Alzheimer's Disease (Incl Subtypes), Dementia, Mild Cognitive Impairment
Conditions
Keywords
Improvisation, Memory loss, Caregivers, Quality of Life, Dance, Social Group, MRI, mild cognitive impairment, MCI, Social engagement
Brief summary
Dementia is a progressive decline in cognition that impairs a person's ability to perform activities of daily living. Changes in mood, gait, and balance are prominent secondary symptoms of Alzheimer's dementia that can dramatically decrease quality of life for the person with dementia and increase caregiver burden. The overall aim of this study is to determine the independent and combined effects of dance movement and social engagement on quality of life in people with early-stage dementia, and test the neural mechanisms of these effects.
Detailed description
Dementia is a progressive decline in cognition that impairs a person's ability to perform activities of daily living. Alzheimer's disease is the most common form of dementia, the most common neurodegenerative disease in older adults, and the 6th leading cause of death in the US. Neuropsychiatric symptoms (apathy, depression, anxiety) and altered gait and balance are prominent secondary symptoms of Alzheimer's disease that increase medical costs and decrease quality of life for both the person with dementia and their caregiver. In a report from the Secretariat (Executive Board, 134th Session, December 20th, 2013), the World Health Organization identified a need to integrate evidence-based palliative care services into the continuum of care for serious chronic diseases, including Alzheimer's disease. However, two recent NIH workshops identified major gaps in the evidence supporting the wider use of non-pharmacologic activities to ameliorate secondary symptoms of chronic disease. Arts-based activities were identified as particularly understudied for symptom management, given growing evidence that various arts-based activities can improve quality of life, relieve symptoms, and reduce reliance on medications. It is important that these benefits can be achieved without adding medications. Dance is an arts-based activity that can improve quality of life, decrease symptoms of depression, and improve balance in healthy older adults, those with Parkinson disease, and Alzheimer's disease. Thus, dance is a non-pharmacological intervention that simultaneously addresses two sets of prominent secondary symptoms in Alzheimer's disease: 1) gait and balance and 2) neuropsychiatric symptoms. However, the mechanisms through which dance exerts these effects are unknown. Pilot data from the investigators' laboratory suggest that participating in a group improvisational movement class twice weekly improved balance and connectivity in motor-related brain regions, as well as improving mood and connectivity in brain regions associated with social engagement. Improvisation is the ability to create new gestures and movements spontaneously. Improvisation can be a part of many different art forms. However, improvisational movement can also be practiced as a specific dance form. The objective in improvisational movement is that choreographed movement is replaced by a cue or prompt that allows the possibility for multiple responses. This unique form of dance is especially well-suited for people with dementia because it: 1) does not rely heavily on memory of repeated movements; 2) can be seamlessly adapted to include sitting, standing, or moving around the room; 3) is cognitively challenging; and 4) fosters a social, playful atmosphere. Participants seemed to benefit from both the social nature of the class and the movement. Therefore, the overall aim of this proposal is to experimentally determine the independent and combined effects of dance movement and social engagement on quality of life in people with early stage dementia, and test the neural mechanisms of these effects. To accomplish this goal, the investigators will use a 2x2 factorial design and randomize 120 community-dwelling older adults adjudicated as having early-stage dementia of the presumed Alzheimer's type to one of four 3-month interventions: 1) Dance Group, 2) Non-group Dance, 3) Social Group, or 4) No Contact Control. It is not hypothesized that dance affects the underlying disease course, and therefore no improvement is expected in cognition.
Interventions
BEHAVIORALDance Group
Active imagination refers to working with imagery and is crucial in improvisatory practice. Verbal auditory cues are used to create movement scenarios that cue or activate the motor imagination. Variability means the improvisational method does not aim to learn a specific movement pattern and habituate to it. Cues are delivered quickly, one after another. Within an average of two minutes, tasks requiring quicker decision-making are introduced. Pacing is the rate at which new movement prompts are presented. Quick changes in pace avoid defaulting to habitual responses, thereby facilitating new movement options. Participants cannot rely on copying another, memory, or anticipation to address the motor problem.
BEHAVIORALNon-Group Dance
The caregiver will be asked to stay in the area while the subject is dancing. A video camera will be affixed in an upper corner of the room to record individual dance sessions. This recording will yield data that a trained student or staff member can view and code to document movement fidelity (e.g., that the person has responded to the dance prompts and for the purpose of comparing the amount of quality of movements that occur in individual vs. group dance settings). For the first two sessions, study staff would observe the full dance session from outside the room to be sure that instruction was clear and adherence was attained, and that no safety issues arise.
BEHAVIORALSocial Group
The social group will consist of improvisational party games to foster curiosity and playfulness, use imagery, and encourage non-judgment. Games that may be used include 'Balderdash', 'Wise and Otherwise', 'Charades', 'Pictionary', and 'Tell Me A Story' cards. These games will also use the same core strategies as the dance group. Games will be varied within an hour-long session to incorporate pacing and variability into the social group, akin to the dance group. The social group will occur 2x/week for 1 hour each time and be led by the same instructors who lead the Dance Group, to control for effects of personality of the group leader.
BEHAVIORALNo Contact
The condition of not receiving an intervention can have ethical implications and reduce retention rates. Therefore, these participants will be invited to join in a weekly community improvisational dance class after they complete the study, for as many sessions as they would like.
Sponsors
National Center for Complementary and Integrative Health (NCCIH)
Wake Forest University Health Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
All study assessments will be conducted by experienced staff certified annually on the proper conduct of study assessments and blinded to group assignment.
Intervention model description
Randomized controlled trial. Investigators will use a 2x2 factorial design to test the separate and combined effects of social engagement and dance movement on QoL in 120 community-dwelling older adults adjudicated as having mild cognitive impairment (MCI) or early-stage dementia of the presumed AD or mixed AD/vascular type. Participants will be randomized to one of four 12-week interventions: 1) Dance Group 2) Non-group Dance, 3) Social Group, or 4) No Contact Control.
