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The Effect of Dance on Depressive Symptoms in Nursing Home Residents
Abstract
Objective:
To evaluate the effect of a dance-based therapy on depressive symptoms among institutionalized older adults.
Design:
Randomized controlled trial.
Setting:
Nursing homes.
Participants:
Older adults (60 years or older) permanently living in a nursing home.
Intervention:
Exercise Dance for Seniors (EXDASE) Program designed for the use in long-term care settings performed once a week for 60 minutes for 3 months.
Measurements:
Baseline measures included sociodemographic characteristics, ability to perform basic as well as instrumental activities of daily living, basic mobility, self-rated health, and cognitive status. Outcome measures were collected before and after the intervention and included assessment of depressive symptoms using the geriatric depression scale (GDS).
Results:
Comparison of participants with MMSE of 15 or higher showed that GDS scores in the intervention group significantly improved (P = .005), whereas the control group had a trend of further worsening of depressive symptoms (P = .081). GLM analysis documented highly statistically significant effect of dance therapy (P = .001) that was not influenced by controlling for intake of antidepressants and nursing home location. Dance therapy may have decreased depressive symptoms even in participants with MMSE lower than 15 and resulted in more discontinuations and fewer prescriptions of antidepressants in the intervention group than in the control group.
Conclusion:
This study provides evidence that dance-based exercise can reduce the amount of depressive symptoms in nursing home residents. In general, this form of exercise seems to be very suitable and beneficial for this population.
... Nineteen other papers were excluded because of the following reasons: (a) did not include a control group (Azizan & Justine, 2016;Dionigi, 2007;Fremont & Craighead, 1987;Legrand & Mille, 2009;Meigh et al., 2021;Meneghini et al., 2020;Motl et al., 2005;Pieczyńska et al., 2021;Wikman et al., 2017;Yadav & Agashe, 2018), (b) used various exercise interventions (Brittle et al., 2009;Brown et al., 2009;Chou et al., 2004;Dechamps et al., 2010;Ng et al., 2017), (c) insufficient or irrelevant data (Martins et al., 2011;McCann & Holmes, 1984), (d) subjects with mean age <60 years (Bernard et al., 2015), and (e) control group participants were active (Conradsson et al., 2010). Eighteen studies (Ansai & Rebelatto, 2015;Antunes et al., 2005;Bouaziz et al., 2019;Cassilhas et al., 2007;Clegg et al., 2014;Cunha et al., 2021;bib_Damush_and_Damush_1999Damush & Damush, 1999Emery & Gatz, 1990;Kekäläinen et al., 2018;Kim et al., 2019Kim et al., , 2021Kuo et al., 2018;Paw et al., 2004;Pedersen et al., 2017;Sahin et al., 2018;Solà-Serrabou et al., 2019;Swoap et al., 1994;Vankova et al., 2014) met our inclusion criteria and were entered in the meta-analysis ( Figure 1). Studies were carried out in Brazil (4), the USA (3), South Korea (2), and one each in the UK, Finland, China, Netherland, Denmark, Turkey, Spain, France, and Czech. ...
... The intervention period for the included articles ranged from 8 to 36 weeks. Of the 18 included articles, 7 (Antunes et al., 2005;Bouaziz et al., 2019;Emery & Gatz, 1990;Kim et al., 2021;Kuo et al., 2018;Swoap et al., 1994;Vankova et al., 2014) involved aerobic training, 8 (Cassilhas et al., 2007;Clegg et al., 2014;Cunha et al., 2021;bib_Damush_and_Damush_1999Damush & Damush, 1999Kekäläinen et al., 2018;Kim et al., 2019;Sahin et al., 2018;Solà-Serrabou et al., 2019) examined resistance training, one examined combined resistance and team sport exercises, and 2 (Ansai & Rebelatto, 2015;Paw et al., 2004) examined isolated aerobic, resistance or functional and combined aerobic plus resistance or functional training. Of included studies, 13 (Ansai & Rebelatto, 2015;Bouaziz et al., 2019;Clegg et al., 2014;Emery & Gatz, 1990;Kekäläinen et al., 2018;Kim et al., 2021;Kuo et al., 2018;Paw et al., 2004;Pedersen et al., 2017;Sahin et al., 2018;Solà-Serrabou et al., 2019;Swoap et al., 1994;Vankova et al., 2014) recruited both males and females, 3 (Cunha et al., 2021;bib_Damush_and_Damush_1999Damush & Damush, 1999Kim et al., 2019) exclusively recruited female subjects, and 2 (Antunes et al., 2005;Cassilhas et al., 2007) exclusively recruited male subjects. ...
... Of the 18 included articles, 7 (Antunes et al., 2005;Bouaziz et al., 2019;Emery & Gatz, 1990;Kim et al., 2021;Kuo et al., 2018;Swoap et al., 1994;Vankova et al., 2014) involved aerobic training, 8 (Cassilhas et al., 2007;Clegg et al., 2014;Cunha et al., 2021;bib_Damush_and_Damush_1999Damush & Damush, 1999Kekäläinen et al., 2018;Kim et al., 2019;Sahin et al., 2018;Solà-Serrabou et al., 2019) examined resistance training, one examined combined resistance and team sport exercises, and 2 (Ansai & Rebelatto, 2015;Paw et al., 2004) examined isolated aerobic, resistance or functional and combined aerobic plus resistance or functional training. Of included studies, 13 (Ansai & Rebelatto, 2015;Bouaziz et al., 2019;Clegg et al., 2014;Emery & Gatz, 1990;Kekäläinen et al., 2018;Kim et al., 2021;Kuo et al., 2018;Paw et al., 2004;Pedersen et al., 2017;Sahin et al., 2018;Solà-Serrabou et al., 2019;Swoap et al., 1994;Vankova et al., 2014) recruited both males and females, 3 (Cunha et al., 2021;bib_Damush_and_Damush_1999Damush & Damush, 1999Kim et al., 2019) exclusively recruited female subjects, and 2 (Antunes et al., 2005;Cassilhas et al., 2007) exclusively recruited male subjects. The mean age of included studies ranged from 65.2 to 85.4 years (Table 1). ...
Background
Aerobic training, resistance training, or combined training are interventions that can be modified to suit the needs of aged people.
Objective
This meta-analysis aimed to investigate the impact of exercise training on depression symptoms, quality of life, and muscle strength in healthy people aged 60 or more.
Data Sources
Searches were conducted in PubMed, Web of Science, Medline, Google Scholar, and Scopus databases from inception to February 2022.
Results
Eighteen studies, totaling 1354 participants, were included in the meta-analysis. Overall, exercise training significantly declined depressive symptoms (standard mean difference (SMD): −.52, 95% confidence interval (CI): −.76 to −.28; p < .001). Moreover, there was a significant reduction in bodily pain ( p < .05) and body mass ( p < .01), and a significant increase in mental health ( p < .001), physical functioning ( p < .01), and general health ( p < .001) subscales of quality of life as well as upper- ( p < .001) and lower-limb strength ( p < .001). Subgroup analysis revealed that depression decreased significantly when aerobic training ( p = .000) and resistance training ( p = .003) were applied, and for studies including both genders ( p = .000) or men subjects ( p = .002). Moreover, subgroup analysis demonstrated that depression reduced following both medium- ( p = .006) and long-term ( p = .002) interventions.
Conclusion
These findings demonstrate that exercise interventions may produce improvements in depressive symptoms, some components of quality of life, muscle strength, and body mass. Additional research is required to define the optimal dose of exercise training interventions.
... Follow-up assessments were conducted in 27% of included studies at the following timeframes: 12 weeks (n = 2), 18 weeks (n = 1), 6 months (n = 8), 7 months (n = 2), 10 months (n = 1), 12 months (n = 2), and 16 months (n = 1). Exercise session frequency ranged from one [31,37,43,57] to seven times [29,35,36,59] per week, with sessions most commonly conducted two (n = 20) or three times (n = 24) per week. The duration of individual sessions ranged from 10 [64] to 80 min [50]. ...
... Seven interventions exclusively incorporated strength training [23,30,38,39,56,60,73] and six exclusively incorporated aerobic training, in particular, walking [63,64,66] and cycling [29,58,59]. The interventions also incorporated Tai Chi (n = 4) [33,71,77,78], dance (n = 3) [37,43,57], and exercise with 'Whole Body Vibration' (n = 7) [18,22,26,50,51,72,79]. Four interventions were delivered using interactive game-based technologies, including commercially available video-game technologies (Nintendo Wii-Fit [69], Microsoft Xbox-360 [70]), and interactive camera-based technologies (BTS NIRVANA system [62] and Jintronix [67]). ...
... Nineteen studies (30%) assessed mental health outcomes, largely anxiety and depression. Measures used to assess mental health were the Geriatric Depression Scale [28,32,33,48,57,71,73], Goldberg Anxiety and Depression Scale [19,46,47], Philadelphia Geriatric Morale Scale [32,35,74], Cornell Scale for Depression in Dementia [29,52,53], Beck Depression Inventory [42,70], Yesavage Scale [65], and the Profile of Mood State Short Form [77]. ...
Background
The number of older adults in residential aged care is increasing. Aged care residents have been shown to spend most of the day sedentary and have many co-morbidities. This review aimed to systematically explore the effectiveness of reablement strategies in residential aged care for older adults’ physical function, quality of life and mental health, the features of effective interventions and feasibility (compliance, acceptability, adverse events and cost effectiveness).
Method
This scoping review was undertaken according to PRISMA guidelines (extension for scoping reviews). Five e-databases (Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL) were searched from 2010 onwards. Randomised controlled trials investigating reablement strategies addressing physical deconditioning for older adults (mean age ≥ 65 yrs) in residential aged care on physical function, quality of life or mental health were included. Feasibility of the interventions (compliance, acceptability, satisfaction, adverse events and cost effectiveness) was explored.
Results
Five thousand six hundred thirty-one citations were retrieved, and 63 studies included. Sample sizes ranged from 15 to 322 and intervention duration from one to 12 months. Exercise sessions were most often conducted two to three times per week (44 studies) and physiotherapist-led (27 studies). Interventions were predominately multi-component (28 studies, combinations of strength, balance, aerobic, functional exercises). Five interventions used technology. 60% of studies measuring physical function reported significant improvement in the intervention versus control, 40% of studies measuring quality of life reported significant improvements in favour of the intervention, and 26% of studies measuring mental health reported significant intervention benefits. Over half of the studies measured compliance and adverse events, four measured acceptability and none reported cost effectiveness.
Conclusions
There has been a research surge investigating reablement strategies in residential aged care with wide variability in the types and features of strategies and outcome measures. Few studies have measured acceptability, or cost effectiveness. Exploration of core outcomes, mapping stakeholders and co-designing a scalable intervention is warranted.
Trial registration
Prospectively registered review protocol (Open Science Framework: DOI 10.17605/OSF.IO/7NX9M ).
... There is mounting evidence for the benefits of arts engagement and interventions for mental health in various populations, including older adults [13][14][15][16][17] . Creative and cultural participation was identified as the greatest contributor to the well-being of older adults in later life across 40 personal, social, health, resource and local indicators 18 , and a review of available research suggests that arts interventions are costeffective solutions that support mental health and reduce burden on health and social care services 19 . ...
... These studies were also removed from the analyses. This left 39 studies 16,17,58,65, , which reported 36 depression outcomes and ten anxiety outcomes, for entry into the meta-analysis. ...
In this systematic review and meta-analysis, we assessed the efficacy of group arts interventions, where individuals engage together in a shared artistic experience (for example, dance or painting), for reducing depression and anxiety among older adults (> 55 yr without dementia). Fifty controlled studies were identified via electronic databases searched to February 2024 (randomised: 42, non-randomised: 8). Thirty-nine studies were included. Thirty-six studies investigated the impact of group arts
interventions on depression (n = 3,360) and ten studies investigated anxiety
(n = 949). Subgroup analyses assessed whether participant, contextual, intervention and study characteristics moderated the intervention–outcome relationship. Risk of bias was assessed with appropriate tools (RoB-2, ROBINS-1). Group arts interventions were associated with a moderate reduction in depression (Cohen’s d = 0.70, 95% confidence interval (CI) = 0.54–0.87, P < 0.001) and a moderate reduction in anxiety (d = 0.76, 95% CI = 0.37–1.52, P < 0.001), although there was publication bias in the depression studies. After a trim and fill adjustment, the effect for depression remained
(d = 0.42; CI = 0.35–0.50; P < 0.001). Context moderated this effect: There was a greater reduction in depression when group arts interventions were delivered in care homes (d = 1.07, 95% CI = 0.72–1.42, P < 0.001) relative to the community (d = 0.51, 95% CI = 0.32–0.70, P < 0.001). Findings indicate that group arts are an effective intervention for addressing depression and anxiety among older adults.
... A study showed that the use of DMT was effective in treating anxiety and depression among older adults, through movement improvisation, guided exercises focusing on grounding and breathing, and circle dance (Bräuninger, 2014). Prior studies indicated the effectiveness of DMT in reducing depressive symptoms among cognitively impaired institutionalized older adults (Vankova et al., 2014). ...
... Consistent with prior studies, DMT elements have added value in reducing depression among older adults (Bräuninger,2012(Bräuninger, , 2014. In addition to prior literature which showed that dance decreased depressive symptoms among cognitively impaired older adults in an institutional setting (Vankova et al., 2014), our study revealed that DMT is useful in reducing depressive symptoms among cognitively sound older adults in the community setting with combined with SEGCE core elements. A recent meta-analysis showed that the effect size (presented in mean difference with 95% confidence interval) of psychosocial interventions aim to reduce depressive symptoms among older adults is 1.14 (Chen et al., 2021). ...
Depression is a public health issue in older adults. This study followed a participatory train-the-trainer approach to develop the Movement-based x ‘Elderspirituality-Fu Le Man Xin’ intervention. Additionally, a quasi-experimental design was followed to evaluate the effectiveness of the intervention. Data were collected from pre-and post-intervention assessments. A total of 135 older adults with depressive symptoms were recruited, 77 received the intervention and 58 received an active control intervention. Repeated measures ANCOVA showed that the ‘Movement-based x ‘Elderspirituality-Fu Le Man Xin’ intervention significantly reduced depression in cognitively sound participants (F(1, 73) = 62.346, p < .001).
... The dance protocols in the included studies provide information on the duration of each session, ranging from 10 minutes [82] [32], [35], [36], [37], [38], [39], [40], [42], [44], [46], [47], [48], [52], [53], [55], [56], [57], [58], [62], [64], [66], [67], [68], [69], [70], [72], [74], [81], [85] [54], [73], [76] and 110 minutes [20], [21]. The protocols were conducted between 1 and 3 times per week, and lasted from 3 to 40 weeks. ...
... Aerobic dance: This type of dance was used most when implementing the protocols. It included instructions for postures, movements and stretching techniques, leg bounce movements, forward and backward movement, jumping, shoulder movements, arm stretches, trunk stretch, trunk, hip and chest rocking and bending, 10-inch bench interval training with alternate steps with equal periods of aerobic dance patterns, basic up and down steps, lunges, straddle steps, along with coordinated arm movements and knee bends, heel up, boxing, shoulder movement, kicks, square steps, rowing exercises, and balance exercises [32] [53], which included a celebration at the end [54] walking and lying down [35], low-intensity exercise [46] [55], breathing and massage [33]. On the other hand, 33 protocols did not specify their type of cooling down [25] ...
