who can walk unaided, have a certain level of cognitive function and memory concern, completed at least six grades of education or have a solid work history, are not very physically active, and willing to commit to a year-long research program. Those with severe mental health issues, recent hospitalization or conditions that could interfere with the study cannot participate.

Inclusion Criteria

I have been diagnosed with mild memory loss (MCI) according to ADNI standards.

I can perform daily activities without significant assistance.

You have completed six grades of education or have a good work history.

Exclusion Criteria

I have had a stroke within the last three years.

I cannot undergo the procedures required in this study.

Inability to perform MRI (e.g. metal implants or cardiac pacemaker, claustrophobia)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Participants are assigned to 20 biweekly 90-minute lessons over 12 weeks, focusing on either PRR or WALK interventions.

12 weeks

20 visits (in-person)

Maintenance

Participants attend weekly lessons at least 3 times per month for 9 months, continuing with either PRR or WALK interventions.

9 months

At least 36 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the intervention period.

4 weeks

Treatment Details

Interventions

• Group walking (WALK)
• Partnered Rhythmic Rehabilitation (PRR)

Trial Overview The trial tests Partnered Rhythmic Rehabilitation (PRR), which is social dance aimed at improving cardiovascular health, motor-cognitive functions and social interaction against group walking. It's a 12-month Phase II trial where participants do biweekly sessions for three months followed by weekly sessions for nine months.

Participant Groups

Group I: Partnered Rhythmic Rehabilitation (PRR) Experimental Treatment 1 Intervention

Participants in this study are will receive the PRR intervention. Participants will have two phases of intervention. In the three-month Training phase, participants will be assigned to 20, biweekly (90-minute) lessons over 12 weeks. In the nine-month Maintenance phase, participants will attend weekly lessons at least 3 times per month.

Group II: Group walking (WALK) Active Control 1 Intervention

Participants in this study are will receive the WALK intervention. Participants will have two phases of intervention. In the three-month Training phase, participants will be assigned to 20, biweekly (90-minute) lessons over 12 weeks. In the nine-month Maintenance phase, participants will attend weekly lessons at least 3 times per month.

Who Is Running the Clinical Trial?

Emory University

Lead Sponsor

Trials

1,735

Recruited

2,605,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Findings from Research

An 84-year-old woman with multiple health issues, including Alzheimer's and a history of falls, participated in 24 Salsa dance therapy sessions over 12 weeks, leading to significant improvements in her balance, strength, and mobility.

After the therapy, she experienced only one fall during treatment with no injuries, and reported no falls six months later, suggesting that Salsa dance therapy may effectively reduce fall risk in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of Salsa dance on balance, gait, and fall risk in a sedentary patient with Alzheimer's dementia, multiple comorbidities, and recurrent falls. Abreu, M., Hartley, G.[2022]

In a pilot study involving 16 institutionalized older adults with Alzheimer's disease, the Biodanza intervention, which is a nonpharmacological dance movement therapy, significantly reduced agitation and neuropsychiatric behaviors.

The promising results suggest that Biodanza could be a beneficial therapeutic approach for improving the well-being of individuals with Alzheimer's, warranting further effectiveness studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Biodanza as a Nonpharmacological Dance Movement-Based Treatment in Older People With Alzheimer's Disease: An Italian Pilot Study in 2 Tuscan Nursing Homes. Chiesi, F., Gori, E., Collini, F., et al.[2023]

A home-based gait training program using rhythmic auditory cues was found to be feasible and safe for individuals with mild to moderate Alzheimer's disease, with no adverse events reported during the study.

Participants showed significant improvements in walking speed and stride length after the 4-week intervention, indicating that music-cued training can help maintain mobility in people living with Alzheimer's.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and Outcomes. Wittwer, JE., Winbolt, M., Morris, ME.[2020]

In a study involving 28 elderly patients with mild Alzheimer's disease, combining music therapy (MT) and physical rehabilitation (PR) for four months led to the greatest improvements in both cognitive and motor functions compared to other treatment groups.

Music therapy was found to significantly enhance cognitive function, while physical rehabilitation had a more pronounced effect on motor skills, suggesting that a combined approach may be the most effective treatment strategy for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Remediation of cognitive and motor functions in Tunisian elderly patients with mild Alzheimer's disease: implications of music therapy and/or physical rehabilitation. Chéour, S., Chéour, C., Gendreau, T., et al.[2023]

A music-supported video-based group exercise program was found to be feasible for older adults with moderate Alzheimer's disease, with an impressive participation rate of 84.1%.