Eligibility
Sex/Gender
ALL
Age
60 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
Age 60-85 years Adjudicated as having mild cognitive impairment or early-stage dementia of Alzheimer's, vascular, or mixed Alzheimer's/vascular type MRI compatible English speaking Have study partner who is around the person with dementia approximately 10 hours/week and is willing to be an active study partner. Able to attend bi-weekly intervention classes or come to study visits for no-contact control. Not enrolled in another interventional study for at least 3 months prior to beginning this study.
Exclusion criteria
Untreated depression Other causes of dementia (for example, frontotemporal, early onset, Lewy body or Parkinsonian dementia) Current cancer treatment or other major medical problems that might independently affect cognition or movement Other neurological disorders (e.g., Parkinson disease, multiple sclerosis) Taking medication that could negatively influence safety during intervention Planned extensive travel during the study period Any reason for which the study doctor or personal physician feels the intervention is contraindicated for the participant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quality of Life in Alzheimer's Disease (QOL-AD)--Participants With Dementia (PWD) | Baseline | Self-reported quality of life in the person with dementia is the primary outcome and will be measured using the QOL-AD . The QOL-AD is validated for use in people with Mini Mental State Exam scores as low as 10.The QOL\_AD contains 13 items.Points are assigned to each item as follows: poor = 1, fair = 2, good = 3, excellent = 4.The total score is the sum of all 13 item (range 13- 52) higher scores represent better outcomes. |
| QOL-AD--PWD | Week 12 | Self-reported quality of life in the person with dementia is the primary outcome and will be measured using the QOL-AD . The QOL-AD is validated for use in people with Mini Mental State Exam scores as low as 10.The QOL\_AD contains 13 items.Points are assigned to each item as follows: poor = 1, fair = 2, good = 3, excellent = 4.The total score is the sum of all 13 item (range 13- 52) higher scores represent better outcomes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Fullerton Advanced Balance Scale (Overall Balance) PWD | Baseline | Fullerton Advanced Balance Scale (FAB) measures balance using 10 different performance-based tests (scored 0 worst - 4 best), including; standing with feet together and eyes closed, standing on a foam pad with eyes closed, walking while turning the head from side to side rhythmically, functional standing reach, turning around to the left and right, stepping up and over a 6-inch box, standing on one leg, and a test for postural reaction. The scale goes from 0-40 with 40 being the best outcome and a cutoff of \<=25 for risk of falls. |
| Geriatric Depression Scale | Baseline | The person with dementia will be asked to complete a screening tool for assessing depression. This test has 15 yes/no questions with a yes receiving 1 point for a depressive answer. A total score is calculated and will be on a scale from 0-15 with 0-4 indicating no depression, 5-10 suggestive of a mild depression, and 11+ suggestive of severe depression. |
| Geriatric Anxiety Scale | Baseline | The Geriatric Anxiety Scale measures symptoms of anxiety in older adults. A single total score ranges from 0 (low anxiety) to 63 (high anxiety). Four cutoff scores have been provided by authors in the manuals: 0-7 (normal anxiety), 8-15 (mild-moderate anxiety), 16-25 (moderate-severe anxiety), and 26-63 (severe anxiety). |
| Apathy Evaluation Scale--PWD | Baseline | The Apathy Evaluation Scale (AES) addresses characteristics of goal directed behavior that reflect apathy including behavioral, cognitive, and emotional indicators. A short form will be used that has been modified for use with people with dementia. This shortened version has 10 questions scored 1-4 with 4 being the positive outcome answer. The total score is calculated and on a scale of 10-40 with lower scores reflecting less apathy and thus a better outcome. |
| Expanded Short Physical Performance Battery (eSPPB) | Baseline | The eSPPB is a brief test of global mobility function with excellent test-retest and inter-examiner reliability; is sensitive to change; is safe, and is a robust predictor of future physical disability and death. To avoid ceiling effects, investigators will use an expanded version (eSPPB) that increases the difficulty of the standing balance task by asking participants to hold postures for 30 instead of 10 seconds, adds a one-leg stand, and adds a narrow walk. The resulting score is normally distributed, continuous, and shows greater sensitivity to change. Dementia patients have lower scores on the SPPB so a favorable outcome for this outcome measure would be a significantly higher score post treatment. The eSPPB is scored as a continuous measure with a minimum score of 0 and a maximum score of 3.0 where 3 is the best possible outcome. |
| Postural Sway--PWD | Baseline | Center of pressure displacement (area of the 95% confidence ellipse) using an AccuSway forceplate. Center of pressure displacement is one way to characterize postural sway. Increased postural sway is correlated with decreased balance in older adults and increased fall risk. Center of pressure displacement was measured using the area of the 95% confidence ellipse using an AccuSway forceplate. Higher numbers indicate greater levels of postural sway. |
| Gait Speed--PWD | Baseline | The time one takes to walk a specified distance on level surfaces over a short distance. 4m usual gait speed was measured as part of the eSPPB. |
| Gait Variability--PWD | Baseline | Stride time variability, which is calculated out of the mean and standard deviation of stride time, reflects the change in time elapsed between the first two contacts of two consecutive footfalls of the same foot over a number of gait cycles. Increased gait variability is associated with increased fall risk in older adults. |
| Falls Efficacy Scale - International (FES) PWD | Baseline | A 16-item scale to assess fear of falling where higher scores reflect a higher fear and risk of falling. Out of a total score of 100, a score of 70 or above indicates the individual has a fear of falling. |
| Community Structure--PWD | Baseline | This is a brain imaging variable derived from fMRI images. Modularity (Q) ranges from 0 (no community structure) to 1 (perfectly modular network). One Q-value is generated for each person and group averages are shown. |
| Global Efficiency (eGlob)--PWD | Baseline | This is a brain imaging variable derived from fMRI images.Scale ranges from 0 (no long-range information processing) to 1 (maximal distributed processing). Decreased Eglob has been associated with aging, cognitive impairment, and depression. |