Objective
To describe the use of dance-based intervention protocols as a rehabilitation proposal.
Method
Papers containing protocols used in adult patients and written in Spanish, English, and Portuguese were collected using the following keywords: Physical Therapy; Dance Therapy; Rehabilitation; and Clinical Trial Protocol. The PUBMED, MEDLINE, LILACS, BVS ScienceDirect, PEDro, OTseeker, The Cochrane Library (Cochrane Central Register of Controlled Trials), and Scopus databases were used for the collection of information to define the type of dance, the established protocol, pathologies, and the population involved.
Results
70 studies met the eligibility criteria, all of which presented a dance protocol. This was used in the rehabilitation of pathologies covering the neuromuscular, musculoskeletal, and cardiovascular systems, as well as in a healthy population. Positive results were the main outcome measure.
Discussion
Dance is an innovative intervention strategy for patients with comorbidities or underlying pathologies as well as for those in good health. It offers, without limitations, a field of applicability through the use of a dancing style as a rehabilitation process, generating significant changes in the physical, mental, and social skills of the individual.
... Inclusion criteria were (i) being a permanent resident of one of the facilities and (ii) being 60 years of age or older. In this study, the analysis focused on depressive NH residents as defined by the additional inclusion criteria (iii) a Geriatric Depression Scale (GDS) score of 6 or more, indicating presence of depression and (iv) a Mini Mental State examination (MMSE) score of 10 or more, to avoid the lower specificity of GDS results in people with more profound cognitive impairment [22,23]. Accordingly, 161 participants were not included in the analysis because of low or unknown MMSE scores, and 608 because of low GDS scores. ...
... First, it used the GDS for people with cognitive impairment. However, this scale has been used in other studies [32], and in our previous study we found that GDS effectively described the affective status of NH residents with MMSE scores between 10 and 15 [23]. Second, we did not administer an anxiety scale to the participants; however, we had documented clinical diagnoses of anxiety disorder, which were quite rare. ...
An investigation of inappropriate medication use in treatment of depressivity in institutionalized older adults, based on a nurse-led evaluation of functional status and depressive symptoms in nursing home residents. Methods: A cross-sectional multicenter study was performed using records from 1087 residents cared for in fifteen nursing homes (NHs) in the Czech Republic. Inclusion criteria were being a permanent resident of one of the facilities, being 60 years of age or older, having a Geriatric Depression Scale score of 6 or more, and having a Mini Mental State examination score 10 or more. The final sample for analysis included 317 depressed NH residents. Results: 52 percent of NH residents with depressivity had no antidepressant treatment. Benzodiazepines were the only medication in 16 percent of depressed residents, and were added to antidepressant treatment in 18 percent of residents. Benzodiazepine users had significantly higher GDS scores compared to non-users (p = 0.007). Conclusion: More than half of depressed NH residents remained without antidepressant treatment. Residents inappropriately treated with benzodiazepines were more depressed than residents treated with antidepressants only, or even not treated at all. Cooperation of the interprofessional team in the screening of depressive symptoms has the potential to improve the quality of care.
... LD requires a lot of memory, and very often, some steps are forgotten. Several studies showed that dance-based exercise could reduce the number of depressive symptoms [28][29][30][31][32][33][34][35][36][37]. The first study [28] showed that 12 weeks of dance training decreased levels of depression in college students compared to the control group. ...
... The second one [36] showed the effects of a dance intervention twice a week for 12 weeks on depression, physical function, and disability in older adults, and again there had been a significant improvement in the depression status of the older adults. Finally, in the third case [37], dance-based exercises were performed once a week for 60 min for 3 months, and this reduced the number of depressive symptoms in nursing home residents. Moreover, in our case, LD appeared to improve dancers' mood levels and reduced stress levels due to the social and physical benefits of the activity [38]. ...
Line dancing is one of the most practiced dance styles by adults and seniors due to the ease of execution of choreography. Due to the COVID-19 pandemic prolonging the restrictions of physical and sports activities, the elderly population has been forced into increased sedentariness and social isolation, resulting in the development of symptoms of depression. The aim of this study was to investigate the effects of line dancing practice on the mental state of late second- and third-age dancers. The sample consisted of 14 Italian female dancers with an average age of 65 years old. The Geriatric Depression Scale was used to verify whether 3 months of LD classes were able to produce improvements. Paired Samples T-Test and effect size were performed to test the difference between pre- and post-training protocol. The result was statistically significant (p < 0.05). Dancers improved their state of depression; in particular, they felt a better satisfaction in their life (d = 0.6), a greater interest in activities (d = 1), less boredom (d = 0.8), a good mood most of the time (d = 0.8), greater happiness throughout the day (d = 0.7), and the perception of a wonderful life (d = 0.5). Line dancing has proven to be an effective physical activity for improving the state of depression in late second- and third-age dancers.
... 14 16 Exercise with music promotes improvements in mobility, balance, gait, 17 muscle strength 18 and cognition 18 19 and mitigates depressive moods. 20 In particular, exercise with music such as dancing is suitable for frail older adults. 21 Factors closely related to frailty, such as reduced physical activity, cognitive decline and depression, can be addressed by exercise with music. ...
Objectives
Frail older adults need to improve their health through exercise, and effective interventions are necessary to ensure their participation. Exercise with music has been shown to enhance adherence among older adults and improve both physical and mental health outcomes, making it a suitable intervention for frail older adults. This study evaluated the impact of exercise with music on the physical and emotional health of frail, community-dwelling older adults.
Design
A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines.
Data sources
MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane Library, PsycINFO, Google Scholar and the Virginia Henderson International Nursing Library were last searched on 14 March 2025.
Eligibility criteria for selecting studies
We included randomised controlled trials (RCTs) and non-RCTs that applied exercise with music to community-dwelling frail older adults.
Data extraction and synthesis
Five independent reviewers used standardised methods to search, screen and code included studies. Study quality was assessed using the revised Cochrane Risk of Bias 2 tool and the Risk of Bias in Non-Randomized Studies of Interventions tool. A meta-analysis and narrative synthesis were conducted, and the findings were summarised using Grading of Recommendation, Assessment, Development, and Evaluation evidence profiles. Publication bias was checked, and sensitivity analyses were used to assess the robustness of the results.
Results
After screening the initial 1425 studies, 17 studies (13 RCTs and 4 non-RCTs) were analysed. The overall risk of bias indicated that two had high risk and three had serious risk among the RCTs, and two had serious risk and two had moderate risk among the non-RCTs included in the meta-analysis. As for physical health outcomes, studies reported on frailty, Timed Up and Go (TUG), handgrip strength, falls, balance, gait speed, endurance and other performance. As for emotional health outcomes, studies reported on depression, social support and activities, quality of life or satisfaction and cognitive function. The pooled analysis suggested that exercise with music may have a positive effect on reducing frailty (standardised mean difference (SMD)=−0.20, 95% CI=−0.34 to −0.07, p=0.003, I ² =0%; very low certainty) and decreasing depression levels (SMD=−0.40, 95% CI=−0.65 to −0.15, p=0.002, I ² =0%; very low certainty) compared with control group outcomes in non-RCTs. However, there was no effect on the TUG and handgrip strength. A narrative synthesis of evidence suggested potential beneficial effects on frailty and depression.
Conclusions
Exercise with music may help improve frail older adults’ physical and emotional health and potentially reduce the burden of frailty. However, further rigorous investigation is needed, as the evidence has a very low level of certainty. Additionally, results from this review should be interpreted with caution because of concerns associated with the risk of bias. Community-based health professionals should consider using music when providing exercise interventions to frail older adults, while applying tailored approaches that consider their unique needs.
PROSPERO registration number
CRD42022369774.
... Many residents expressed feelings of joy, excitement, and a renewed sense of purpose after participating in game room activities. This aligns with research suggesting that recreational activities can reduce feelings of boredom and depression while promoting positive emotions (Adams et al., 2011;Vankova et al., 2014). Observations captured residents smiling, laughing, and displaying positive body language, further supporting the idea that the game room provided a much-needed emotional boost. ...
Background: The global ageing population presents significant challenges for healthcare and social systems, with the number of individuals aged 60 and above projected to exceed 2 billion by 2050. In Singapore, where seniors constitute 12% of the population, nursing homes play a critical role in providing care. However, residents often lead sedentary lifestyles, increasing their risk of physical and cognitive decline. Recreational interventions, such as game rooms, offer opportunities for social interaction, emotional well-being, and cognitive stimulation. This study explores the influence of a game room on nursing home residents’ social interactions, emotional well-being, and quality of life, addressing gaps in understanding how such spaces can enhance residents’ daily experiences. Methods: This study was undertaken via a qualitative, phenomenological approach. Data was collected through face-to-face semi structured interviews and observations with field notes. Interviews were transcribed verbatim and thematically analysed. Baseline interviews were conducted prior to the initiation of the game room. After baseline data was collected, the game room was set up and introduced to the nursing home environment. Follow-up interviews were conducted three months after the initiation of the game room. Results: Findings revealed significant improvements in residents’ social connections, emotional states, and overall satisfaction. Residents reported forming new friendships, experiencing joy and purpose, and feeling more engaged in daily life. Observations corroborated these accounts, showing increased participation, positive interactions, and enthusiasm for game room activities. Conclusion: The game room emerged as a valuable intervention, enhancing residents’ well-being and fostering a sense of community. These results highlight the importance of recreational spaces in nursing homes and their potential to improve residents’ quality of life.
... There is some evidence from previous research. Existing studies in the United Kingdom revealed that Dance Movement Therapy (DMT) is effective in the treatment of adults with depression and dementia (Karkou et al., 2019(Karkou et al., , 2023Meekums et al., 2015;Vankova et al., 2014). A similar study focused on dementia also found the effectiveness of DMT especially for older adults (Ho et al., 2020). ...
The aging population in Indonesia is facing an issue of health and productivity. Moreover, the elderly are a population group that is vulnerable to decreased independence in carrying out daily activities. Existing studies found Dance Movement Therapy (DMT) and Tai Chi Gymnastics can be effective alternative therapy in improving the independence of the elderly. However, there have not been many studies that combine these two therapies in the context of elderly care in Indonesia. This study aimed to test the effectiveness of the combination of DMT and Tai Chi Gymnastics in improving independence and Activity Daily Living (ADL) among the elderly. This study is quasy- Experiment with pre-test and post-test nonequivalent group design. The sample in this study totalled 60 respondents (30 intervention group dan 30 control group). The participants of this study were selected based on the inclusion criteria which included the elderly with decreased functional activity. The results of data analysis showed a significant increase in the independence and moving of ADL of the elderly after receiving a combination intervention of Dance Movement Therapy and Tai Chi Gymnastics. This study is important to arrange more efforts for related stakeholders to improve the health and productivity of the elderly. Future studies can include a larger number of respondents and more independent and control variables.
... Symptoms of depression were assessed using the GDS scale. After three months of intervention, there was a statistically significant improvement in depressive symptoms, which was not observed in the control group [19]. On a study group of mild to moderate cognitively impaired elderly aged between 60 and 80 years, an intervention was carried out to include training in Indonesian folk poco-poco dance and relaxation exercises at a frequency of twice a week for 6 weeks. ...
Introduction: Depression is a medical condition affecting hundreds of millions of people worldwide. It can affect different age groups, both children and the elderly. The principal treatments for depression are pharmacotherapy based mainly on SSRIs and SNRIs and psychotherapy (e.g. cognitive-behavioural). Researchers are looking for interventions that can support the treatment of depressive disorders and complement primary therapy. One of the issues being explored is the impact of Dance Movement Therapy and other dance- based interventions on depressive symptoms and general well-being. Aim of the study: Analysis of the available research on the effects of Dance Movement Therapy and other dance- based interventions on depressive symptoms and general psychological well-being including anxiety and stress symptoms. Methods: Review of the available literature available in the scientific databases PubMed and Google Scholar by searching with key words such as: dance movement therapy, dance, depression, depressive disorders, stress. In addition, a review of specialised literature from the field of psychiatry was performed. Conclusion: According to the available data, the introduction of DMT or other forms of dance generally has positive effects, alleviating depressive symptoms in many study groups. In some trials, a reduction in anxiety and stress was also noted among those who underwent the intervention. The best effects of the therapy have been found among people with mild depression. The effects among people with severe depression are not as clear. The inclusion of dance in people with depressive disorders is likely to be a good intervention in patients with mild depressive symptoms and can be used as an adjunctive therapy to appropriate psychiatric treatment. The positive effects of DMT and dance on the wellbeing of cancer patients have also been noted.
... 71,72 Our results did not show significant increases in serum BDNF after the dance intervention, but a significant decrease in depressive signs in DG assessed by GDS was observed, confirming that dance can indeed ameliorate mood in older adults and reduce depressive signs. [73][74][75] Teixeira-Machado et al 76 claim that dance practice improves neuroplasticity, and scientists link endurance exercise with BDNF expression in the brain concretely showing that neuroplasticity could well be induced by acute or chronic exposure to PA. 7,77-79 ...
Background
Maintaining healthy brain function during ageing is of great importance, especially for the self-sufficiency of older adults. The main aim of this study was to determine the effects of dance and martial arts on exerkines Brain Derived Neurotrophic Factor (BDNF) and irisin blood serum levels.
Methods
This randomized controlled trial examined the effects of dance and martial arts on serum Brain-Derived Neurotrophic Factor (BDNF) and irisin levels, as well as cognitive function, mood, and physical measures in older adults. Seventy-seven independently living older adults (mean age 70.3±3.8 years) were randomized into three groups: dance (DG), martial arts (MaG), and control (CG), followed over 12 weeks. Generalized linear models were used to assess the interventions’ effects.
Results
There was a significant increase in BDNF levels in both the DG (1.8 ± 4.9, p < 0.05) and MaG (3.5 ± 6.3, p < 0.05), while CG experienced a decrease (−4.9 ± 8.2, p < 0.05). Between-group effects were significant for BDNF, with DG and MaG showing higher levels than CG (p < 0.05). No significant changes in irisin levels were found. Cognitive performance, particularly attention and mental flexibility (measured by the Trail Making Test A and B), significantly improved in the DG compared to CG (p < 0.05). Additionally, participants in DG showed improved mood based on the Geriatric Depression Scale (p < 0.05) compared to CG. Anthropometric T-scores were significantly associated with changes in irisin levels (p < 0.05) after intervention.
Conclusion
The study found that dance and martial arts upregulated BDNF levels, with dance showing notable improvements in cognitive function and mood in older adults. Changes in anthropometric measures were linked to increased irisin levels. These findings suggest that both dance and martial arts may promote healthy brain function in aging populations.
Trial Registration
NCT05363228.
... Some patients with impaired cognition will be unable to respond to verbal therapies [22]. They may respond to music [23] or even dance therapies [24]. Regular dancing after six months can result in improvements in motor and cognitive functions. ...
Psychological depression is a frequent disorder still underdiagnosed and untreated in the elderly. It is treated like something that belongs to the last phase of life. Depression is known to compromise the quality of life near death. Pharmacological therapy is not always possible in this group because of frequent adverse effects and interactions with other drugs used and limited time until death. Besides pharmacological therapy, there are many non-toxic non-pharmacological therapies, more suitable for this population. These therapies, like cognitive behavioural therapy or mindfulness meditation therapy as well as many others, are confirmed to be effective and safe in this population. Some of these therapies are suitable for cognitively impaired patients.
