Effects of dance on physical and psychological well-being in older persons

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Abstract

This study was aimed at determining the effects of dancing on the health status of older persons. A pool of 111 community-dwelling subjects were allocated to either an intervention group (IG), which included 23 sessions of dance over 12 weeks, or a control group (CG). All participants were assessed at baseline and 12 weeks. Physical outcome measures included the 6-min timed walking test (6MWT), trunk flexibility, body composition, lower limb endurance and strength, balance, the timed up-and-go test (TUG), resting heart rate and blood pressure. Quality of life was assessed by the Medical Outcomes Survey Short Form (SF-36) questionnaire. The IG’s views toward dancing were also evaluated at 12 weeks. Significant difference was observed between the groups in six outcome measures: mean change in resting heart rate, 6MWT, TUG, lower limb endurance and the ‘general health’ and ‘bodily pain’ domains of SF-36. The majority of the dance group felt the intervention improved their health status. These findings demonstrate that dancing has physical and psychological benefits, and should be promoted as a form of leisure activity for senior citizens.

Introduction

Population aging is becoming prominent in many developed countries due to declining natural growth, low fertility rate, low mortality rate and long life expectancy (Kart and Kinney, 2001). In Hong Kong, 11.1% (0.75 million) of the population was over the age of 65 in 2001 (Hong Kong Census, 2001). By 2031, this figure is expected to reach 2.1 million, or 24.3% of the population (Hong Kong Social Welfare Department Elderly Services, 2008). Consequently, demands on social services, housing and health care are expected to rise.

In view of this, there is growing concern and interest in health promotion and disease prevention in older persons. The focus of aging is shifting from disease, disability, death and dementia to “successful aging.” The concept of “successful aging” was introduced by Rowe and Kahn (1997), who defined it as the ability to maintain three key behaviors: (1) low risk of disease and disease-related disability, (2) high mental and physical function and (3) active engagement with life. Nonetheless, researchers studying successful aging often tend to only select older persons with minimal disability or high levels of physical function (Guralnik and Kaplan, 1989, Strawbridge et al., 1996). A study of older people in Hong Kong showed that life satisfaction was negatively correlated with the presence of chronic illness and functional impairment (Kwan and Ip, 1996). Hence, a “prevention is better than cure” approach is preferred in the promotion of successful aging.

Health promotion is defined as the collection of efforts to enhance health and prevent ill-health through health education, prevention and protection. Exercise is an essential element of health promotion. It has been demonstrated that exercise and activity significantly reduce the risk of cardiovascular disease, stroke, hip fracture, osteoporosis and falls (Young, 1996, Davidhizar et al., 2002, Karmisholt et al., 2005). Along with Tai Chi, dance is an example of a form of exercise commonly practiced by older persons in Hong Kong. Dance can be performed at home or at a park, without any equipment, alone or in a group, making it particularly attractive in the older population.

Dance is a choreographed routine of movements usually performed to music. When dancing in a low impact routine, one foot must be in contact with the ground at all times (Dowdy et al., 1985). Studies have demonstrated that aerobic dance has physiological and psychological benefits. Hopkins et al. (1990) studied a group of sedentary older women and found that dancing improved cardiorespiratory endurance, balance, lower limbs strength and endurance, body agility and flexibility, and decreased body fat. A study from Japan showed that a 12-week dance-based aerobic exercise program improved selected components of balance and agility in healthy older women (Shigematsu et al., 2002). Adiputra et al. (1996) found that dancing lowered the resting heart rate and blood pressure and increased the maximum aerobic capacity in young male ballet dancers. In addition to physiological benefits, dancing was also shown to elevate mood, increase sense of self-esteem and well being, and increase social contact in healthy adolescent females (Blackman et al., 1988, Estivill, 1995). The above findings have been substantiated by numerous investigators (Kirkendall and Calabrese, 1983; Karlsson et al., 1993, Palo-Bengtsson and Ekman, 1997), although the subjects were mainly younger adults (age range 19–44 years) or professional dancers. To date, few studies have been conducted in older subjects (Hopkins et al., 1990), especially among Asian populations (Shigematsu et al., 2002).

The purpose of this study was to determine the effects of low impact aerobic dance on the physical and psychological well-being of Chinese older persons in Hong Kong.

Section snippets

Subjects

A sample of 111 community-dwelling volunteers were recruited from ten social centers for seniors in the Shatin District of Hong Kong. The subjects fulfilled all of the following inclusion criteria: (1) aged 60–75 years. (2) Intact cognitive function, tested by an abbreviated Mini Mental Test with a score  7 (Hodkinson, 1972). (3) Able to walk unaided with or without a walking stick. (4) Have not danced on a regular basis in the past 6 months. (5) Able to communicate in the Cantonese Chinese

Recruitment

One hundred and eleven individuals were divided into two groups. Fifty-seven were assigned to the IG and 54 to the CG. Nine (8%) participants (three in the IG, six in the CG) dropped out before the final assessment visit. Reasons for dropping out were: unrelated medical problems (n = 1), personal reasons unrelated to study participation (n = 2), noncompliance with study procedures (n = 2), and personal reasons (time commitment and inconvenience) (n = 4).

Furthermore, two subjects in the IG and one in

Discussion

This study provides evidence for the success and effectiveness of low impact aerobic dance in improving the physical and psychological well-being of a group of older subjects in Hong Kong. These findings are comparable with those from western countries regarding the effect of dance among older persons (Hopkins et al., 1990). Given the accessibility and prominence of dance among older persons, our findings confirm that aerobic dance can be developed as a readily available means for positive

Conclusion

This study provides evidence that a structured dance program is effective in improving aspects of physical and psychological health in community-dwelling Chinese older persons. With continued development, dancing may be an effective means for health promotion and disease prevention. Through social contact with other peers, dancing can also enhance psychosocial well-being. It is therefore recommended that dancing should be promoted in the community to senior citizens as a suitable, enjoyable and

Conflict of interest

None.

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