The quality of exercise performance was consistently above acceptable levels, suggesting that the combination of music and video effectively maintained attention and motivation among participants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A physical exercise program using music-supported video-based training in older adults in nursing homes suffering from dementia: a feasibility study. Spildooren, J., Speetjens, I., Abrahams, J., et al.[2019]

A 3-month group balance training program specifically designed for individuals with Alzheimer disease (IwAD) significantly improved balance and mobility, as shown by enhanced scores on the Berg Balance Scale (BBS) and Timed Up and Go (TUG) tests.

While cognitive function, measured by the Mini-Mental Status Examination (MMSE), did not decline during the training, there was a noted decline after the intervention, suggesting that the balance training may have a protective effect on cognition during the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Group Balance Training Specifically Designed for Individuals With Alzheimer Disease: Impact on Berg Balance Scale, Timed Up and Go, Gait Speed, and Mini-Mental Status Examination. Ries, JD., Hutson, J., Maralit, LA., et al.[2015]

The pilot study of the IMOVE trial involved 10 dyads (people with mild cognitive impairment or early-stage dementia and their caregivers) participating in an 8-week improvisational dance intervention, which showed promising increases in quality of life and balance.

Participants attended classes 96% of the time and reported feeling socially connected, while brain imaging indicated improvements in brain network characteristics, suggesting that dance may enhance cognitive and social engagement in individuals with dementia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improvisational Movement to Improve Quality of Life in Older Adults With Early-Stage Dementia: A Pilot Study. Thumuluri, D., Lyday, R., Babcock, P., et al.[2022]

Dance movement therapy significantly improves cognitive impairment in patients with neurological diseases, particularly in those with Parkinson's disease, but does not show benefits for depression, fatigue, or apathy.

The therapy is effective in the rehabilitation of various neurological conditions, including post-stroke recovery, multiple sclerosis, Huntington's disease, and spinal cord injury, highlighting its broad applicability in neurological rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Dance therapy in the rehabilitation of neurological diseases]. Sivertseva, SA., Anfilofeva, KS., Zotova, AV., et al.[2022]

The DANCIN intervention, which involves Latin Ballroom dance therapy, showed potential in improving mood and reducing problematic behaviors in residents with mild to moderate dementia, as evidenced by changes in 21 items on the Dementia Mood Assessment Scale (DMAS).

Out of the seven participants, most experienced a small to medium magnitude of positive change, indicating that DANCIN could be a beneficial therapeutic approach for enhancing well-being in dementia care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychomotor Dance Therapy Intervention (DANCIN) for people with dementia in care homes: a multiple-baseline single-case study. Guzmán, A., Freeston, M., Rochester, L., et al.[2019]

Dance interventions, referred to as Dance-Specific Activity (DSA), show a positive tendency in improving neuropsychiatric symptoms in people with dementia, although the evidence is limited and the studies reviewed were of generally low quality.

DSA appears to be a safe non-pharmacological therapy for individuals with dementia, with no exacerbation of symptoms reported in the trials, suggesting it can be a viable option in dementia care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dance-Specific Activity in People Living With Dementia: A Conceptual Framework and Systematic Review of Its Effects on Neuropsychiatric Symptoms. Schroeder, H., Haussermann, P., Fleiner, T.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

The effects of Salsa dance on balance, gait, and fall risk in a sedentary patient with Alzheimer's dementia, multiple comorbidities, and recurrent falls. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Biodanza as a Nonpharmacological Dance Movement-Based Treatment in Older People With Alzheimer's Disease: An Italian Pilot Study in 2 Tuscan Nursing Homes. [2023]

3. Switzerland pubmed.ncbi.nlm.nih.gov

Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and Outcomes. [2020]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Remediation of cognitive and motor functions in Tunisian elderly patients with mild Alzheimer's disease: implications of music therapy and/or physical rehabilitation. [2023]

5. Germany pubmed.ncbi.nlm.nih.gov

A physical exercise program using music-supported video-based training in older adults in nursing homes suffering from dementia: a feasibility study. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Group Balance Training Specifically Designed for Individuals With Alzheimer Disease: Impact on Berg Balance Scale, Timed Up and Go, Gait Speed, and Mini-Mental Status Examination. [2015]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Improvisational Movement to Improve Quality of Life in Older Adults With Early-Stage Dementia: A Pilot Study. [2022]

8. Russia (Federation) pubmed.ncbi.nlm.nih.gov

[Dance therapy in the rehabilitation of neurological diseases]. [2022]

9. England pubmed.ncbi.nlm.nih.gov

Psychomotor Dance Therapy Intervention (DANCIN) for people with dementia in care homes: a multiple-baseline single-case study. [2019]

10. United States pubmed.ncbi.nlm.nih.gov

Dance-Specific Activity in People Living With Dementia: A Conceptual Framework and Systematic Review of Its Effects on Neuropsychiatric Symptoms. [2023]