... Preventative element is used by selected geriatric teams. Furthermore, it is a non-pharmacological intervention that may affect the cognitive functions of the elderly and prevent depression, for example among nursing home residents [25,26]. Dance, as a type of group physical activity, is a form of social interaction, which establishes social bonds through synchronization with the partner, the group and the music. ...
Background
Due to increasing life expectancy, the number of elderly people is increasing. This contributes to the increased incidence of geriatric syndromes, which lead to a loss of mobility, independence and worsens the quality of life.
Aim
The aim of this article is to review the literature on the use of dance training as a factor in reducing the risk of falls, depression and dementia in the elderly, and also in reducing the effects of these conditions.
Material and Methods
40 articles were reviewed using PubMed, Google Scholar and ResearchGate databases published between 2008 and 2022.
Conclusions
Dancing can be an element of training, which, by improving coordination, balance and muscle strength, reduces the risk of falls among the elderly. By positively influencing the mood, creating opportunities to build new relationships or reducing the feeling of loneliness, it is one of the factors preventing the occurrence of depression and alleviating its symptoms. Although dancing increases the level of neurotrophic factors and increases the volume of the hippocampus, its effects on cognitive and executive functions are not fully understood. However, there are reports that it can reduce the risk of Alzheimer’s disease and alleviate anxiety in people with dementia, so the use of dance interventions seems to be a beneficial form of exercise among the elderly, especially since it does not require the use of specialized equipment and costs are not high.
... The older adults enjoyed participating in the creatively crafted CDP and learned about nature-and world travel-based dance movements from the student instructors. Older adults enjoy dancing, which can evoke positive memories of the past in the form of reminiscence (Vankova et al., 2014). A meta-analysis demonstrated that reminiscence-based interventions significantly reduce depressive symptoms, improve life satisfaction, and enhance self-esteem and happiness amongst cognitively intact older adults (Tam et al., 2021). ...
Dance programs promote physical and psychosocial well‐being. However, studies focusing on the experiences of older adults in dancing are limited. This study aims to develop a community dance program (CDP) for older adults at senior activity centers in Singapore, as well as to explore the older adults' and student instructors' experiences of the CDP. A qualitative inquiry of semi‐structured and in‐depth focus group discussions was conducted. In total, 20 older adults and 10 student dance instructors participated in the study. Student instructors who were undergraduate students from a dance society were trained in how to provide step‐by‐step instructions for the older adults. An inductive approach of thematic analysis was undertaken. Three main themes were identified: (i) promotion of physical, cognitive, and psychosocial health with dance; (ii) imagination is power—travel through dance; and (iii) further enhancement of the dance program. The themes highlighted the prominence of CDP in improving memory, physical health, mood, and social interactions—thus mitigating the risk of social isolation. The findings illustrated the benefits of CDP in cultivating intergenerational bonds amongst older adults and student instructors.
... Furthermore, we synthesized studies of older populations without a clinical diagnosis of depression or anxiety. Effects of DMI on psychological health may be more pronounced in participants with clinically relevant psychological symptoms [82,106,107]. Another limitation relates to the rather wide age range (55+) of participants who were considered to be eligible, which might have concealed intervention effects distinct to older age groups [37]. ...
Background:
Lifestyle-based multimodal interventions that integrate physical, sensory, cognitive and social enrichment are suggested to promote healthy mental aging and resilience against aging and Alzheimer's disease (AD).
Objectives:
This meta-analysis examined the efficacy of dance movement interventions (DMI) as an integrated mind-body activity on outcomes of psychological health in older adults.
Methods:
Pre-registration was carried out with PROSPERO (CRD42021265112). PubMed, Web of Science and PsycINFO were searched for randomized controlled trials (RCT) evaluating the effects of DMI (>4 weeks' duration) compared to comparators on measures of psychological health (primary outcome) and cognitive function (additional outcome) among older adults without dementia (aged ≥55). Data of 14 primary RCT (n = 983, n-DMI = 494, n-control = 489) were synthesized using a random effects meta-analysis with robust variance estimation.
Results:
DMI had a small positive effect on overall psychological health (g = 0.30; 95% confidence interval [CI]: 0.06, 0.53; p = 0.02, I2= 65.04) compared to control conditions. Small effects of DMI on positive and negative psychological domains as well as quality of life were not statistically significant. DMI had a medium positive effect on general cognitive function (g = 0.50; 95% CI: 0.12, 0.89, p = 0.02, I2= 79.61) over comparators. None of the primary intervention studies evaluated measures of neuroplasticity.
Conclusions:
We found that DMI was effective in promoting mental health amongst older adults without dementia, suggesting that the multimodal enrichment tool is a potential strategy for health promotion and prevention of AD. High-quality intervention studies are needed to expand evidence on DMI-induced changes in specific psychological domains and identify underlying neurophysiological correlates.
... Dance engagement among people living with dementia in residential care settings increases mood and social interaction (47). Engagement in 12 weeks of dance at a residential nursing home reduced the need for depression medication among older adult participants (including people with diagnoses of dementia) (48). Dance-based interventions are significantly beneficial to persons with MCI and dementia in decreasing depression compared with controls, with similar effects in both hospital and community settings (49). ...
There is a growing appreciation for the ability of person-centered arts-based approaches to extend multiple domains of brain health of people living with dementia. Dance is a multi-modal artistic engagement which has positive impacts on cognition, mobility and the emotional and social aspects of brain health. Although research into multiple domains of brain health among older adults and people living with dementia is promising, several gaps remain, specifically in understanding the benefits of co-creative and improvisational dance practices. Collaborative research between dancers, researchers, people living with dementia and care partners is needed to design and evaluate future research on dance and to determine relevance and usability. Furthermore, the respective praxes and experience of researchers, dance artists and people living with dementia contribute distinctly and uniquely to the identification and the assignment of value to dance in the context of the lives of people living with dementia. In this manuscript the author, a community-based dance artist, creative aging advocate and Atlantic Fellow for Equity in Brain Health, discusses current challenges and gaps in the understanding of the value of dance for and with people living with dementia and how transdisciplinary collaboration between neuroscientists, dance artists and people living with dementia can advance collective comprehension and implementation of dance practice.
... Dance is more like a kind of social activity, especially in the group dance environment [28], which will further strengthen a person's sense of belonging to society, thus reducing their loneliness [29]. Vankova [30] et al. performed dance therapy for depressive symptoms of older adults people in nursing homes. Participants are all people aged 60 or above, and the intervention method is Exercise Dance for Seniors (EXDASE) program, which is specially designed for the older adults living in the nursing home environment for a long time, once a week for 60 minutes at a time for three months. ...
Dance, as a non-drug intervention means, has a positive effect on health. From the perspective of developmental psychology, the definition of health has different tendencies at different age. For example, in teenagers, emotional health is worthy of attention. Besides emotional health, cognitive health is also a major concern for the older adults. By introducing dance therapy, this paper sorts out and summarize the influence of dance therapy on teenagers' emotion, as well as the influence on emotion and cognition of the older adults. This study supports the positive influence and role of dance therapy in alleviating negative emotions in the two groups and improving cognitive function in the older adults group, which is of great significance for improving people's happiness index in the future.
... In the present study, the multicomponent physical exercise program improved GDS scores for depressive symptomatology, although not significantly, nor did it produce differences between CG and IG. In older people living in LTNHs, the evidence also seems contradictory, while some studies have shown a significant improvement in participants after completing the physical exercise programme [24,36], others have not obtained benefits [25,26,34,37,38], such as that of Rezola-Pardo et al. [25] and Arrieta et al. [26]. Likewise, the results of the study by Underwood et al. [34] do not support the effectiveness of an exercise programme for two days/week of moderate intensity for 12 months in reducing depressive symptoms in residents from LTNHs; while it is important to point out that, in this case, the participants only attended approximately half of the possible sessions. ...
Objectives:
This study aimed to investigate the impact of a multicomponent exercise programme on perceived health-related quality of life (HRQoL) and depressive symptomatology in older people living in a long-term nursing home (LTNH).
Methods:
A quasi-experimental study was conducted. Forty-one older people were conveniently selected from the largest LTNH in the Basque Country. The participants were assigned to either an intervention group (n = 21) or a control group (n = 20). The intervention group participated in 50-min moderate intensity multicomponent physical exercise sessions (strength and balance, three sessions a week for 3 months). The control group participants continued their usual activities in the LTNH. Assessments were completed at baseline and reassessed after the 12-week intervention by the same nurse researchers who filled out the questionnaires: the 36-item Short Form Survey (SF-36) and the Geriatric Depression Scale (GDS).
Results:
Thirty-eight participants completed the study (19 participants in each group). In the SF-36 parameters, physical functioning increase in the intervention group tends with a mean increase of 11.06 units (a 17.2% increase over the pre). In the role-emotional, the increase in the intervention group is with a mean increase of 5.27 units (a 29.1% increase over the pre) (P < 0.05). In social functioning, the increase in the control group is significant with a mean increase of 13.16 units (a 15.4% increase over the pre) (P < 0.05). There are no significant changes in the rest of the parameters, there are no differences between groups in the evolutionary pattern either.
Conclusions:
As for the effects of the multicomponent exercise programme on HRQoL and depressive symptomatology, no statistically significant effects were obtained in the outcome data among older adults living in LTNHs. An increase in the sample size could confirm the trends obtained. The results may help inform the design of future studies.
... Besides helping overcome emotional problems, DMT also helps individuals increase self-efficacy and social support, thereby helping individuals maintain the cognition system for the process of selftransformation(Rahmawati et al., 2018). In addition, from several previous studies that implemented DMT, it was found that DMT was proven to be effective in improving well-being(Barnet-Lopez et al., 2016;Garcia-Medrano, 2021); improving quality of life(Adam et al., 2016;Allet et al., 2017;Bräuninger, 2012) reducing levels of anxiety and depressive symptoms(Adam et al., 2016;Vankova et al., 2014); increasing self-esteem. ...
Dewasa ini masalah kesehatan psikologis atau mental menjadi salah satu masalah yang membutuhkan intervensi psikologis. Salah satu intervensi yang digunakan untuk mengatasi kesehatan psikologis adalah Dance Movement Therapy (DMT) salah satu varian dari Art Therapy. Penelitian ini bertujuan untuk mengetahui efektifitas DMT berdasarkan variasi kasus serta kategori usia. Systematic literature review dilakukan menggunakan protokol PRISMA pada 10 artikel jurnal terpilih berdasarkan kriteria ekslusi dan inklusi yang sudah ditetapkan. Hasil yang didapat dari review bahwa DMT dapat dilakukan pada rentang usia remaja sampai dengan lansia, serta dapat memberikan efektifitas menangani permasalahan psikologis seperti depresi, stress, autism, dan quality of life. Dalam implementasinya DMT dapat dikombinasikan dengan intervensi lain agar dapat memberikan hasil yang lebih optimal.
... (5) Physical or occupational therapists, or another member of the staff, should organize group activities that are motivating and pleasant. Establishing groups to look after the garden, promoting dancing, 75 or organizing walks in green spaces 76 around the LTCF, are examples of potential group activities that can be implemented. Group activities must take into account social affinities among residents, but also residents' interests and preferences to define the most suitable activities to implement. ...
... One effective approach to alleviate depressive symptoms is the use of preferred leisure activities in a format adapted for older adults (5). In particular, some recreational activities improve mental agility (card games) (6) and increase kinetic movements with other partners (gate ball/table tennis/dance) (7,8). These activities have been shown to be an effective way to improve depressive symptoms as well as increase mutual socialization. ...
... We can hypothesize that CSDD is not an appropriate measure for assessing depression in our study cohort, in contrast to other tests such as the Geriatric Depression Scale (GDS). 44 The CSDD assesses the intensity of the depressive symptoms using caregiver interviews, caregivers often respond subjectively and may underestimate the real prevalence of depressive symptoms. 45 On the contrary, the GDS is based on a direct interview with the patient and questions are dichotomized to include either "yes" or "no". ...
The aim of this pilot, feasibility study was to assess health improvements in 16 institutionalized older people with Alzheimer's disease, after the Biodanza intervention, a nonpharmacological dance movement-based treatment. Biodanza significantly decreased agitated and neuropsychiatric behaviors. Effectiveness studies will be performed in order to assess the implication of such interventions.
... The majority of control groups adopted normal daily activities as the usual care (n = 15, 53.6 %) [30,[52][53][54][55][56][57][58][59][60][61][62][63], active control conditions such as other physical activities (n = 5, 17.9 %) [59,[63][64][65][66], music, and other social activities (n = 12, 42.9 %) [30,59,63,65,[67][68][69][70][71][72][73] (Table 1). ...
Objective
To examine the effect of dancing interventions on depression symptoms, anxiety, and stress in adults with and without musculoskeletal disorders, and to determine the duration of the effectiveness of a dancing intervention.
Methods
Five electronic databases, CINAHL, MEDLINE, SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO were searched from January 2010 to March 2021. Data were extracted for a quality synthesis and meta-analysis, and GRADEpro software was used to rate the quality of evidence.
Results
Twenty-eight randomized controlled trials involving 2249 eligible subjects were selected. They were found to be of satisfactory quality (fair n = 12, good n = 16). These studies revealed that dance interventions had a significant effect on relieving depression symptoms (SMD = −0.69, 95 % CI -0.91 to −0.35, p < 0.001), anxiety (SMD = −0.99, 95 % CI = −1.92 to −0.05, p < 0.05), and stress (SMD = −1.0, 95 % CI = −1.83 to −0.17, p < 0.05). Exposure to a dancing intervention for at least 150 min per week was found to have reduced depression symptoms (SMD = −0.72, 95 % CI -0.20, −0.25, p < 0.01). The quality of evidence ranged from very low to low.
Conclusions
This review indicates that dancing interventions significantly reduce depression symptoms, stress, and anxiety; and adults with or without musculoskeletal disorders would benefit from engaging in a dancing intervention for at least 150 min per week. Dancing interventions are recommended to be incorporated in health promotion activities to promote psychological wellbeing.
... 7 Research on dance with older people has been conducted in a range of settings and across the globe. [8][9][10][11][12][13][14] But there are a limited number of studies that include frail or functionally impaired adults. 15 Furthermore, not all studies have identified positive outcomes. ...
Objectives
To explore the perceptions of hospitalised older people and their relatives of the impact of taking part in group dance sessions in an acute hospital setting.
Design
A qualitative descriptive approach was used.
Setting
An acute hospital trust in the East of England.
Participants
Purposive sample of dance group participants.
Intervention
Weekly music and movement sessions for frail older people on Department of Elderly Medicine Wards and the Stroke Rehabilitation Unit. Sessions take place in the ward and are facilitated by a dance artist supported by ward staff.
Results
Twenty-one semistructured interviews were conducted with older people and/or their relatives. Thematic analysis of the data identified three overarching themes: (1) dance as a physical activity, (2) dance as an opportunity for social interaction and (3) the dance group as a source of emotional support. Sessions were valued as an enjoyable way to undertake physical activity and provided an opportunity for social interaction between patients. This is important as loneliness and boredom are a common occurrence during hospitalisation and are detrimental to overall health and well-being. Patients reported an emotional impact though taking part; happiness from engaging with the group and the release of pent up emotions through the triggering of memories by the music and conversations within the group.