| Local Efficiency (eLoc)--PWD | Baseline | Scale ranges from 0 (no local connectivity) to 1 (maximal local connectivity - all connections are local) and has been observed to change with cognitive impairment and depression. |
| Path Length--PWD | Baseline | Refers to the number of edges that must be crossed to get from one node to another. Longer path length in people with AD has been associated with slower cognitive performance, beta amyloid deposition, and depression. |
| Neuropsychiatric Inventory Questionnaire (NPI-Q) | Baseline | The NPI is a reliable and valid structured interview designed to assess neuropsychiatric symptoms in person with dementia through a structured interview with the caregiver. The NPI includes questions about 12 domains of symptoms: delusions, hallucinations, agitation/aggression, depression, anxiety, elation/ euphoria, apathy, disinhibition, irritability, aberrant motor activity, sleep, and eating. For each, symptom severity is scored on a scale of 0-4, with 4 being the worst outcome and caregiver distress is scored on a scale from 0-5, with 5 being the worst outcome. The sum of all 12 domains is calculated. Severity scores are reported here with a range from 0-36 with a higher score reflecting greater symptom severity. |
| NPI-Q | Week 12 | The NPI is a reliable and valid structured interview designed to assess neuropsychiatric symptoms in person with dementia through a structured interview with the caregiver. The NPI includes questions about 12 domains of symptoms: delusions, hallucinations, agitation/aggression, depression, anxiety, elation/ euphoria, apathy, disinhibition, irritability, aberrant motor activity, sleep, and eating. For each, symptom severity is scored on a scale of 0-4, with 4 being the worst outcome and caregiver distress is scored on a scale from 0-5, with 5 being the worst outcome. The sum of all 12 domains is calculated. Severity scores are reported here with a range from 0-36 with a higher score reflecting greater symptom severity. |
Other
| Measure | Time frame | Description |
|---|---|---|
| White Matter Lesion Burden | Baseline, Week 12 | The volume of white matter lesions is calculated using the Lesion Segmentation Toolbox. PWD only. |
| Blood-based Stress Biomarkers (Covariate or Alternative Hypothesis) | Baseline, Week 12 | Social engagement may change biomarkers of stress relevant for interpreting outcomes. These stress biomarkers include cortisol and allostatic load, a composite measure of blood-based biomarkers associated with chronically elevated stress. PWD only |
| Caregiver Quality of Life With the 36-item Short-Form Health (SF-36)--Covariate or Alternative Hypothesis | Baseline, Week 12 | The SF-36 consists of 36 questions assessing physical functioning, role functioning difficulties caused by physical problems, bodily pain, general health, vitality, social functioning, role functioning difficulties caused by emotional problems, and mental health. High scores are representative of a great health status and better outcomes, while low scores are representative of a poor health status. |
| Caregiver Burden With Zarit Caregiver Burden Scale--Covariate or Alternative Hypothesis | Baseline, Week 12 | The Zarit Caregiver Burden Scale is administered in interview form to the caregiver. It consists of 22 questions scored 0-4 with 0=Never, 1=Rarely, 2=Sometimes, 3=Quite Frequently, 4=Nearly Always. The total score range is 0-88 with 88 being the worst possible outcome. 0-20 represents little or no burden on the caregiver, 21-40 represents mild to moderate burden, 41-60 represents moderate to severe burden, and 61-88 represents severe burden. |
| Blood Pressure | Baseline, Week12 | PWD only |
| Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) | Baseline | A measure of five domains of personality (neuroticism, extraversion, openness, agreeableness, and conscientiousness). A higher score on any scale indicates stronger presence of that trait. PWD only |
| Body Mass Index (BMI) | Baseline, Week 12 | a measure of body fat based on height and weight that applies to adult men and women--PWD only |
Countries
United States
Participant flow
Recruitment details
All Persons With Dementia (PWDs) were enrolled with one caregiver each. There was never a time when one was enrolled without the other, so these two people are represented in the participant flow as a dyad.
Pre-assignment details
Participants were enrolled in dyads consisting of one person with dementia (PWD) and one caregiver (CG). Participant flow section includes numbers as dyad since both were considered enrolled. Elsewhere in the record, numbers include either participants with dementia or caregivers as indicated in baseline analysis population description and in outcome titles or descriptions.
Participants by arm
| Arm | Count |
|---|---|
| Dance Group The Dance Group will participate in 1-hour group improvisational dance lessons 2x/week for 12 weeks. Improvisational dance classes are grounded in 4 principles that shape the tone of the class and result in a sense of social belonging: non-judgment, non-competitiveness, curiosity, and playfulness. The following training strategies are used to maintain: active imagination, variability, and pacing.
Dance Group: Active imagination refers to working with imagery and is crucial in improvisatory practice. Verbal auditory cues are used to create movement scenarios that cue or activate the motor imagination. Variability means the improvisational method does not aim to learn a specific movement pattern and habituate to it. Cues are delivered quickly, one after another. Within an average of two minutes, tasks requiring quicker decision-making are introduced. Pacing is the rate at which new movement prompts are presented. Quick changes in pace avoid defaulting to habitual responses, thereby facilitating new movement options. Participants cannot rely on copying another, memory, or anticipation to address the motor problem. | 24 |
| Non-group Dance The Non-group dance intervention is designed to capture the same dance movement and auditory stimuli as the group class without social interaction. Recordings of the dance instructor teaching a dance class will be played. This will ensure participants hear comparable music and receive comparable verbal auditory cues to prompt dance movements that students in the group class will hear, without interacting with other people. Improvisational dance is particularly suited for this means of delivery because the primary method of instruction is verbal auditory cueing. Participants will be asked to follow the same schedule as participants in the Dance Group arm and complete 2 one-hour dance sessions each week.
