It is widely known that as cognitive functions begin to deteriorate, individuals with dementia can experience feelings of anxiety, irritability, confusion, agitation, depression or apathy (Cerejeira et al., 2012). Managing these emotional symptoms requires a careful balance of pharmacological and non-pharmacological treatments, as there is a prominent risk of medication misuse in a solely pharmacological approach. Current guidelines recommend that non-pharmacological interventions should be used as a first-line treatment, whereas psychotropic medications can be incorporated into the treatment selectively and only when necessary (Gauthier et al., 2010; Azermai et al., 2011). Thus, it is urgent that non-pharmacological interventions are clinically explored. Fortunately dance activities are a non-invasive, cost-effective activity which has demonstrated a high efficacy in improving the emotional symptoms of dementia.
Research has been supporting this claim since the late 90s, as an early study by Palo-Bengtsson et al. (1998) analysed videos of individuals with dementia dancing and concluded that dancing together ignited an overwhelming evidence of happiness and joy. Since then, subsequent research has done nothing but strengthen these findings. Duignan et al. (2009) found that a month worth of 60 minute dance sessions at a dementia care unit helped to reduce agitation and lift residents’ spirits. Agitation was measured using the Cohen-Mansfield Agitation Inventory and indeed, agitation scores decreased in 66% of the residents. Likewise, researchers observed that the sessions helped lift the spirits of both residents and staff, and bonding between the two groups strengthened. Along similar lines, Hamill et al. (2011) conducted group dance sessions once a week for 10 weeks with people experiencing dementia and their family carers. These sessions were said to stimulate moments of warmth, social interaction, empathy and the processing of a range of feelings in the group. Additionally, self-reports from the attendees, observations from the dance facilitator and weekly monitoring notes illustrated benefits such as improved mood. In Guzmán-García et al.’s (2012) study, residents with dementia also spoke about how dancing made them feel youthful and excited. Their carers agreed, saying they observed the residents appearing less anxious and frustrated after the sessions, even noting a decrease in wandering after the dancing. Not only this, but researchers found that dancing promoted feelings of confidence and achievement. These findings are corroborated by a study showing that following a dance program, measures taken using the Dementia Mood Assessment Scale showed that residents experienced decreased irritability and increased self-esteem (Guzmán et al., 2016).
Judging by this evidence, a question arises: why and how exactly does dance create these emotional benefits? There is preliminary research exploring this, one of which is the work of Guzmán-García et al. (2012) who analysed feedback from residents who took part in a dance session. The residents reported that dancing generated a sense of reminiscence, where dancing allowed them to recall past memories of dance such as dancing with friends, family and special events. Thus, researchers theorised that dancing stimulated these enjoyable memories, thereby lifting their mood. Further facilitating these benefits, it is equally possible that the residents, in learning the dance, improved in dance competence, which then stimulated feelings of pride, enjoyment and capability. A more recent theory by Olsson & Heikkinen (2019) explains the emotional benefits of dance by viewing dance as an ‘interaction ritual’. An ‘interaction ritual’ is defined as a common activity where two or more people are engaged, and a successful ‘interaction ritual’ is one that results in a sense of solidarity, community and positive emotions. Additionally, people and their bodies sharing the same rhythm is an important aspect of successful ‘interaction rituals’. Therefore, dance, being a common activity where movement is synchronised, is more likely to create a successful interaction ritual, thereby generating the positive emotions that are so well-documented in the literature.
To conclude, dance has the potential to help manage feelings of anxiety, depression, confusion and a host of other difficult emotions associated with dementia, by promoting feelings of warmth, empathy and joy. More research should be done to substantiate and expand on these early, yet promising findings.
By Hoi Ching Leung