Conclusion
Dance for Health provides a range of physical, social and emotional benefits for hospitalised older people. Further research is required to investigate the effectiveness of group dance sessions in increasing physical activity on an acute ward and the potential psychological benefits for hospitalised older people.
... It integrates multiple physical, cognitive, and social elements for the older population, and it may be a way to motivate sedentary elderly people to increase their physical activity [15]. It has been reported that dancing promotes a low incidence of depression and increases quality of life, improves balance and flexibility, reduces the number of falls [16,17], and raises muscular strength, cardiorespiratory function, and psychocognitive activity [18,19] in the elderly. Moreover, a previous study showed that a recreational dancing program decreases TNF-α plasma levels and neutrophil DNA fragmentation in T2DM patients [20]; however, there are no studies currently available on the possible changes promoted by a recreational dancing program on the lymphocyte function of elderly women. ...
This study aimed to investigate the impact of a 16-week dance-based aerobic exercise program on lymphocyte function in healthy and type 2 diabetes mellitus (T2DM) women. We enrolled 23 women: 11 with T2DM and 12 non-diabetic controls. Initially, we performed anthropometry and body composition measurements, afterwards, plasma levels of C-reactive protein, lipids, and glucose were determined. We used flow cytometry to measure the CD25 and CD28 expression in circulating lymphocytes, T-regulatory (Treg) cell percentage, lymphocyte proliferation, and cytokines released by cultured lymphocytes. The T2DM group had a lower proportion of CD28+ cells and a higher percentage of Treg lymphocytes and proliferative capacity at the baseline compared with the control group. After 16 weeks of the program, differences in lymphocytes between the T2DM and the control groups disappeared. The dance program promoted IL-10 increase in both groups. We found decreased IL-4, IL-2, and IL-6 secretion in lymphocytes from the control group and increased IL-17 secretion and IL-10/IL-17 ratio in the T2DM group after the program. The program promoted marked changes in lymphocytes in diabetic women, leading to a balance between the different profiles.
... Ballroom dance is a social dance in which body movements and their synchronization between partners play a prominent role (Cohen-Stratyner, 2020). Because ballroom dance steps can be adjusted in pace and steps and because ballroom dance improves body posture and body expression, it can also be performed by people with physical constraints and by different age groups (Hackney and Earhart, 2010;Vankova et al., 2014). Ballroom dance can be classified as aesthetic type of exercise (Fong Yan et al., 2018). ...
Physical activity, specifically exercising, has been suggested to improve body image, mental health, and well-being. With respect to body image, previous findings highlight a general benefit of exercise. This study investigates whether the relationship between exercising and body image varies with the type of exercise that individuals preferentially and regularly engage in. In addition, physical efficacy was explored as a potential psychological mediator between type of exercise and body image. Using a cross-sectional design, healthy regular exercise practitioners of yoga, ballroom dance, team sports, or individual sports as well as healthy adults reporting no regular exercising were surveyed. Body image and its different facets were assessed by a set of standardized self-report questionnaires, covering perceptual, cognitive, and affective body image dimensions particularly related to negative body image. In addition, participants were questioned with regard to mental health. Participants were 270 healthy adults. Descriptive statistics, measures of variance (ANOVA), and multiple linear regression analysis with orthogonal contrasts were performed to investigate differences between the different exercise and non-exercise groups in the variables of interest. In line with the hypotheses and previous findings, the statistic comparisons revealed that body dissatisfaction (as one important factor of negative body image) was most pronounced in the non-exercise group compared to all exercise groups [contrast: no exercise versus exercise (all groups taken together)]. Physical efficacy, as assessed with a standardized questionnaire, mediated the difference between type of exercise (using contrasts) and body image including perceptual, cognitive, and affective body image dimensions. The findings shed light on so far less systematically investigated questions regarding the relationship between types of exercise, like yoga and ballroom dance, and body image. The results underscore the relevance of considering possible influencing factors in exercise research, such as the perception of one’s physical efficacy as a mediator of this relationship.
... Dentre os indivíduos mais pesquisados e que obtiveram alterações fisiológicas com a prática da dança, é possível destacar os idosos 10,11,21,28,35,58,59,60,73,74 ; mulheres 30,36,49,57,58,59,67,71 ; e homens 20,49 . ...
A busca pela saúde e longevidade atrai cada vez mais olhares da comunidade científica. Há diversas formas de se conseguir alterações fisiológicas que previnam doenças ou colaborem para modificar estados patológicos já existentes no organismo humano. Atividades diferenciadas como é o caso da dança, tem sido um recurso utilizado na busca da prevenção de doenças e de agravos, devido à proporção terapêutica à ação sistêmica que esta exerce e também do baixo custo comparada com outros recursos de tratamento multidisciplinar. Este artigo trata-se de uma Pesquisa Bibliográfica na modalidade revisão integrativa da literatura, tendo como objetivo conhecer e demonstrar o que vem sendo publicado na comunidade científica sobre o impacto do exercício da dança na fisiologia humana. Como método utilizou-se as bases de dados: PUBMED, SCIELO, LILACS, com os seguintes descritores associados: "dança, alterações fisiológicas e terapia através da dança”, “dança e terapia através da dança” e “dança e alterações fisiológicas”, “alterações fisiológicas e terapia através da dança”, tendo como critérios de inclusão dos de material utilizado: artigos originais, disponíveis na íntegra, publicados nas línguas portuguesa inglesa e espanhola, entre os anos de 2013 a 2018, e que estejam relacionados com as modificações fisiológicas através da dança. Como resultados da busca englobando estas combinações, foram encontrados 2.643 artigos, e destes, foram selecionados para estudo 47 artigos. Conclui-se pelos estudos revisados e organizados no quadro sinóptico, que na relação entre a fisiologia e a dança, há diversas alterações positivas no organismo humano obtidas através da dança, seja como coadjuvante em tratamento, ou seja como fator de prevenção.
... These study findings were similar to the study conducted by Vankova H. (2014) to evaluate the effects of dance and movement therapy on depressive symptoms where the result showed that there was significant difference within the group (p=0.00) in terms of depression in experimental group. 17 In the presents study there was significant difference in terms of depression as calculated Friedman test for depression (F=52.91, p=0.00). ...
Depression is a universal health related problem which is increasing the life expectancy worldwide associatedwith morbidity and disability among elderly people. Elderly age group is a controversial issue as it is a naturalprocess which presents a unique challenge for every individual in society. The objectives of the study wereto assess and compare depression among elderly before and after administration of dance and movementtherapy and progressive muscle relaxation, to determine the relationship between depression and to find outthe association of depression with selected variables. Quantitative research approach, quasi experimentalnon equivalent control group pretest post test design was used to collect the data. Sixty participants (30DMT group, 30 PMR group) were enrolled for the study those who fulfilled the inclusion criteria by usingpurposive sampling technique. Homogeneity was checked by enrolling the participants. Data was collectedby using Geriatric Depression Scale (GDS) for assessing depression by interview technique. Analysis wasdone by applying non parametric test after K-S test to check normality of data. Thus findings of the studyshowed effectiveness of dance and movement therapy and progressive muscle relaxation on depression asthe calculated Friedman test Chi square value (DMT ?2 =51.44, p=0.00 and PMR ?2 =52.91, p=0.00) wassignificant at 0.05 in both groups. There was no any significant difference between DMT and PMR groupsin terms of depression. Depression among elderly was found to be statistically significant with duration ofstay in old age homes and history of chronic illness i.e (?=5.764, p=0.05) and (?=49.00, p=0.02) in DMTgroup, and depression among elderly was found to be statistically significant with history of chronic illnessi.e (?=49.00, p=0.04) in PMR group. Conclusion: Dance and movement therapy and Progressive musclerelaxation was effective in reducing depression among elderly as there was significant difference within thegroup.
... It integrates multiple physical, cognitive, and social elements for the older population, and it may be a way to motivate sedentary elderly people to increase their physical activity [15]. It has been reported that dancing promotes a low incidence of depression and increases quality of life, improves balance and flexibility, reduces the number of falls [16,17], and raises muscular strength, cardiorespiratory function, and psychocognitive activity [18,19] in the elderly. Moreover, a previous study showed that a recreational dancing program decreases TNF-α plasma levels and neutrophil DNA fragmentation in T2DM patients [20]; however, there are no studies currently available on the possible changes promoted by a recreational dancing program on the lymphocyte function of elderly women. ...
This study aimed to investigate the impact of a 16-week dance-based aerobic exercise program on lymphocyte function in healthy and type 2 diabetes mellitus (T2DM) women. We enrolled 23 women: 11 with T2DM and 12 non-diabetic controls. Initially, we performed anthropometry and body composition measurements, afterwards, plasma levels of C-reactive protein, lipids, and glucose were determined. We used flow cytometry to measure the CD25 and CD28 expression in circulating lymphocytes, T-regulatory (Treg) cell percentage, lymphocyte proliferation, and cytokines released by cultured lymphocytes. The T2DM group had a lower proportion of CD28+ cells and a higher percentage of Treg lymphocytes and proliferative capacity at the baseline compared with the control group. After 16 weeks of the program, differences in lymphocytes between the T2DM and the control groups disappeared. The dance program promoted IL-10 increase in both groups. We found decreased IL-4, IL-2, and IL-6 secretion in lymphocytes from the control group and increased IL-17 secretion and IL-10/IL-17 ratio in the T2DM group after the program. The program promoted marked changes in lymphocytes in diabetic women, leading to a balance between the different profiles.
The Behaviour observation scale for Psychomotor Therapy for elderly people with dementia (BPMT-dem) was
developed to (1) evaluate the cognitive, emotional and social functioning of people with dementia in psychomotor
therapy, and (2) to facilitate the interdisciplinary communication in treatment of behavioural and mood
disruptions. The objective was to investigate the homogeneity and reliability of the BPMT-dem73. The Mokken
scaling procedure was used on items and 10 a-priori determined subscales in a sample of 105 people with dementia
or severe cognitive impairments.
68 items demonstrated sufficient scalability (item-scalability coefficient Hi ranged from .30 to .81). 6 subscales
had strong, and 4 had moderate homogeneity. The 68-item version of BPMT-dem has satisfactory reliability (Rho
ranged from .65 to .89 for the subscales). Researchers and psychomotor therapists are recommended to use
BPMT-dem68 to gain insight into the efficacy of psychomotor therapy on the cognitive, emotional and social
functioning of people with dementia.
Background:
Dance combines cultural and aesthetic elements with behaviors important for brain health, including physical activity, social engagement, and cognitive challenge. Therefore, dance could positively impact public health given the rapidly aging population, increasing incidence of Alzheimer's disease and related dementias, and lack of uptake of exercise in many older adults. Despite a high volume of literature, existing literature does not support evidence-based guidelines for dance to support healthy aging.
Objective:
To conduct a scoping review of the dance intervention literature in older adults and provide information to facilitate a more consistent approach among scientists in designing dance interventions for older adults that stimulate physical and neurocognitive health adaptations.
Methods:
Study characteristics (sample size, population, study design, outcomes, intervention details) were ascertained from 112 separate studies of dance reported in 127 papers that reported outcomes important for brain health (cardiorespiratory fitness, balance and mobility, cognition, mood, and quality of life).
Results:
High heterogeneity across studies was evident. Class frequency ranged from < 1 to 5 classes per week, class length from 30-120 minutes, and intervention duration from 2 weeks to 18 months. Studies often did not randomize participants, had small (< 30) sample sizes, and used varied comparator conditions. Over 50 tests of cognition, 40 dance forms, and 30 tests of mobility were identified.
Conclusions:
Based on these results, important future directions are establishing common data elements, developing intervention mapping and mechanistic modeling, and testing dosing parameters to strengthen and focus trial design of future studies and generate evidence-based guidelines for dance.
Os sintomas depressivos estão produzindo grande impacto na vida dos idosos, diminuindo a percepção de qualidade de vida nesta faixa etária. A prática do exercício físico durante o processo de envelhecimento é considerada um fator protetivo da saúde geral e da qualidade das relações interpessoais. O estudo busca realizar uma revisão sistemática da literatura e analisar a eficácia da prática do exercício como estratégia no auxílio do tratamento de idosos com sintomas depressivos. Trata-se de uma revisão sistemática conduzida conforme as recomendações do Cochrane Handbook for Systematic Reviews of Interventions e do Preferred Reporting Items for Systematic Reviews e Meta-Analyzes (PRISMA). As bases de dados consultadas foram o Pubmed, Scielo, PsycInfo e Scopus, sendo utilizado os termos de pesquisa, "exercise" OR "physical activity", "depressive disorder" OR "depression" e “clinical trial”. Foram incluídos estudos de intervenção com idosos (de idade igual ou superior a 60 anos), que apresentavam sintomas depressivos. Ao total foram identificados 10164 artigos, resultando no fim do processo de identificação 17 artigos incluídos (com indivíduos de ambos os sexos). Destes, 14 apresentaram diferença significativa, indicando que a prática do exercício físico foi eficiente na redução dos sintomas depressivos em pacientes com uso ou não das terapias padrão (psicoterapia e terapia medicamentosa). Todos os pesquisadores adaptaram as diversas categorias de exercício praticados nos estudos (caminhada livre, natação, treino de força) às fragilidades dos idosos presentes em contextos institucionais ou não. Grande parte dos estudos apontaram que a prática do exercício físico gera melhora nos sintomas depressivos, podendo ser recomendado como tratamento auxiliar às terapias medicamentosas e psicoterápicas no tratamento dos sintomas depressivos em idosos.
Resumo: Os sintomas depressivos estão produzindo grande impacto na vida do idoso, diminuindo a percepção de qualidade de vida nesta faixa etária. A prática do exercício físico durante o processo de envelhecimento é considerada um fator protetivo da saúde geral e da qualidade das relações interpessoais. O estudo busca realizar uma revisão sistemática da literatura e analisar a eficácia da prática do exercício como estratégia no auxílio do tratamento de idosos com sintomas depressivos. Trata-se de uma revisão sistemática conduzida conforme as recomendações do Cochrane Handbook for Systematic Reviews of Interventions e do Preferred Reporting Items for Systematic Reviews e Meta-Analyzes (PRISMA). As bases de dados consultadas foram o Pubmed, Scielo, PsycInfo e Scopus, sendo utilizado os termos de pesquisa, "exercise" OR "physical activity", "depressive disorder" OR "depression" e "clinical trial". Foram incluídos estudos de intervenção com idosos (de idade igual ou superior a 60 anos), que apresentavam sintomas depressivos. Ao total foram identificados 10164 artigos, resultando no fim do processo de identificação 17 artigos incluídos (com indivíduos de ambos os sexos). Destes, 14 apresentaram diferença significativa, indicando que a prática do exercício físico foi eficiente na redução dos sintomas depressivos em pacientes com uso ou não das terapias padrão (psicoterapia e terapia medicamentosa). Em três estudos, os participantes não apresentaram melhora ou piora dos sintomas, sendo que em um deles é des tacado pelos autores o baixo nível de adesão ao treinamento. Todos os estudos foram realizados em países desenvolvidos ou em desenvolvimen to e os níveis de sintomas depressivos foram mensurados por questionários psicométricos. Todos os pesquisadores adaptaram as diversas categorias de exercício praticados nos estudos (caminhada livre, natação, treino de força) às fragilidades dos idosos presentes em contexto s institucionais ou não. Grande parte dos estudos apontaram que a prática do exercício físico gera melhora nos sintomas depressivos, podendo ser recomendado como tratamento auxiliar às terapias medicamentosas e psicoterápicas no tratamento dos sintomas depressivos em idosos.