Non-Group Dance: The caregiver will be asked to stay in the area while the subject is dancing. A video camera will be affixed in an upper corner of the room to record individual dance sessions. This recording will yield data that a trained student or staff member can view and code to document movement fidelity (e.g., that the person has responded to the dance prompts and for the purpose of comparing the amount of quality of movements that occur in individual vs. group dance settings). For the first two sessions, study staff would observe the full dance session from outside the room to be sure that instruction was clear and adherence was attained, and that no safety issues arise. | 25 |
| Social Group The social group will consist of improvisational party games to foster curiosity and playfulness, use imagery, and encourage non-judgment. Games that may be used include 'Balderdash', 'Wise and Otherwise', 'Charades', 'Pictionary', and 'Tell Me A Story' cards. These games will also use the same core strategies as the dance group. Games will be varied within an hour-long session to incorporate pacing and variability into the social group, akin to the dance group. The social group will occur 2x/week for 1 hour each time and be led by the same instructors who lead the Dance Group, to control for effects of personality of the group leader.
Social Group: The social group will consist of improvisational party games to foster curiosity and playfulness, use imagery, and encourage non-judgment. Games that may be used include 'Balderdash', 'Wise and Otherwise', 'Charades', 'Pictionary', and 'Tell Me A Story' cards. These games will also use the same core strategies as the dance group. Games will be varied within an hour-long session to incorporate pacing and variability into the social group, akin to the dance group. The social group will occur 2x/week for 1 hour each time and be led by the same instructors who lead the Dance Group, to control for effects of personality of the group leader. | 27 |
| No Contact A No Contact condition captures the condition of no added social contact and no added dance movement. Participants randomized to the No Contact condition will be asked to continue their current disease management and lifestyle for 12 weeks
No Contact: The condition of not receiving an intervention can have ethical implications and reduce retention rates. Therefore, these participants will be invited to join in a weekly community improvisational dance class after they complete the study, for as many sessions as they would like. | 25 |
| Never Randomized Subject dyads who signed consent but withdrew prior to randomization. | 3 |
| Total | 104 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 |
|---|---|---|---|---|---|---|
| Overall Study | Adverse Event | 2 | 1 | 1 | 1 | 0 |
| Overall Study | Caregiver withdrew | 0 | 2 | 1 | 0 | 0 |
| Overall Study | COVID interrupted enrollment--had to rescreen and didn't qualify | 0 | 0 | 2 | 0 | 0 |
| Overall Study | Withdrawal by Subject | 0 | 0 | 1 | 1 | 3 |
Baseline characteristics
| Characteristic | Dance Group | Total | Never Randomized | No Contact | Social Group | Non-group Dance |
|---|---|---|---|---|---|---|
| Age, Continuous | 75.33 years STANDARD_DEVIATION 5.94 | 75.29 years STANDARD_DEVIATION 6.45 | 69.87 years STANDARD_DEVIATION 3.23 | 76.0 years STANDARD_DEVIATION 6.43 | 76.75 years STANDARD_DEVIATION 6.29 | 73.62 years STANDARD_DEVIATION 7.1 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 24 Participants | 103 Participants | 3 Participants | 25 Participants | 27 Participants | 24 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 2 Participants | 0 Participants | 0 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 2 Participants | 13 Participants | 0 Participants | 2 Participants | 6 Participants | 3 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 21 Participants | 89 Participants | 3 Participants | 23 Participants | 20 Participants | 22 Participants |
| Region of Enrollment United States | 24 participants | 104 participants | 3 participants | 25 participants | 27 participants | 25 participants |
| Sex: Female, Male Female | 12 Participants | 50 Participants | 0 Participants | 11 Participants | 14 Participants | 13 Participants |
| Sex: Female, Male Male | 12 Participants | 54 Participants | 3 Participants | 14 Participants | 13 Participants | 12 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk | EG007 affected / at risk | EG008 affected / at risk | EG009 affected / at risk |
|---|---|---|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 24 | 0 / 24 | 0 / 25 | 0 / 25 | 0 / 27 | 0 / 27 | 0 / 25 | 0 / 25 | 1 / 3 | 0 / 3 |
| other Total, other adverse events | 15 / 24 | 13 / 24 | 15 / 25 | 5 / 25 | 11 / 27 | 8 / 27 | 17 / 25 | 15 / 25 | 0 / 3 | 0 / 3 |
| serious Total, serious adverse events | 1 / 24 | 4 / 24 | 0 / 25 | 2 / 25 | 2 / 27 | 4 / 27 | 4 / 25 | 2 / 25 | 3 / 3 | 1 / 3 |
Outcome results
Primary
QOL-AD--PWD
Self-reported quality of life in the person with dementia is the primary outcome and will be measured using the QOL-AD . The QOL-AD is validated for use in people with Mini Mental State Exam scores as low as 10.The QOL\_AD contains 13 items.Points are assigned to each item as follows: poor = 1, fair = 2, good = 3, excellent = 4.The total score is the sum of all 13 item (range 13- 52) higher scores represent better outcomes.
Time frame: Week 12
Population: Overall number of participants analyzed corresponds to the number of participants who completed the study.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | QOL-AD--PWD | 35.23 score on a scale | Standard Deviation 6.54 |
| Non-group Dance | QOL-AD--PWD | 40.0 score on a scale | Standard Deviation 5.36 |
| Social Group | QOL-AD--PWD | 36.68 score on a scale | Standard Deviation 4.76 |
| No Contact | QOL-AD--PWD | 35.96 score on a scale | Standard Deviation 8.04 |
Primary
Quality of Life in Alzheimer's Disease (QOL-AD)--Participants With Dementia (PWD)
Self-reported quality of life in the person with dementia is the primary outcome and will be measured using the QOL-AD . The QOL-AD is validated for use in people with Mini Mental State Exam scores as low as 10.The QOL\_AD contains 13 items.Points are assigned to each item as follows: poor = 1, fair = 2, good = 3, excellent = 4.The total score is the sum of all 13 item (range 13- 52) higher scores represent better outcomes.