This systematic review and meta-analysis (PROSPERO CRD42023428105) investigated the effect of dancing on depression and anxiety symptoms in older adults. Conducted up to October 2023, the search across seven databases and gray literature yielded 5020 records. Only randomized trials that analyzed dance interventions for depression and/or anxiety in older adults were included. Nineteen randomized trials, involving 508 participants in dance classes lasting 5 weeks to 18 months, were included and 16 were subjected to meta-analysis. Risk of bias was assessed using the Cochrane tool. The meta-analysis showed a statistically significant reduction in depression among older adults participating in dance interventions (p < 0.01). A decrease in depressive symptoms was significant compared to that in those involved in no other intervention (p = 0.02) but not compared to that achieved with other interventions in control groups (p = 0.96). Subgroup analysis showed no significant differences in depression scores for those with mild cognitive impairment (p = 0.47). These conclusions are associated with moderate bias and very low certainty. Due to heterogeneity and the small number of studies, conclusions for anxiety outcomes could not be drawn. These results underscore the potential clinical relevance of integrating dance into mental health interventions for older adults, thereby highlighting a promising avenue for enhancing the mental well-being of this demographic.
Purpose
Depression disorder is the most commonly diagnosed type of mental illness among youths. Although a plethora of evidence suggests a positive relationship between exercise and lower levels of depression in youths, the findings regarding the variation in magnitude of this relationship are inconclusive with respect to the preventive and therapeutic effects of different types of exercise. This network meta-analysis aimed to determine the best type of exercise for the treatment and prevention of depression in youths.
Methods
A comprehensive search of databases, including PubMed, EMBASE, The Cochrane Library, Web of Science, PsychINFO, ProQuest, Wanfang, and CNKI, was conducted to identify relevant research on exercise interventions for depression in youth populations. The risk of bias in the included studies was evaluated using Cochrane Review Manager 5.4 according to the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria. The network meta-analysis was performed using STATA 15.1 to calculate the standardized mean difference (SMD) of all concerned outcomes. The node-splitting method was used to test the local inconsistency of the network meta-analysis. Funnel plots were used to evaluate the potential impact of bias in this study.
Result
Utilizing data extracted from 58 studies (10 countries, 4,887 participants), we found that for depressed youths, exercise is significantly better than usual care in reducing anxiety (SMD = −0.98, 95% CI [-1.50, −0.45]). For non-depressed youths, exercise is significantly better than usual care in reducing anxiety (SMD = −0.47, 95% CI [ −0.66, −0.29]). In the treatment of depression, resistance exercise (SMD = −1.30, 95% CI [ −1.96, −0.64]), aerobic exercise (SMD = −0.83, 95% CI [-1.10 −0.72]), mixed exercise (SMD = −0.67, 95% CI [−0.99, −0.35]), and mind-body exercise (SMD = −0.61, 95% CI [−0.84, −0.38]) all showed significant efficacy over usual care. For the prevention of depression, resistance exercise (SMD = −1.18, 95% CI [-1.65, −0.71]), aerobic exercise (SMD = −0.72, 95% CI [−0.98, −0.47]), mind-body exercise (SMD = −0.59, 95% CI [-0.93, −0.26]), and mixed exercise (SMD = −1.06, 95% CI [−1.37 to −0.75]) were all significantly effective compared to usual care. According to the test of the surface under the cumulative ranking score (SUCRA), the ranking of exercises for the treatment of depression in depressed youths is as follows: resistance exercise (94.9%) > aerobic exercise (75.1%) > mixed exercise (43.8%) > mind-body exercise (36.2%) > usual care (0%). For the prevention of depression in non-depressed youths, resistance exercise (90.3%) > mixed exercise (81.6%) > aerobic exercise (45.5%) > mind-body exercise (32.6%) > usual care (0%). Resistance exercise thus had the best comprehensive effect on both the treatment and prevention of depression in youths (clusterank value = 1914.04). Subgroup analyses show that a frequency of 3–4 times per week, a duration of 30–60 min, and a length of more than 6 weeks were found to be the most effective interventions for depression (P > 0.001).
Conclusion
This study provides compelling evidence that exercise is a viable intervention for improving depression and anxiety in young individuals. In addition, the study emphasizes the importance of selecting the appropriate type of exercise to optimize treatment and prevention. Specifically, the results suggest that resistance exercise, performed 3–4 times per week, with sessions lasting 30–60 min and a length of more than 6 weeks, yields optimal results for the treatment and prevention of depression in young individuals. These findings have significant implications for clinical practice, particularly given the challenges associated with implementing effective interventions and the economic burden of treating and preventing depression in young people. However, it is worth noting that additional head-to-head studies are necessary to confirm these findings and strengthen the evidence base. Nevertheless, this study provides valuable insights into the role of exercise as a potential treatment and preventative measure for depression in young people.
Systematic review registration
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=374154, identifier: 374154.
Meta-analyses of the effects of dance on depressive symptoms in older adults have shown contradictory results, but few primary studies were included (5 and 8 studies). We aimed to examine the effects of dance on depressive symptoms in older adults aged 60 years and older and to examine the moderator effects of the source, participants, methods, and intervention characteristics. We included 23 primary studies that compared depressive symptoms across dance and comparison/control groups of older adults (72 ± 6.7 years old) and were written in English ( N = 1,398) participants. Dance groups showed significantly less depressive symptoms post-intervention than comparison groups (ES = 0.66, 95% CI [0.42, 0.91], p < .001, I ² = 76.80%). South America and Australia showed the greatest effects. Using quasi-experimental designs showed significant effect sizes compared to using randomized designs. Only one quality indicator, intention-to-treat, influenced effect size. Dance might be used as an alternative treatment to improve depression.
Multimodal lifestyle-based interventions that integrate physical, mental and social stimulation could promote mental health and brain resilience against dementia. This meta-analysis examined the efficacy of dance movement interventions (DMI) on psychological health in older adults. Pre-registration was done with PROSPERO (CRD42021265112). PubMed, Web of Science and PsycInfo were searched for randomized controlled trials (RCT) evaluating the effects of DMI (>4 weeks duration) on measures of psychological health (primary outcome) and cognitive function (additional outcome) among older adults without dementia (≥55). Data of 13 primary RCT (n=943, n-DMI=474, n-control=469) were synthesized using a random effects meta-analysis with robust variance estimation. DMI had a small positive effect on overall psychological health (g=0.31; 95% CI: [0.09,0.53]; p=.01, I2=62.55) and a medium effect on general cognitive function (g=0.48; 95% CI: [0.03,0.93], p=.04, I2=82.45) compared to comparators. None of the primary studies included neurophysiological measures. DMI may serve as a multimodal enrichment strategy to promote healthy mental aging. High-quality intervention studies are needed to expand evidence for psychological domains and identify the underlying neurophysiological correlates.
Aerobic exercise improves executive function—which tends to decline with age—and dual-task training with aerobic exercise improves the global cognitive function. However, home-based older adults could not follow these programs due to social isolation during the coronavirus disease 2019 pandemic. Therefore, we conducted a single-blind randomized controlled trial with 88 healthy older adults without dementia or sarcopenia who were randomly assigned into the Nordic walking (aerobic exercise), dance (dual-task training with aerobic exercise), or control group. The participants in both exercise intervention groups trained for 30 min, three times per week, for 4 weeks. All groups consumed amino acid-containing foods three times per week. We found that both exercise intervention groups showed improvements in executive function, while the dance group showed additional improvement in global cognitive function. The dance group showed a higher maximum gait speed, greater improvement in imitation ability, and improved executive function and cognitive function than the Nordic walking group. The intervention programs did not significantly affect the muscle mass or muscle output than the control group; however, both programs improved the participant neurological functions such as the heel lift, with dance training being the most effective intervention. In conclusion, dance training effectively improves cognitive function.
The aim of this study was to develop and evaluate the psychological impact of a chair-based dance intervention for older people with depressive symptoms in residential care in Macau. In addition, feasibility and acceptability of this complex intervention were explored. An exploratory phase quasiexperimental study with pre- and posttest intervention was used. Psychological data for the study were collected using several self-reported questionnaires, including the Geriatric Depression Scale (GDS) Short-Form, Multidimensional Scale of Perceived Social Support (MSPSS), University of California, Los Angeles Loneliness Scale (UCLA-LS), and Connor-Davidson Resilience Scale-10 item (CD-RISC-10). In addition, sociodemographic characteristics were collected from the 13 residents who fully completed the study. After receiving chair-based dance intervention, the mean GDS score (P = .001), mean MSPSS score (P = .000), mean UCLA-LS score (P = .000), and mean CD-RISC-10 score (P = .012) of the group improved with statistical significance. From the scores of the primary outcome, the GDS-15, item 2 “dropped many of your activities and interests” improved the most (−46%), followed by item 5 “in good spirits” (−43%), then item 3 “life is empty” (−33%) and item 7 “feel happy” (−33%). Our chair-based dance intervention may have a positive effect on decreasing symptoms of depression and improving other aspects of psychological well-being in older Chinese people in long-term residential care. In addition, chair-based dance would appear to be a safe, inexpensive, feasible, and acceptable form of intervention for rehabilitation in this setting. These findings provide valuable information to inform a full randomized controlled trial.
Background
Depression is associated with a greater risk of disability, cognitive impairment, and suicide. Older adults in long-term care facilities (LTCFs) are more likely to develop depression due to changes in family roles and separation from family members. The aim of this study was to synthesize and analyze the effects of different types of exercise and training duration on depressive symptoms of older adults in LTCFs.
Methods
Relevant peer-reviewed journal articles published in English were identified through a search of six electronic databases up to June 2021.
Results
A total of 25 studies were included in the systematic review and 22 in the meta-analysis. The results of meta-analysis showed that exercise interventions reduced depression in cognitively intact older adults and in cognitively impaired older adults. Both exercising less than 150 minutes per week or more than 150 minutes per week, reduced depressive symptoms of older adults. In terms of exercise types, mind-body exercises, exergames, and strength training reduced depressive symptoms.
Conclusion
Exercise has a positive effect on reducing depressive symptoms with mind-body exercises, exergames, and strength training producing the best effect. Regardless of cognitive impairment, older adults in LTCFs benefited from exercise in reducing depressive symptoms.
The number of older adults in the U.S. with mental health disorders is projected to rise and traditional therapies are costly, carry stigma, and lack efficacy for all patients. Expansion of innovative treatments is needed. Movement Therapy (MT) involves the psychotherapeutic use of expressive movement to produce physical and emotional change. Effects of short-term MT on subjective measures of quality of life, sleep, depression, personality, self-esteem, and anxiety were examined. Participants (N = 49) were older adults (M = 69.3, SD = 8.37) living in [BLIND], [BLIND], a 55+ active lifestyle community, referred by their primary care providers following diagnosis of depression or anxiety. Structured, small group sessions focused on establishing peer-support and healthy responses to psychological distress during weekly, 1-hour meetings. Pre/post-intervention surveys were analyzed using paired sample t-tests. Significant reductions were found in depression as measured by Beck’s Depression Inventory, t(45) = 3.16, p =.004, d = 0.14 and The Hospital Anxiety and Depression Scale, t(44) =2.47, p =.018, d = 0.31. Additionally, significant improvements in self-esteem t(45) = 3.14, p =.004, d = 0.32 were reported using Rosenberg’s Self-Esteem Scale. Participants reported a highly positive experience, as measured by scores of program efficacy on a scale of 1-10 (M = 9.24, SD = 1.51). Further studies may benefit from using control groups and follow-up measurements to confirm the effectiveness of MT with older adults.
Objective
The present study aimed to verify the feasibility and preliminary effects of nurse-led square dancing designed to improve older adults’ cognitive function and depressive symptoms who with MCI.
Methods
A quasi-experimental pilot study design was adopted for the present study. Screening for cognitive function was conducted among older adults (≥ 60 years old) living in two communities in Beijing who complained of memory loss. A total of 107 older patients with MCI and depressive symptoms were diagnosed after obtaining informed consent. Thirty-five patients selected from each community were included in the study as control and intervention groups, respectively. The two groups of patients received health education while the intervention group participated in a square dance intervention program led by nurses three times per week for 60 min per session over a period of three months. The Montreal Cognitive Assessment-Peking version (MoCA-P) and Geriatric Depression Scale (GDS-30) were used to assess the cognitive function and depressive symptoms of patients in the two groups at three time intervals; before intervention, at the end of the three-month intervention period, and over a three-month follow-up period after the end of intervention.
Results
Feasibility of the intervention was established with a high completion rate of 90%. Data collection for 63 out of 70 patients enrolled for the study was completed after six months. MoCA-P and GDS-30 scores of the intervention group were significantly different after the intervention when compared with the control group. A significant improvement in cognition was observed in the intervention group, and depressive symptoms decreased after intervention and follow-up when compared with the control group. During the intervention and follow-up phases, the MoCA-P score of the intervention group increased gradually with time. Furthermore, the MoCA-P and GDS-30 scores of the control group remained unchanged.
Conclusion
This study has revealed that square dance intervention exerts a positive impact on cognitive function and depressive symptoms among older patients suffering from MCI and depressive symptoms. The results of this study support the feasibility and preliminary effects of square dancing on relieving cognitive decline and depressive symptoms. Square dancing is a recommended type of intervention that can be applied to the local Chinese population because of its simplicity, convenience, and suitability for the older adults.
Objective
We examined the effects of exercise on depression in older adults living in nursing homes and explored the moderator effects of participants, methods, and intervention characteristics.
Methods
We searched 8 databases from inception to January 2020 without date restrictions. We retrieved primary studies measuring exercise with 60-year-olds with depression that were written in English. Two researchers independently coded each primary study and compared codes for discrepancies. They consulted a third researcher to come to consensus. We used random-effects model to compute effect sizes using Hedges’ g, a forest plot, and Q and I² statistics as measures of heterogeneity. We also examined moderator analyses.
Results
Twenty-one studies included 2,594 participants (81.8 ± 4.8 years old). Overall, exercise showed a small improvement in depression compared to controls (ES=.25; 95%CI 0.11, 0.38; p=.000). Interestingly, interventionists by physiotherapists had a smaller effect on depressive symptoms (.04) than other health interventionists (.37). As people aged, exercise was less effective in reducing depression (slope=-.03, Qmodel=5.03, p=.025). Researchers who included a higher percentage of women in exercise showed less improvement of depression (slope=-.01, Qmodel=8.60, p=.003). Also, when researchers used depression scales with higher reliability values, they measured higher levels of depression (slope = 5.48, Qmodel=5.60, p=.018). No other quality indicators moderated the effects of exercise on depression.
Conclusion
Exercise significantly improved depressive symptoms among older adults in nursing homes. Exercise might be used as adjunct/alternative complementary treatment for improving depressive symptoms in older adults in nursing homes.
Introduction: Compared to old people who live at home, depressive symptoms are more prevalent in those who live in long-term care facilities (LTCFs). Different kinds of non-pharmacological treatment approaches in LTCFs have been studied, including behavioral and cognitive-behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy and life review/reminiscence. The aim of the current review was to systematically review non-pharmacological treatments used to treat depressed older adults with no or mild cognitive impairment (as described by a Mini Mental State Examination score > 20) living in LTCFs.
Methods: A research was performed on PubMed and Scopus databases. Following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) flowchart, studies selection was made. The quality of each Randomized Controlled Trial was scored using the Jadad scale, Quasi-Experimental Design studies and Non-Experimental studies were scored based on the Newcastle-Ottawa Scale (NOS)
Results: The review included 56 full text articles; according to the type of intervention, studies were grouped in the following areas: horticulture/gardening (n = 3), pet therapy (n = 4), physical exercise (n = 9), psychoeducation/rehabilitation (n = 15), psychotherapy (n = 3), reminiscence and story sharing (n = 14), miscellaneous (n = 8).
Discussion and Conclusion: Despite mixed or negative findings in some cases, most studies included in this systematic review reported that the non-pharmacological interventions assessed were effective in the management of depressed elderly in the LTCFs context. Regrettably, the limitations and heterogeneity of the studies described above hinder the possibility to generalize and replicate results.
Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years.
Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12 th , 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups.
Results: The systematic review included 82 RCTs, with 69 meeting eligibility for the network meta-analysis ( n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges’ g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges’ g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges’ g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges’ g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment.
Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults.
Registration: PROSPERO CRD42018115866 (23/11/2018).
Context: Dance has been suggested as a way of helping people with advanced dementia, providing meaningful involvement and activity.Objectives: To investigate if individuals with advanced dementia would be able to take part in dancing in a Dance Café within a residential home setting and undertake the assessment of nutrition, quality of life, balance and mobility.Methods: A wait-list intervention approach was used, with residents allocated randomly to the intervention or a control group, who received the dance intervention later. A Dance Café was held weekly for 8 weeks, and assessments were made of weight, nutrition, balance, mobility and quality of life. Focus groups were held with staff and family members after the intervention period to assess their opinions.Findings: The regular assessments of nutrition, balance and quality of life were obtained for the residents with dementia, and they were able to join in the Dance Café. No conclusions could be made from the limited quantitative results; in the qualitative assessment, however, the staff and families all felt the participants had benefitted from the Dance Café in terms of improved mobility and positive psychosocial effects.Limitations: The small size of the intervention group prevented any statistical analysis of the quantitative assessments.Implications: It is possible to undertake a Dance Café with people with severe dementia, and assessments of nutrition and mobility can be undertaken. Further research with a larger group would be needed to investigate its effectiveness.
Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years.
Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12 th , 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups.
Results: The systematic review included 81 RCTs, with 69 meeting eligibility for the network meta-analysis ( n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges’ g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges’ g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges’ g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges’ g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment.
Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults, irrespective of severity.
Registration: PROSPERO CRD42018115866 (23/11/2018).
Background:
Insufficient response to monotreatment for depression is a common phenomenon in clinical practice. Even so, evidence indicating how to proceed in such cases is sparse.
Methods:
This study looks at the second phase of a sequential treatment algorithm, in which 103 outpatients with moderately severe depression were initially randomized to either short-term supportive psychodynamic therapy (PDT) or antidepressants. Patients who reported less than 30% symptom improvement after 8 weeks were offered combined treatment. Outcome measures were the Hamilton Depression Rating Scale (HAM-D), the Clinical Global Impression of Severity and Improvement, the SCL-90 depression subscale and the EuroQOL questionnaire.
Results:
Despite being nonresponsive, about 40% of patients preferred to continue with monotherapy. At treatment termination, patients initially randomized to PDT had improved more than those initially receiving antidepressants, as indicated by the HAM-D and the EuroQOL, independently of whether the addition was accepted or not.
Conclusions:
Starting with psychotherapy may be preferable in mildly and moderately depressed outpatients. For patients who receive either PDT or antidepressants, combined therapy after early nonresponse seems to be helpful. Nevertheless, this sequential strategy is not always preferred by patients.
Several studies have suggested that depression is associated with an increased risk of stroke; however, the results are inconsistent.
To conduct a systematic review and meta-analysis of prospective studies assessing the association between depression and risk of developing stroke in adults.
A search of MEDLINE, EMBASE, and PsycINFO databases (to May 2011) was supplemented by manual searches of bibliographies of key retrieved articles and relevant reviews.
We included prospective cohort studies that reported risk estimates of stroke morbidity or mortality by baseline or updated depression status assessed by self-reported scales or clinician diagnosis.
Two independent reviewers extracted data on depression status at baseline, risk estimates of stroke, study quality, and methods used to assess depression and stroke. Hazard ratios (HRs) were pooled using fixed-effect or random-effects models when appropriate. Associations were tested in subgroups representing different participant and study characteristics. Publication bias was evaluated with funnel plots and Begg test.
The search yielded 28 prospective cohort studies (comprising 317,540 participants) that reported 8478 stroke cases (morbidity and mortality) during a follow-up period ranging from 2 to 29 years. The pooled adjusted HRs were 1.45 (95% CI, 1.29-1.63; P for heterogeneity <.001; random-effects model) for total stroke, 1.55 (95% CI, 1.25-1.93; P for heterogeneity = .31; fixed-effects model) for fatal stroke (8 studies), and 1.25 (95% CI, 1.11-1.40; P for heterogeneity = .34; fixed-effects model) for ischemic stroke (6 studies). The estimated absolute risk differences associated with depression were 106 cases for total stroke, 53 cases for ischemic stroke, and 22 cases for fatal stroke per 100,000 individuals per year. The increased risk of total stroke associated with depression was consistent across most subgroups.
Depression is associated with a significantly increased risk of stroke morbidity and mortality.
Physical activity and exercise appear to improve psychological health. However, the quantitative effects of Tai Chi on psychological well-being have rarely been examined. We systematically reviewed the effects of Tai Chi on stress, anxiety, depression and mood disturbance in eastern and western populations.
Eight English and 3 Chinese databases were searched through March 2009. Randomized controlled trials, non-randomized controlled studies and observational studies reporting at least 1 psychological health outcome were examined. Data were extracted and verified by 2 reviewers. The randomized trials in each subcategory of health outcomes were meta-analyzed using a random-effects model. The quality of each study was assessed.
Forty studies totaling 3817 subjects were identified. Approximately 29 psychological measurements were assessed. Twenty-one of 33 randomized and nonrandomized trials reported that 1 hour to 1 year of regular Tai Chi significantly increased psychological well-being including reduction of stress (effect size [ES], 0.66; 95% confidence interval [CI], 0.23 to 1.09), anxiety (ES, 0.66; 95% CI, 0.29 to 1.03), and depression (ES, 0.56; 95% CI, 0.31 to 0.80), and enhanced mood (ES, 0.45; 95% CI, 0.20 to 0.69) in community-dwelling healthy participants and in patients with chronic conditions. Seven observational studies with relatively large sample sizes reinforced the beneficial association between Tai Chi practice and psychological health.
Tai Chi appears to be associated with improvements in psychological well-being including reduced stress, anxiety, depression and mood disturbance, and increased self-esteem. Definitive conclusions were limited due to variation in designs, comparisons, heterogeneous outcomes and inadequate controls. High-quality, well-controlled, longer randomized trials are needed to better inform clinical decisions.
This article reports the results of a study evaluating a preferred music listening intervention for reducing anxiety in older adults with dementia in nursing homes.
Anxiety can have a significant negative impact on older adults' functional status, quality of life and health care resources. However, anxiety is often under-diagnosed and inappropriately treated in those with dementia. Little is known about the use of a preferred music listening intervention for managing anxiety in those with dementia.
A quasi-experimental pretest and posttest design was used.
This study aimed to evaluate the effectiveness of a preferred music listening intervention on anxiety in older adults with dementia in nursing home. Twenty-nine participants in the experimental group received a 30-minute music listening intervention based on personal preferences delivered by trained nursing staff in mid-afternoon, twice a week for six weeks. Meanwhile, 23 participants in the control group only received usual standard care with no music. Anxiety was measured by Rating Anxiety in Dementia at baseline and week six. Analysis of covariance (ancova) was used to determine the effectiveness of a preferred music listening intervention on anxiety at six weeks while controlling for pretest anxiety, age and marital status.
ancova results indicated that older adults who received the preferred music listening had a significantly lower anxiety score at six weeks compared with those who received the usual standard care with no music (F = 12.15, p = 0.001).
Preferred music listening had a positive impact by reducing the level of anxiety in older adults with dementia.
Nursing staff can learn how to implement preferred music intervention to provide appropriate care tailored to the individual needs of older adults with dementia. Preferred music listening is an inexpensive and viable intervention to promote mental health of those with dementia.
The aim of this literature review is to explore how music therapy influences the behaviour of older people with dementia.
Music therapy is often informally used in residential care units to enhance communication, emotional, cognitive and behavioural skills in elderly patients diagnosed with dementia both nationally and internationally. However, in Ireland the benefits of music therapy have not been fully recognized. Many studies have been carried out to establish the effectiveness of music therapy on the behaviour of older people with dementia with positive findings. Music therapy should be welcomed into care of the elderly settings in Ireland and elsewhere; however, more research is required to validate the effects of this therapy as a holistic tool to build altruistic connections between carers and clients.
A comprehensive review of nursing literature using the online databases CINAHL, PsycINFO and MEDLINE were carried out. The search was limited to articles in the English language and peer-reviewed journals dating 2003-2009.
Thirteen studies were reviewed and the majority of these studies reported that music therapy influenced the behaviour of older people with dementia in a positive way by reducing levels of agitation. The research further identified a positive increase in participants' mood and socialization skills, with carers having a significant role to play in the use of music therapy in care of the elderly nursing. However, methodological limitations were apparent throughout each of the studies reviewed.
With reference to clinical practice, the authors recommend the undertaking of further research to explore the effects of music therapy on the behaviour and wellbeing of older people with dementia.
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Objectives: The authors conducted a randomized control trial to examine the effect of the Exercise Dance for Seniors (EXDASE) program on lower-body functioning among older individuals from residential care facilities in the Czech Republic. Method: Participants were randomly assigned into an experimental or control group. The experimental group completed a 3-month EXDASE program. Lower-body functioning was assessed using four performance-based measures. A 2 (group) × 2 (test) general linear model for repeated measures was used to explore whether differences in performance could be attributed to the intervention. Results: The authors found Group × Test interactions for the chair stand test, F(1, 50) = 14.37, p < .001, the 2-minute step test, F(1, 50) = 7.33, p = .009, the chair sit-and-reach test, F(1, 50) = 5.28, p = .026, and the timed up-and-go test, F (1, 44) = 6.59, p = .014, indicating that the experimental group outperformed the control group from pretest to posttest. Discussion: A relatively simple dance-based exercise can support lower-body functioning in previously sedentary, frail older adults.
Sex ratios for selected mental disorders such as major depressive disorder and anxiety disorder are much higher in women than men. Anxiety disorders constitute the most prevalent mental disorder in adults, and affect twice as many women as men. Depression and anxiety exist comorbidly and along with other mental disorders. This article focuses on depression and anxiety in women, and other conditions comorbid with depression or anxiety: cardiac disease, obesity, vitamin D deficiency, and irritable bowel syndrome.
Background: The benefits of physical exercise in reducing clinically defined depression in the general population have been established, although a review of the evidence for older adults is needed.
Objectives: To assess the efficacy of physical exercise for the treatment of depressive symptoms in older adults (>60 years).
Data sources: We searched: MEDLINE (1966—May 2008); EMBASE (1980—May 2008); Cumulative Index to Nursing & Allied Health Literature (CINAHL; 1982—May 2008); PsycINFO (1966—May 2008), The Cochrane Library (Issue 2, 2008), and National Research Register (NRR; Issue 2, 2008).
Review methods: Randomized controlled trials and quasi-experimental studies of physical exercise interventions for depression were included where 80% or more of participants were >60 years. Abstracts were assessed to determine whether they met specified inclusion criteria. Primary analysis focused on the prevalence of diagnosable depressive disorder following intervention. Secondary outcome was depression or mood scores on standardized scales.
Results: Eleven randomized controlled trials with a total of 641 participants were included in the review. Short-term positive outcome for depression or depressive symptoms was found in nine studies, although the mode, intensity and duration of intervention varied across studies. Medium- to long-term effects of intervention were less clear.
Conclusion: Physical exercise programmes obtain clinically relevant outcomes in the treatment of depressive symptoms in depressed older people. Exercise, though not appropriate for all in this population, may improve mood in this group. Further research is needed to establish medium- to long-term effects and cost-effectiveness.
One-hundred and ninety-eight elderly subjects attending their general practitioners (GPs) were asked to complete the 15 item Geriatric Depression Scale (GDS15). Analysable results were obtained from 194 (98%). Of these, 67 (34%) scored above the GDS15 cut-off (4/5) for significant depressive symptomatology. 87.6% found the questionnaire to be acceptable and only 3.6% found it very difficult or very stressful. The GDS15 had a high level of internal consistency (Cronbach's alpha = 0.80). All the individual items of the GDS15 associated significantly (P < 0.01) with total score and 'caseness'. A single question "do you feel that your life is empty?" identified 84% of 'cases'. In an attempt to devise short scales to screen elderly primary care patients for depression, the data were subjected to logistic regression analysis. Ten (GDS10), four (GDS4) and on (GDS1) item versions were generated. Agreement between these short scales and the GDS15 in the original sample was 95, 91 and 79% respectively. Cronbach's alpha was 0.72 for the GDS10 and 0.55 for the GDS4. The short scales were then validated in an independent sample of 120 patients in whom both GDS data and the results of a detailed psychiatric interview (the Geriatric Mental Status Schedule, GMS) were available. The sensitivity and specificity of the GDS10 against GMS caseness were 87 and 77% (cut-off 3/4); those of the GDS4 were 89 and 65% (cut-off 0/1) and 61 and 81% (cut-off 1/2). Sensitivity and specificity for the GDS1 were 59 and 75%. It is concluded that these short scales may be useful in helping GPs and practice staff to identify elderly patients with significant depressive symptoms.
Previous observational and interventional studies have suggested that regular physical exercise may be associated with reduced symptoms of depression. However, the extent to which exercise training may reduce depressive symptoms in older patients with major depressive disorder (MDD) has not been systematically evaluated.
To assess the effectiveness of an aerobic exercise program compared with standard medication (ie, antidepressants) for treatment of MDD in older patients, we conducted a 16-week randomized controlled trial.
One hundred fifty-six men and women with MDD (age, > or = 50 years) were assigned randomly to a program of aerobic exercise, antidepressants (sertraline hydrochloride), or combined exercise and medication. Subjects underwent comprehensive evaluations of depression, including the presence and severity of MDD using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and Hamilton Rating Scale for Depression (HAM-D) and Beck Depression Inventory (BDI) scores before and after treatment. Secondary outcome measures included aerobic capacity, life satisfaction, self-esteem, anxiety, and dysfunctional cognitions.
After 16 weeks of treatment, the groups did not differ statistically on HAM-D or BDI scores (P = .67); adjustment for baseline levels of depression yielded an essentially identical result. Growth curve models revealed that all groups exhibited statistically and clinically significant reductions on HAM-D and BDI scores. However, patients receiving medication alone exhibited the fastest initial response; among patients receiving combination therapy, those with less severe depressive symptoms initially showed a more rapid response than those with initially more severe depressive symptoms.