Time frame: Baseline
Population: Results at baseline for this outcome represent all PWD who were randomized.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Quality of Life in Alzheimer's Disease (QOL-AD)--Participants With Dementia (PWD) | 35.42 score on a scale | Standard Deviation 5.02 |
| Non-group Dance | Quality of Life in Alzheimer's Disease (QOL-AD)--Participants With Dementia (PWD) | 38.10 score on a scale | Standard Deviation 4.6 |
| Social Group | Quality of Life in Alzheimer's Disease (QOL-AD)--Participants With Dementia (PWD) | 35.56 score on a scale | Standard Deviation 4.15 |
| No Contact | Quality of Life in Alzheimer's Disease (QOL-AD)--Participants With Dementia (PWD) | 36.12 score on a scale | Standard Deviation 5.75 |
Secondary
Apathy Evaluation Scale--PWD
The Apathy Evaluation Scale (AES) addresses characteristics of goal directed behavior that reflect apathy including behavioral, cognitive, and emotional indicators. A short form will be used that has been modified for use with people with dementia. This shortened version has 10 questions scored 1-4 with 4 being the positive outcome answer. The total score is calculated and on a scale of 10-40 with lower scores reflecting less apathy and thus a better outcome.
Time frame: Baseline
Population: Results at baseline for this outcome represent all PWD who were randomized.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Apathy Evaluation Scale--PWD | 21.83 score on a scale | Standard Deviation 8.49 |
| Non-group Dance | Apathy Evaluation Scale--PWD | 18.88 score on a scale | Standard Deviation 6.23 |
| Social Group | Apathy Evaluation Scale--PWD | 19.74 score on a scale | Standard Deviation 7.04 |
| No Contact | Apathy Evaluation Scale--PWD | 18.44 score on a scale | Standard Deviation 7.53 |
Secondary
Apathy Evaluation Scale--PWD
The Apathy Evaluation Scale (AES) addresses characteristics of goal directed behavior that reflect apathy including behavioral, cognitive, and emotional indicators. A short form will be used that has been modified for use with people with dementia. This shortened version has 10 questions scored 1-4 with 4 being the positive outcome answer. The total score is calculated and on a scale of 10-40 with lower scores reflecting less apathy and thus a better outcome.
Time frame: Week 12
Population: One participant is missing follow-up data due to a recording error during data collection.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Apathy Evaluation Scale--PWD | 19.32 score on a scale | Standard Deviation 9.89 |
| Non-group Dance | Apathy Evaluation Scale--PWD | 19.0 score on a scale | Standard Deviation 6.61 |
| Social Group | Apathy Evaluation Scale--PWD | 18.68 score on a scale | Standard Deviation 6.24 |
| No Contact | Apathy Evaluation Scale--PWD | 22.87 score on a scale | Standard Deviation 7.5 |
Secondary
Community Structure--PWD
This is a brain imaging variable derived from fMRI images. Modularity (Q) ranges from 0 (no community structure) to 1 (perfectly modular network). One Q-value is generated for each person and group averages are shown.
Time frame: Week 12
Population: Numbers at baseline and week 12 differ due to withdrawals, poor data quality, and inability to complete scans.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Community Structure--PWD | .74 Q-Value | Standard Deviation 0.04 |
| Non-group Dance | Community Structure--PWD | .73 Q-Value | Standard Deviation 0.05 |
| Social Group | Community Structure--PWD | .75 Q-Value | Standard Deviation 0.04 |
| No Contact | Community Structure--PWD | .75 Q-Value | Standard Deviation 0.03 |
Secondary
Community Structure--PWD
This is a brain imaging variable derived from fMRI images. Modularity (Q) ranges from 0 (no community structure) to 1 (perfectly modular network). One Q-value is generated for each person and group averages are shown.
Time frame: Baseline
Population: Participants are missing at baseline imaging data due to an undisclosed contraindicated device, aborting scan, refusing scans, or excessive head motion.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Community Structure--PWD | .74 Q-Value | Standard Deviation 0.05 |
| Non-group Dance | Community Structure--PWD | .72 Q-Value | Standard Deviation 0.05 |
| Social Group | Community Structure--PWD | .73 Q-Value | Standard Deviation 0.05 |
| No Contact | Community Structure--PWD | .74 Q-Value | Standard Deviation 0.04 |
Secondary
Expanded Short Physical Performance Battery (eSPPB)
The eSPPB is a brief test of global mobility function with excellent test-retest and inter-examiner reliability; is sensitive to change; is safe, and is a robust predictor of future physical disability and death. To avoid ceiling effects, investigators will use an expanded version (eSPPB) that increases the difficulty of the standing balance task by asking participants to hold postures for 30 instead of 10 seconds, adds a one-leg stand, and adds a narrow walk. The resulting score is normally distributed, continuous, and shows greater sensitivity to change. Dementia patients have lower scores on the SPPB so a favorable outcome for this outcome measure would be a significantly higher score post treatment. The eSPPB is scored as a continuous measure with a minimum score of 0 and a maximum score of 3.0 where 3 is the best possible outcome.