An exercise training program may be considered an alternative to antidepressants for treatment of depression in older persons. Although antidepressants may facilitate a more rapid initial therapeutic response than exercise, after 16 weeks of treatment exercise was equally effective in reducing depression among patients with MDD.
Major depressive disorder is a potentially debilitating condition that often is unrecognized or undertreated in the elderly. Even when aggressively treated, the course of geriatric depression can be severe. There is growing evidence that suggests that late-life depression may carry a higher illness burden than depression with onset earlier in life, and that severity is linked to medical and psychiatric comorbidity. Data continue to accumulate in support of various treatment modalities, including medication, electroconvulsive therapy, and psychotherapy. Given the increased risk of adverse outcomes associated with geriatric depression, such as dementia and suicide, it is essential that future investigations continue to build on the evidence base supporting improved diagnosis and treatment of this complex disorder.
The "get-up and go test" requires patients to stand up from a chair, walk a short distance, turn around, return, and sit down again. This test was conducted in 40 elderly patients with a range of balance function. Tests were recorded on video tapes, which were viewed by groups of observers from different medical backgrounds. Balance function was scored on a five-point scale. The same patients underwent laboratory tests of gait and balance. There was agreement among observers on the subjective scoring of the clinical test, and good correlation with laboratory tests. The get-up and go test proved to be a satisfactory clinical measure of balance in elderly people.
The observability of the combined state of the strapdown inertial navigation system (SINS) was inferred on the stationary base only by using velocity errors as the observable parameter, which is equal to evaluation of the SINS states by using the velocity errors and position errors as the observable parameters. Furthermore, the observability of continuous rotation of SINS was studied by means of the observability analysis theory of piece-wise constant system (PWCS). Results show that the continuous rotation improves the observability of SINS, the equivalent accelerometer biases both in the east and north are observable and can be compensated in the alignment, the accuracy and speed of alignment is improved obviously.
Background:
Depression is common and is associated with poor outcomes among elderly care-home residents. Exercise is a promising low-risk intervention for depression in this population. We tested the hypothesis that a moderate intensity exercise programme would reduce the burden of depressive symptoms in residents of care homes.
Methods:
We did a cluster-randomised controlled trial in care homes in two regions in England; northeast London, and Coventry and Warwickshire. Residents aged 65 years or older were eligible for inclusion. A statistician independent of the study randomised each home (1 to 1·5 ratio, stratified by location, minimised by type of home provider [local authority, voluntary, private and care home, private and nursing home] and size of home [<32 or ≥32 residents]) into intervention and control groups. The intervention package included depression awareness training for care-home staff, 45 min physiotherapist-led group exercise sessions for residents (delivered twice weekly), and a whole home component designed to encourage more physical activity in daily life. The control consisted of only the depression awareness training. Researchers collecting follow-up data from individual participants and the participants themselves were inevitably aware of home randomisation because of the physiotherapists' activities within the home. A researcher masked to study allocation coded NHS routine data. The primary outcome was number of depressive symptoms on the geriatric depression scale-15 (GDS-15). Follow-up was for 12 months. This trial is registered with ISRCTN Register, number ISRCTN43769277.
Findings:
Care homes were randomised between Dec 15, 2008, and April 9, 2010. At randomisation, 891 individuals in 78 care homes (35 intervention, 43 control) had provided baseline data. We delivered 3191 group exercise sessions attended on average by five study participants and five non-study residents. Of residents with a GDS-15 score, 374 of 765 (49%) were depressed at baseline; 484 of 765 (63%) provided 12 month follow-up scores. Overall the GDS-15 score was 0·13 (95% CI -0·33 to 0·60) points higher (worse) at 12 months for the intervention group compared with the control group. Among residents depressed at baseline, GDS-15 score was 0·22 (95% CI -0·52 to 0·95) points higher at 6 months in the intervention group than in the control group. In an end of study cross-sectional analysis, including 132 additional residents joining after randomisation, the odds of being depressed were 0·76 (95% CI 0·53 to 1·09) for the intervention group compared with the control group.
Interpretation:
This moderately intense exercise programme did not reduce depressive symptoms in residents of care homes. In this frail population, alternative strategies to manage psychological symptoms are required.
Funding:
National Institute for Health Research Health Technology Assessment.
The Index of ADL was developed to study results of treatment and prognosis in the elderly and chronically ill. Grades of the Index summarize over-all performance in bathing, dressing, going to toilet, transferring, continence, and feeding. More than 2,000 evaluations of 1,001 individuals demonstrated use of the Index as a survey instrument, as an objective guide to the course of chronic illness, as a tool for studying the aging process, and as an aid in rehabilitation teaching. Of theoretical interest is the observation that the order of recovery of Index functions in disabled patients is remarkably similar to the order of development of primary functions in children. This parallelism, and similarity to the behavior of primitive peoples, suggests that the Index is based on primary biological and psychosocial function, reflecting the adequacy of organized neurological and locomotor response.
Previous meta-analyses investigating the effect of exercise on depression have included trials where the control condition has been categorized as placebo despite the fact that this particular placebo intervention (e.g., meditation, relaxation) has been recognized as having an antidepressant effect. Because meditation and mindfulness-based interventions are associated with depression reduction, it is impossible to separate the effect of the physical exercise from the meditation-related parts. The present study determined the efficacy of exercise in reducing symptoms of depression compared with no treatment, placebo conditions or usual care among clinically defined depressed adults. Of 89 retrieved studies, 15 passed the inclusion criteria of which 13 studies presented sufficient information for calculating effect sizes. The main result showed a significant large overall effect favoring exercise intervention. The effect size was even larger when only trials that had used no treatment or placebo conditions were analyzed. Nevertheless, effect size was reduced to a moderate level when only studies with high methodological quality were included in the analysis. Exercise may be recommended for people with mild and moderate depression who are willing, motivated, and physically healthy enough to engage in such a program.
Major depression, defined according to DSM IV TR criteria, is less common in older subjects, while other types of depression are two to three times more prevalent. This heterogeneous group of disturbances has received different names: depression not otherwise specified, minor depression, subthreshold or subsyndromal depression. Moreover, each condition has been defined using heterogeneous criteria by different authors. The term of subthreshold depression will be adopted in this position statement. Subthreshold depression has been associated with the same negative consequences of major depression, including reduced well being and quality of life, worsening health status, greater disability, increased morbidity and mortality. Nevertheless, there is a dearth of clinical trials in this area, and therefore older patients with subthreshold depression are either not treated or they are treated with the same non pharmacological and pharmacological therapies used for major depression, despite the lack of supporting scientific evidence. There is an urgent need to reach a consensus concerning the diagnostic criteria for subthreshold depression as well as to perform clinical trials to identify effective and safe therapies in this too long neglected patient group.
The prevelance of depression in older people is high, treatment is inadequate, it creates a substantial burden and is a public health priority for which exercise has been proposed as a therapeutic strategy.
To estimate the effect of exercise on depressive symptoms among older people, and assess whether treatment effect varies depending on the depression criteria used to determine participant eligibility.
Systematic review and meta-analysis of randomised controlled trials of exercise for depression in older people.
Nine trials met the inclusion criteria and seven were meta-analysed. Exercise was associated with significantly lower depression severity (standardised mean difference (SMD) = -0.34, 95% CI -0.52 to -0.17), irrespective of whether participant eligibility was determined by clinical diagnosis (SMD = -0.38, 95% CI -0.67 to -0.10) or symptom checklist (SMD = -0.34, 95% CI -0.62 to -0.06). Results remained significant in sensitivity analyses.
Our findings suggest that, for older people who present with clinically meaningful symptoms of depression, prescribing structured exercise tailored to individual ability will reduce depression severity.
Purpose:
The purpose of this pilot study was to evaluate the impact of jazz dance class instruction on balance, cognition, and mood (specifically depression) in 13 healthy, community-dwelling, English-speaking older women with a mean age of 68.
Data sources:
Data were collected using self-report questionnaires (Folstein Mini Mental Status Examination [MMSE] and Geriatric Depression Scale [GDS]), and the sensory organization test (SOT) for balance measurements (using the NeuroCom Smart Balance Master) was performed at three time periods in the study: time 1: between week 1 and week 2 of jazz class (baseline), time 2: between week 8 and week 9 of jazz class (midpoint), and time 3: after week 15 of jazz class (final measurement).
Conclusions:
Differences in mean MMSE and GDS scores over time were not significant; however, SOT scores showed an increasing trend (p < .001). Data analysis using analysis of variance with repeated measures showed that balance measures improved throughout the duration of the study (F(2,10)= 19.68, p < .001). Post hoc analyses using paired t tests with a Bonferroni correction indicated that significant increases in balance occurred from time 1 to time 2 and from time 2 to time 3. These preliminary pilot study findings suggest that jazz dance does not impact cognition or mood but may improve balance in older women. This finding may have significant implications for fall prevention in the postmenopausal population.
Implications for practice:
Because falls are a leading cause of morbidity and mortality in older adults of both genders, research is needed to evaluate both the impact of jazz dance on balance in older men and jazz dance as a fall prevention strategy in aging adults. Additionally, longitudinal research with a larger sample size is needed to test the effectiveness of jazz dance as a strategy for improving balance, cognition, and mood.
Depression is a major public health burden among the aging population. While older adults prefer non-pharmacological treatment, few options for psychotherapy are available in primary care settings, which is where older adults tend to receive mental health services. Indicated prevention is a cost-effective, public health approach to prevent major depressive disorder among people with depressive symptoms who do not yet meet standard criteria for major depression. We critically reviewed randomized controlled trials (RCTs) that assessed the efficacy of psychotherapy among community-dwelling older adults with subthreshold depression (depressive symptoms that do not meet standard criteria for major depression). We examined the intervention types, results, internal validity, and external validity of five studies. We used the United States Preventive Services Task Force (USPSTF) guidelines to rate the quality of the studies and to provide recommendations. Results suggest that psychotherapy is a safe and cost-effective method to reduce the public health burden of depression among older adults with subthreshold depression.
Twenty depressed, community-dwelling older adults (average age = 69) completed a pilot study of ballroom dance lessons as a treatment for geriatric depression. Participants were randomly assigned to either an immediate or delayed treatment condition. All participants received eight ballroom dance lessons from a selection of six dances (foxtrot, waltz, rumba, swing, cha-cha, and tango) from the National Dance Council of America's syllabus. Effect sizes were in the medium range for the HRSD (d = .51) and GDS (d = .40), and in the small range for the SCL-90R (d = .17). There was some support for self-efficacy and hopelessness as outcome predictors. Participant feedback indicated the dance lessons were enjoyable and well-received.
Dance and movement therapy are consisted of music, easy exercises and sensorial stimulus and provide drugless treatment for the depression on low rates. In this study, it has been aimed to examine the effect of dance over the depression. A total of 120 healthy male and female conservatory students ranged from 20 and 24 ages volunteered to participate in this study. They were divided randomly into 1 of 2 groups: dance training group (DTG; N = 60) and control group (CG; N = 60). A dance training program was applied to the subjects three days a week (Tuesday, Thursday, and Saturday) during 12 weeks. The subjects in the control group did not participate in the training and participated only in the pre and post test measurements. Beck Depression Scale was used for the pre and post test measurements of subjects. 12 weeks of dance training has been found to be effective on the depression levels of the subjects participating in the research as the training group (p < 0.05). The depression level of males and females before training has meaningfully decreased after 12 weeks of dance training (p < 0.05). When the depression levels of the subjects participated in research as the control group were separately evaluated for males and females, no meaningful change has been found in the depression levels during 12 weeks (p > 0.05). In conclusion, it has been seen that dance affects the depression levels of university students positively and decreases their depression levels.
We aim to review trials of the effectiveness of music listening in reducing depressive symptoms in adults, and identify areas requiring further study.
Little is known about the efficacy of music listening in the mediation of depressive symptoms.
We systematically search 9 databases and reviewed 17 studies included randomized controlled and quasi-experimental trails of music listening in reducing depressive symptoms in adults. The Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument was used for quality assessment of included studies.
Music listening over a period of time helps to reduce depressive symptoms in the adult population. Daily intervention does not seem to be superior over weekly intervention and it is recommended that music listening session be conducted repeatedly over a time span of more than 3weeks to allow an accumulative effect to occur.
All types of music can be used as listening material, depending on the preferences of the listener. So, it is recommended that the listeners are given choices over the kind of music which they listen to. There is a need to conduct more studies, which replicate the designs used in the existing studies that met the inclusion criteria, on the level of efficacy of music listening on the reduction of depressive symptoms for a more accurate meta-analysis of the findings and reflect with greater accuracy the significant effects that music has on the level of depressive symptoms.
To determine the effect of music on depression levels in older adults. Background. Depression is a common psychiatric disorder in older adults, and its impacts on this group of people, along with its conventional treatment, merit our attention. Conventional pharmacological methods might result in dependence and impairment in psychomotor and cognitive functioning. Listening to music, which is a non-pharmacological method, might reduce depression.
A randomised controlled study.
The study was conducted from July 2009-June 2010 at participants' home in Singapore. In total, 50 older adults (24 using music and 26 control) completed the study after being recruited. Participants listened to their choice of music for 30 minutes per week for eight weeks.
Depression scores were collected once a week for eight weeks.
Depression levels reduced weekly in the music group, indicating a cumulative dose effect, and a statistically significant reduction in depression levels was found over time in the music group compared with non-music group.
Listening to music can help older people to reduce their depression level.
Music is a non-invasive, simple and inexpensive therapeutic method of improving life quality in community-dwelling older people.
Antidepressant medications are the most common psychopharmacologic therapy used to treat depressed nursing home (NH) residents. Despite a significant increase in the rate of antidepressant prescribing over the past several decades, little is known about the effectiveness of these agents in the NH population.
To conduct a systematic review of the literature to examine and compare the effectiveness of antidepressant medications for treating major depressive symptoms in elderly NH residents.
The following databases were searched with searches completed prior to January 2011 and no language restriction: MEDLINE, Embase, PsycINFO, CINHAL, CENTRAL, LILACS, ClinicalTrials.gov, International Standard Randomized Controlled Trial Number Register, and the WHO International Clinical Trial Registry Platform. Additional studies were identified from citations in evidence-based guidelines and reviews as well as book chapters on geriatric depression and pharmacotherapy from several clinical references. Studies were included if they described a clinical trial that assessed the effectiveness of any currently-marketed antidepressant for adults aged 65 years or older, who resided in the NH, and were diagnosed by DSM criteria and/or standardized validated screening instruments with Major Depressive Disorder, minor depression, dysthymic disorder, or Depression in Alzheimer's disease.
A total of eleven studies, including four randomized and seven non-randomized open-label trials, met all inclusion and exclusion criteria. It was not feasible to conduct a meta-analysis because the studies were heterogeneous in terms of study design, operational definitions of depression, participant characteristics, pharmacologic interventions, and outcome measures. Of the four randomized trials, two had a control group and did not demonstrate a statistically-significant benefit for antidepressant pharmacotherapy over placebo. While six of the seven non-randomized studies identified a response to an antidepressant, their results must be interpreted with caution as they lacked a comparison group.
The limited amount of evidence from randomized and non-randomized open-label trials suggests that depressed NH residents have a modest response to antidepressant medications. Further research using rigorous study designs are needed to examine the effectiveness and safety of antidepressants in depressed NH residents, and to determine the various facility, provider, and patient factors associated with response to treatment.