Time frame: Week 12
Population: Number at baseline and follow-up differ due to withdrawals, staff error, participant unwilling to complete, and participant unable to complete test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Expanded Short Physical Performance Battery (eSPPB) | 1.62 score on a scale | Standard Deviation 0.57 |
| Non-group Dance | Expanded Short Physical Performance Battery (eSPPB) | 1.98 score on a scale | Standard Deviation 0.39 |
| Social Group | Expanded Short Physical Performance Battery (eSPPB) | 1.66 score on a scale | Standard Deviation 0.44 |
| No Contact | Expanded Short Physical Performance Battery (eSPPB) | 1.88 score on a scale | Standard Deviation 0.5 |
Secondary
Expanded Short Physical Performance Battery (eSPPB)
The eSPPB is a brief test of global mobility function with excellent test-retest and inter-examiner reliability; is sensitive to change; is safe, and is a robust predictor of future physical disability and death. To avoid ceiling effects, investigators will use an expanded version (eSPPB) that increases the difficulty of the standing balance task by asking participants to hold postures for 30 instead of 10 seconds, adds a one-leg stand, and adds a narrow walk. The resulting score is normally distributed, continuous, and shows greater sensitivity to change. Dementia patients have lower scores on the SPPB so a favorable outcome for this outcome measure would be a significantly higher score post treatment. The eSPPB is scored as a continuous measure with a minimum score of 0 and a maximum score of 3.0 where 3 is the best possible outcome.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Expanded Short Physical Performance Battery (eSPPB) | 1.57 score on a scale | Standard Deviation 0.55 |
| Non-group Dance | Expanded Short Physical Performance Battery (eSPPB) | 1.99 score on a scale | Standard Deviation 0.37 |
| Social Group | Expanded Short Physical Performance Battery (eSPPB) | 1.67 score on a scale | Standard Deviation 0.46 |
| No Contact | Expanded Short Physical Performance Battery (eSPPB) | 1.86 score on a scale | Standard Deviation 0.4 |
Secondary
Falls Efficacy Scale - International (FES) PWD
A 16-item scale to assess fear of falling where higher scores reflect a higher fear and risk of falling. Out of a total score of 100, a score of 70 or above indicates the individual has a fear of falling.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Falls Efficacy Scale - International (FES) PWD | 27.54 score on a scale | Standard Deviation 10.06 |
| Non-group Dance | Falls Efficacy Scale - International (FES) PWD | 22.64 score on a scale | Standard Deviation 4.86 |
| Social Group | Falls Efficacy Scale - International (FES) PWD | 26.07 score on a scale | Standard Deviation 7.76 |
| No Contact | Falls Efficacy Scale - International (FES) PWD | 25.56 score on a scale | Standard Deviation 8.65 |
Secondary
Falls Efficacy Scale - International (FES) PWD
A 16-item scale to assess fear of falling where higher scores reflect a higher fear and risk of falling. Out of a total score of 100, a score of 70 or above indicates the individual has a fear of falling.
Time frame: Week 12
Population: Overall number of participants analyzed corresponds to the number of participants who completed the study.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Falls Efficacy Scale - International (FES) PWD | 27.23 score on a scale | Standard Deviation 10.38 |
| Non-group Dance | Falls Efficacy Scale - International (FES) PWD | 21.73 score on a scale | Standard Deviation 5.32 |
| Social Group | Falls Efficacy Scale - International (FES) PWD | 25.36 score on a scale | Standard Deviation 5.27 |
| No Contact | Falls Efficacy Scale - International (FES) PWD | 28.09 score on a scale | Standard Deviation 11.42 |
Secondary
Fullerton Advanced Balance Scale (Overall Balance) PWD
Fullerton Advanced Balance Scale (FAB) measures balance using 10 different performance-based tests (scored 0 worst - 4 best), including; standing with feet together and eyes closed, standing on a foam pad with eyes closed, walking while turning the head from side to side rhythmically, functional standing reach, turning around to the left and right, stepping up and over a 6-inch box, standing on one leg, and a test for postural reaction. The scale goes from 0-40 with 40 being the best outcome and a cutoff of \<=25 for risk of falls.
Time frame: Baseline
Population: One participant is missing baseline data due to a recording error during data collection.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Fullerton Advanced Balance Scale (Overall Balance) PWD | 23.71 score on a scale | Standard Deviation 8.22 |
| Non-group Dance | Fullerton Advanced Balance Scale (Overall Balance) PWD | 27.88 score on a scale | Standard Deviation 5.4 |
| Social Group | Fullerton Advanced Balance Scale (Overall Balance) PWD | 24.22 score on a scale | Standard Deviation 6.32 |
| No Contact | Fullerton Advanced Balance Scale (Overall Balance) PWD | 26.79 score on a scale | Standard Deviation 4.57 |
Secondary
Fullerton Advanced Balance Scale (Overall Balance) PWD
Fullerton Advanced Balance Scale (FAB) measures balance using 10 different performance-based tests (scored 0 worst - 4 best), including; standing with feet together and eyes closed, standing on a foam pad with eyes closed, walking while turning the head from side to side rhythmically, functional standing reach, turning around to the left and right, stepping up and over a 6-inch box, standing on one leg, and a test for postural reaction. The scale goes from 0-40 with 40 being the best outcome and a cutoff of \<=25 for risk of falls.
Time frame: Week 12
Population: Number at baseline and week 12 differ due to withdrawals.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Fullerton Advanced Balance Scale (Overall Balance) PWD | 23.41 score on a scale | Standard Deviation 8.57 |
| Non-group Dance | Fullerton Advanced Balance Scale (Overall Balance) PWD | 29.95 score on a scale | Standard Deviation 4.33 |
| Social Group | Fullerton Advanced Balance Scale (Overall Balance) PWD | 24.27 score on a scale | Standard Deviation 6.26 |
| No Contact | Fullerton Advanced Balance Scale (Overall Balance) PWD | 26.78 score on a scale | Standard Deviation 6.65 |
Secondary
Gait Speed--PWD
The time one takes to walk a specified distance on level surfaces over a short distance. 4m usual gait speed was measured as part of the eSPPB.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Gait Speed--PWD | 5.47 seconds | Standard Deviation 1.55 |
| Non-group Dance | Gait Speed--PWD | 4.61 seconds | Standard Deviation 1.03 |
| Social Group | Gait Speed--PWD | 5.12 seconds | Standard Deviation 1.39 |
| No Contact | Gait Speed--PWD | 4.66 seconds | Standard Deviation 0.85 |
Secondary
Gait Speed--PWD
The time one takes to walk a specified distance on level surfaces over a short distance. 4m usual gait speed was measured as part of the eSPPB.
Time frame: Week 12
Population: Number at baseline and follow-up differ due to withdrawals, staff error, participant unwilling to complete and participant unable to complete.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Gait Speed--PWD | 5.51 seconds | Standard Deviation 1.71 |
| Non-group Dance | Gait Speed--PWD | 4.79 seconds | Standard Deviation 0.94 |
| Social Group | Gait Speed--PWD | 5.12 seconds | Standard Deviation 1.06 |
| No Contact | Gait Speed--PWD | 4.77 seconds | Standard Deviation 1.14 |
Secondary
Gait Variability--PWD
Stride time variability, which is calculated out of the mean and standard deviation of stride time, reflects the change in time elapsed between the first two contacts of two consecutive footfalls of the same foot over a number of gait cycles. Increased gait variability is associated with increased fall risk in older adults.
Time frame: Week 12
Population: Subject numbers differ due to equipment failure, technical error, subjects withdrawing, subject inability to complete task, or subject unwilling to complete task.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Gait Variability--PWD | 4.46 percentage of variability | Standard Deviation 2.88 |
| Non-group Dance | Gait Variability--PWD | 2.71 percentage of variability | Standard Deviation 0.75 |
| Social Group | Gait Variability--PWD | 3.45 percentage of variability | Standard Deviation 1.3 |
| No Contact | Gait Variability--PWD | 4.06 percentage of variability | Standard Deviation 4.15 |
Secondary
Gait Variability--PWD
Stride time variability, which is calculated out of the mean and standard deviation of stride time, reflects the change in time elapsed between the first two contacts of two consecutive footfalls of the same foot over a number of gait cycles. Increased gait variability is associated with increased fall risk in older adults.
Time frame: Baseline
Population: Subject numbers differ due to equipment failure, subjects withdrawing, subject inability to complete task, or lost to follow up.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Gait Variability--PWD | 3.41 percentage of variability | Standard Deviation 1.57 |
| Non-group Dance | Gait Variability--PWD | 3.10 percentage of variability | Standard Deviation 1.68 |
| Social Group | Gait Variability--PWD | 3.44 percentage of variability | Standard Deviation 1.27 |
| No Contact | Gait Variability--PWD | 3.15 percentage of variability | Standard Deviation 1.07 |
Secondary
Geriatric Anxiety Scale
The Geriatric Anxiety Scale measures symptoms of anxiety in older adults. A single total score ranges from 0 (low anxiety) to 63 (high anxiety). Four cutoff scores have been provided by authors in the manuals: 0-7 (normal anxiety), 8-15 (mild-moderate anxiety), 16-25 (moderate-severe anxiety), and 26-63 (severe anxiety).
Time frame: Baseline
Population: Results at baseline for this outcome represent all PWD who were randomized.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Geriatric Anxiety Scale | 3.71 score on a scale | Standard Deviation 3.34 |
| Non-group Dance | Geriatric Anxiety Scale | 2.92 score on a scale | Standard Deviation 2.06 |
| Social Group | Geriatric Anxiety Scale | 4.04 score on a scale | Standard Deviation 3.01 |
| No Contact | Geriatric Anxiety Scale | 3.56 score on a scale | Standard Deviation 3.31 |
Secondary
Geriatric Anxiety Scale
The Geriatric Anxiety Scale measures symptoms of anxiety in older adults. A single total score ranges from 0 (low anxiety) to 63 (high anxiety). Four cutoff scores have been provided by authors in the manuals: 0-7 (normal anxiety), 8-15 (mild-moderate anxiety), 16-25 (moderate-severe anxiety), and 26-63 (severe anxiety).
Time frame: Week 12
Population: Overall number of participants analyzed corresponds to the number of participants who completed the study.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Geriatric Anxiety Scale | 3.64 score on a scale | Standard Deviation 3.63 |
| Non-group Dance | Geriatric Anxiety Scale | 2.23 score on a scale | Standard Deviation 1.57 |
| Social Group | Geriatric Anxiety Scale | 3.64 score on a scale | Standard Deviation 3.27 |
| No Contact | Geriatric Anxiety Scale | 4.0 score on a scale | Standard Deviation 4.65 |
Secondary
Geriatric Depression Scale
The person with dementia will be asked to complete a screening tool for assessing depression. This test has 15 yes/no questions with a yes receiving 1 point for a depressive answer. A total score is calculated and will be on a scale from 0-15 with 0-4 indicating no depression, 5-10 suggestive of a mild depression, and 11+ suggestive of severe depression.
Time frame: Baseline
Population: Results at baseline for this outcome represent all PWD who were randomized.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Geriatric Depression Scale | 2.17 score on a scale | Standard Deviation 2.5 |
| Non-group Dance | Geriatric Depression Scale | 1.24 score on a scale | Standard Deviation 1.05 |
| Social Group | Geriatric Depression Scale | 2.37 score on a scale | Standard Deviation 2.13 |
| No Contact | Geriatric Depression Scale | 2.04 score on a scale | Standard Deviation 2.28 |
Secondary
Geriatric Depression Scale
The person with dementia will be asked to complete a screening tool for assessing depression. This test has 15 yes/no questions with a yes receiving 1 point for a depressive answer. A total score is calculated and will be on a scale from 0-15 with 0-4 indicating no depression, 5-10 suggestive of a mild depression, and 11+ suggestive of severe depression.