The severity of depression is related to its clinical features and also its impact in terms of morbidity and mortality. Depression is the most common psychiatric disorders associated with suicide and is found in almost one out of two cases, in 85% of situations associated with another mental disorder. Clinically severe depression also has a 4 to 5 times higher long term risk of suicide than mild or moderate depression. Severe depression is also associated with significantly increased deaths from natural causes : in absolute terms this is similar to the additional mortality rate from suicide. Cardiovascular diseases, particularly coronary, are a particular feature of this increased cause of natural deaths. These findings justify the development of prevention and screening for these diseases in depressed patients.
Copyright 2009 L'Encéphale. Published by Elsevier Masson SAS.. All rights reserved.
Nearly two-thirds of elderly patients treated for depression fail to achieve symptomatic remission and functional recovery with first-line pharmacotherapy. In this study, we ask whether a mind-body exercise, Tai Chi Chih (TCC), added to escitalopram will augment the treatment of geriatric depression designed to achieve symptomatic remission and improvements in health functioning and cognitive performance.
: One hundred twelve older adults with major depression age 60 years and older were recruited and treated with escitalopram for approximately 4 weeks. Seventy-three partial responders to escitalopram continued to receive escitalopram daily and were randomly assigned to 10 weeks of adjunct use of either 1) TCC for 2 hours per week or 2) health education (HE) for 2 hours per week. All participants underwent evaluations of depression, anxiety, resilience, health-related quality of life, cognition, and inflammation at baseline and during 14-week follow-up.
Subjects in the escitalopram and TCC condition were more likely to show greater reduction of depressive symptoms and to achieve a depression remission as compared with those receiving escitalopram and HE. Subjects in the escitalopram and TCC condition also showed significantly greater improvements in 36-Item Short Form Health Survey physical functioning and cognitive tests and a decline in the inflammatory marker, C-reactive protein, compared with the control group.
: Complementary use of a mind-body exercise, such as TCC, may provide additional improvements of clinical outcomes in the pharmacologic treatment of geriatric depression.
Depression is very common in people above 65 years living in long-term care. However, little is known about how well depression is recognized and how adequately it is treated. Therefore, the present study aimed at assessing accuracy of the unaided clinical diagnosis of the attending physicians, and the medical treatment situation in nursing home residents.
A random sample of 97 residents of 10 nursing homes in Munich was examined with the Section A "Affective Syndrome" of the Structured Clinical Interview (SCID) for DSM-IV to detect depression. Information concerning clinical diagnosis and medication was obtained from the subjects' medical records.
14.4% suffered acutely from major depression, 14.4% suffered from minor depression, and 18.6% were diagnosed as depressive according to the physician and nursing records. In total, 27.8% received antidepressants. Merely 42.9% of the subjects with acute major depression were diagnosed by their attending physicians as depressive, and only half of them received an antidepressant; 17.5% received antidepressants without a diagnosis of depression in their physician and nursing records. In accordance with the guidelines, 73.3% of the antidepressants prescribed were SSRIs or newer antidepressants. Only 20.0% were tricyclic antidepressants.
Findings show that depression is relatively frequent in residents of nursing homes. Moreover, it is insufficiently recognized by physicians and is even more seldom adequately treated. Also, a significant proportion of residents receive antidepressants without a documented associated indication. Therefore, the recognition and guideline-based treatment of depression should be improved in this high-risk group.
To compare functional mobility, depressive symptoms, level of independence, and quality of life of the elderly living at home and in the nursing home.
A prospectively designed, comparative study.
A nursing home and a university hospital department.
In this study, 33 elderly living in a nursing home and 25 elderly living at home, who fulfilled the inclusion criteria and volunteered to participate, were included.
Sociodemographic characteristics were recorded. Functional mobility (Timed Up & Go Test), depressive symptoms (Geriatric Depression Scale), level of independence (Kahoku Aging Longitudinal Study Scale), and quality of life (Visual Analogue Scale) scores were compared between the groups.
Functional mobility and independence level of the nursing home residents were higher than the home-dwelling elderly (95% CI: -4.88, -0.29 and 0.41, 6.30, respectively), but they had more depressive symptoms (95% CI: 0.30, 5.45), and their level of QoL was lower (95% CI: -15.55, -2.93).
These findings are thought to be important and of benefit for health care professionals and caregivers as indicating the areas that need to be supported for the elderly living at home (functional mobility and independence) and in the nursing home (depressive symptoms and quality of life).
Many people over the age of 65 do not regard depression as a treatable mental disorder and find it difficult to express themselves verbally. Listening to music can facilitate the non-verbal expression of emotion and allow people's inner feelings to be expressed without being threatened. The aim of this study was to determine the effect of music on depression levels in elderly people. A randomized controlled study was conducted with 47 elderly people (23 using music and 24 controls) who completed the study after being recruited in Hong Kong. Blood pressure, heart rate (HR), respiratory rate (RR), and depression level variables were collected. In the music group, there were statistically-significant decreases in depression scores (P < 0.001) and blood pressure (P = 0.001), HR (P < 0.001), and RR (P < 0.001) after 1 month. The implication is that nurses may utilize music as an effective nursing intervention for patients with depressive symptoms in the community setting.
"Depression" and "old age" are often associated among our contemporaries. In this case, "depression" is understood to be "existential despair" and not a "depressive disease": an amalgam is made of the tragedy of the patient's existence and a pathological condition. Clinical pictures of depression, the pathological nature of which is obvious, are frequent in the elderly; however, the line between normal and pathological becomes less clear above a certain symptomatic threshold, in the presence of chronic evolutions and in situations of comorbidity. The nosographical tool, in spite of its limits, is precious. Epidemiological studies that include the comorbidities of the depressive episode with cognitive and/or somatic affections permit better estimations of the prevalence of the symptoms and the depressive problems among elderly populations. The formula "depression is depression at whatever age" harbours a certain truth if one takes into account the multiple factors that modify the symptomatic expression of depression in later life. The most documented factor is the comorbidity of depression with somatic affections that is present in the majority of those aged over 80. Other psychological or sociocultural factors are also apparent, but their influence has been studied less. The decline in cognitive performance observed during depression is not exclusive to the elderly but is undeniably more marked in this population. Making an early diagnosis of Alzheimer's disease or, conversely, eliminating this diagnosis in a depressed patient complaining of diminished cognition is an essential step in the subsequent management. Together with the neuropsychological assessment and brain imaging, required for diagnosis, a neuropsychogeriatric pluridisciplinary assessment is obviously required. The management of geriatric depression is based on various approaches that include somatic care, psychotropic drugs, brain stimulation techniques and psychotherapy, but also requires medicosocial care. The coordination of care is incumbent on the general practitioner in the heart of the plan. However, this theoretical mission may appear impossible for the management of complex cases. Based on this, reflections on were initiated on the modalities of adapting the Anglo-Saxon "collaborative care" to France: coordination of the various therapeutic interventions by a care manager would offer greater efficacy than that of the usual care modalities.
Elders with chronic medical conditions are vulnerable to depression. Mainstream interventions for treating their depression is however far from satisfactory which stimulates the interests of researchers to look for alternative therapies to alleviate geriatric depression. Qigong, a Chinese mindful exercise, is demonstrated to have anti-depressive effects. Results of our earlier studies shed light on the psychological mechanism underlying this effect. The neurobiological mechanism remains unclear. This article attempts to review extant evidence and suggests possible neurobiological pathways of the anti-depressive effect of qigong based on the neurotransmitter, neuroendocrine, and neurotropic perspectives. Further research to consolidate its scientific base is suggested.
The "get-up and go test" requires patients to stand up from a chair, walk a short distance, turn around, return, and sit down again. This test was conducted in 40 elderly patients with a range of balance function. Tests were recorded on video tapes, which were viewed by groups of observers from different medical backgrounds. Balance function was scored on a five-point scale. The same patients underwent laboratory tests of gait and balance. There was agreement among observers on the subjective scoring of the clinical test, and good correlation with laboratory tests. The get-up and go test proved to be a satisfactory clinical measure of balance in elderly people.
A new Geriatric Depression Scale (GDS) designed specifically for rating depression in the elderly was tested for reliability and validity and compared with the Hamilton Rating Scale for Depression (HRS-D) and the Zung Self-Rating Depression Scale (SDS). In constructing the GDS a 100-item questionnaire was administered to normal and severely depressed subjects. The 30 questions most highly correlated with the total scores were then selected and readministered to new groups of elderly subjects. These subjects were classified as normal, mildly depressed or severely depressed on the basis of Research Diagnostic Criteria (RDC) for depression. The GDS, HRS-D and SDS were all found to be internally consistent measures, and each of the scales was correlated with the subject's number of RDC symptoms. However, the GDS and the HRS-D were significantly better correlated with RDC symptoms than was the SDS. The authors suggest that the GDS represents a reliable and valid self-rating depression screening scale for elderly populations.
The GDS (Geriatric Depression Scale) has demonstrated validity among ambulatory elderly but is less useful in nursing home (NH) populations, probably because of high rates of cognitive impairment. We, therefore, sought the lowest level of Mini-Mental Status Exam (MMSE) score for which the GDS would remain valid.
Validation Study.
Nursing Homes in New York City.
A total of 66 of 168 newly admitted residents to the NH were able to complete psychiatric assessment, undergo an MMSE, and complete the GDS. The psychiatrists and testers (all non-MDs) were blinded to each others' results. Using a cutoff of 10 or greater on the GDS to indicate depression, the GDS's validity (when compared with the psychiatric diagnoses) was sought at ever decreasing levels of cognitive function as measured by the MMSE.
The results of all participants (n = 66) revealed a sensitivity of 63% and a specificity of 83%. When only those with an MMSE score > or = 15 (the best cutoff score) were included, 44 (64%) participants were selected, with a sensitivity and specificity of 84% and 91%, respectively.
The two-step procedure of first selecting those with MMSE scores > or = 15 and then giving the GDS significantly increases the utility of the GDS in detecting depression in NH residents and should improve the diagnostic process for this widely underdetected problem.
To determine the validity of short Geriatric Depression Scale (GDS) versions for the detection of a major depressive episode according to ICD-10 criteria for research and DSM-IV.
Cross-sectional evaluation of depressive symptoms in a sample of elderly subjects with short GDS versions. Different GDS cutoff points were used to estimate the sensitivity, specificity, positive predictive value and negative predictive value for the diagnosis of major depressive episode. Internal consistency of the scales was estimated with the Cronbach's alpha coefficient.
Mental Health Unit for the Elderly of 'Santa Casa' Medical School in São Paulo, Brazil.
Sixty-four consecutive outpatients aged 60 or over who met criteria for depressive disorder (current or in remission). Subjects with severe sensory impairment, aphasia or Mini-Mental State score lower than 10 were excluded from the study.
ICD-10 Checklist of Symptoms, GDS with 15, 10, 4 and 1 items, Montgomery-Asberg Depression Rating Scale (MADRS), ICD-10 diagnostic criteria for research and DSM-IV diagnostic criteria.
The use of the cutoff point 4/5 for the GDS-15 produced sensitivity and specificity rates of 92.7% and 65.2% respectively, and positive and negative predictive values of 82.6% and 83.3% respectively when ICD-10 diagnostic criteria for major depressive episode were used as the 'gold standard'. Similarly, rates of 97.0%, 54.8%, 69.6% and 94.4% were found when DSM-IV was the comparing diagnostic criteria. Sensitivity, specificity and positive and negative predictive values for the cutoff point 6/7 were 80.5%, 78. 3%, 86.8% and 69.2% according to ICD-10, and 84.8%, 67.7%, 73.7% and 80.8% respectively according to DSM-IV. Intermediate values were found for the cutoff point 5/6. The best fit for GDS-10 was the cutoff point 4/5, which produced a sensitivity rate of 80.5%, specificity of 78.3%, positive predictive value of 86.8% and negative predictive value of 60.2% according to ICD-10 diagnosis of a major depressive episode. Similarly, rates of 84.8%, 67.7%, 73.7% and 80.8% were found when DSM-IV criteria for major depression were used. GDS-4 cutoff point of 2/3 was associated with a sensitivity rate of 80.5%, specificity of 78.3%, positive predictive value of 86. 8% and negative predictive value of 69.2% when compared to ICD-10. Again, rates of 84.8%, 67.7%, 73.7% and 80.8% respectively were found when the criteria used were based on DSM-IV. GDS-1 had low sensitivity (61.0% and 63.6% for ICD-10 and DSM-IV respectively) and negative predictive value (56.7% and 67.6% for ICD-10 and DSM-IV respectively), suggesting that this question is of limited clinical utility in screening for depression. GDS-15 (rho=0.82), GDS-10 (rho=0.82) and GDS-4 (rho=0.81) scores were highly correlated with subjects' scores on the MADRS. Reliability coefficients were 0.81 for GDS-15, 0.75 for GDS-10 and 0.41 for GDS-4.
GDS-15, GDS-10 and GDS-4 are good screening instruments for major depression as defined by both the ICD-10 and DSM-IV. The shorter four- and one-item versions are of limited clinical value due to low reliability and failure to monitor the severity of the depressive episode. General practitioners may benefit from the systematic use of short GDS versions to increase detection rates of depression among the elderly. (c) 1999 John Wiley & Sons, Ltd.
This study examined the effectiveness of reminiscence focused music therapy treatment on depressive symptoms in elderly people with dementia. Twenty elderly (3 male & 17 female) who were diagnosed as having dementia and residing at 2 different residential care facilities in Florida were assigned to 1 of 4 small groups. Each of the participants served as his or her own control in an O1 O2 X O3 design. The depressive symptoms were measured using Cornell Scale for Depression in Dementia. The differences between the scores of pretest, posttest 1 after a week of 5-day no treatment, and posttest 2 after a week of 5-day reminiscence focused music therapy treatment were compared. A one-way analysis of variance (ANOVA) and Newman-Keuls Multiple Comparison Procedure indicated statistically significant differences between pretest and posttest 2 as well as posttest 1 and posttest 2, while no significant differences were found between pretest and posttest 1. Results indicated that participation in small group reminiscence focused music therapy groups might help to reduce depressive symptoms in elderly people with dementia. Results of behavioral observations and future implications are also discussed.
Cognitive impairment is common in the oldest old. This might influence the sensitivity and specificity of the 15-item Geriatric Depression Scale (GDS-15). Few studies, however, have included subjects older than 85 years to evaluate the GDS-15 as a screening instrument for depression.
To assess the sensitivity and specificity of the GDS-15 in a community sample of the oldest old.
Seventy-nine subjects aged 85 and over were enrolled in the study. The GDS-15 and the Mini-Mental State Examination (MMSE) were administered by a trained interviewer. Within two days the Geriatric Mental State (GMS)/AGECAT, was administered to obtain a clinical diagnosis of depression.
Eight subjects (10%) were diagnosed with clinical depression. At a cut-off point of 3/4 the sensitivity and specificity of the GDS-15 were 88% and 76% respectively. In the group with MMSE scores of 28 and higher sensitivity was unaffected at all cut-off points while specificity increased. In the group with MMSE scores below 28 sensitivity was also unaffected at all cut-off points while specificity decreased.
The GDS-15 is a suitable instrument to diagnose depression in the general population of the oldest old. The optimal cut-off point depends on its intended use. In subjects with cognitive impairment the accuracy should be investigated further.