Time frame: Week 12
Population: Overall number of participants analyzed corresponds to the number of participants who completed the study.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Geriatric Depression Scale | 2.27 score on a scale | Standard Deviation 2.76 |
| Non-group Dance | Geriatric Depression Scale | 1.32 score on a scale | Standard Deviation 1.36 |
| Social Group | Geriatric Depression Scale | 1.68 score on a scale | Standard Deviation 1.29 |
| No Contact | Geriatric Depression Scale | 2.74 score on a scale | Standard Deviation 3.54 |
Secondary
Global Efficiency (eGlob)--PWD
This is a brain imaging variable derived from fMRI images.Scale ranges from 0 (no long-range information processing) to 1 (maximal distributed processing). Decreased Eglob has been associated with aging, cognitive impairment, and depression.
Time frame: Baseline
Population: Participants are missing at baseline imaging data due to an undisclosed contraindicated device, aborting scan, refusing scans, or excessive head motion.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Global Efficiency (eGlob)--PWD | .19 score on a scale | Standard Deviation 0.02 |
| Non-group Dance | Global Efficiency (eGlob)--PWD | .18 score on a scale | Standard Deviation 0.03 |
| Social Group | Global Efficiency (eGlob)--PWD | .19 score on a scale | Standard Deviation 0.03 |
| No Contact | Global Efficiency (eGlob)--PWD | .19 score on a scale | Standard Deviation 0.03 |
Secondary
Global Efficiency (eGlob)--PWD
This is a brain imaging variable derived from fMRI images.Scale ranges from 0 (no long-range information processing) to 1 (maximal distributed processing). Decreased Eglob has been associated with aging, cognitive impairment, and depression.
Time frame: Week 12
Population: Number at baseline and follow-up differ due to withdrawals, poor data quality, participant refusal of procedure, inability to complete scan.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Global Efficiency (eGlob)--PWD | .19 score on a scale | Standard Deviation 0.03 |
| Non-group Dance | Global Efficiency (eGlob)--PWD | .18 score on a scale | Standard Deviation 0.03 |
| Social Group | Global Efficiency (eGlob)--PWD | .19 score on a scale | Standard Deviation 0.02 |
| No Contact | Global Efficiency (eGlob)--PWD | .19 score on a scale | Standard Deviation 0.03 |
Secondary
Local Efficiency (eLoc)--PWD
Scale ranges from 0 (no local connectivity) to 1 (maximal local connectivity - all connections are local) and has been observed to change with cognitive impairment and depression.
Time frame: Week 12
Population: Number at baseline and follow-up differ due to withdrawals, poor data quality, participant refusal of procedure, inability to complete scan.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Local Efficiency (eLoc)--PWD | .58 units on a scale | Standard Deviation 0.03 |
| Non-group Dance | Local Efficiency (eLoc)--PWD | .58 units on a scale | Standard Deviation 0.03 |
| Social Group | Local Efficiency (eLoc)--PWD | .59 units on a scale | Standard Deviation 0.03 |
| No Contact | Local Efficiency (eLoc)--PWD | .58 units on a scale | Standard Deviation 0.04 |
Secondary
Local Efficiency (eLoc)--PWD
Scale ranges from 0 (no local connectivity) to 1 (maximal local connectivity - all connections are local) and has been observed to change with cognitive impairment and depression.
Time frame: Baseline
Population: Participants are missing at baseline imaging data due to an undisclosed contraindicated device, aborting scan, refusing scans, or excessive head motion.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Local Efficiency (eLoc)--PWD | .59 units on a scale | Standard Deviation 0.03 |
| Non-group Dance | Local Efficiency (eLoc)--PWD | .57 units on a scale | Standard Deviation 0.04 |
| Social Group | Local Efficiency (eLoc)--PWD | .59 units on a scale | Standard Deviation 0.03 |
| No Contact | Local Efficiency (eLoc)--PWD | .58 units on a scale | Standard Deviation 0.04 |
Secondary
Neuropsychiatric Inventory Questionnaire (NPI-Q)
The NPI is a reliable and valid structured interview designed to assess neuropsychiatric symptoms in person with dementia through a structured interview with the caregiver. The NPI includes questions about 12 domains of symptoms: delusions, hallucinations, agitation/aggression, depression, anxiety, elation/ euphoria, apathy, disinhibition, irritability, aberrant motor activity, sleep, and eating. For each, symptom severity is scored on a scale of 0-4, with 4 being the worst outcome and caregiver distress is scored on a scale from 0-5, with 5 being the worst outcome. The sum of all 12 domains is calculated. Severity scores are reported here with a range from 0-36 with a higher score reflecting greater symptom severity.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Neuropsychiatric Inventory Questionnaire (NPI-Q) | 6.83 score on a scale | Standard Deviation 5.64 |
| Non-group Dance | Neuropsychiatric Inventory Questionnaire (NPI-Q) | 5.44 score on a scale | Standard Deviation 4.44 |
| Social Group | Neuropsychiatric Inventory Questionnaire (NPI-Q) | 6.85 score on a scale | Standard Deviation 4.86 |
| No Contact | Neuropsychiatric Inventory Questionnaire (NPI-Q) | 7.72 score on a scale | Standard Deviation 6.13 |
Secondary
NPI-Q
The NPI is a reliable and valid structured interview designed to assess neuropsychiatric symptoms in person with dementia through a structured interview with the caregiver. The NPI includes questions about 12 domains of symptoms: delusions, hallucinations, agitation/aggression, depression, anxiety, elation/ euphoria, apathy, disinhibition, irritability, aberrant motor activity, sleep, and eating. For each, symptom severity is scored on a scale of 0-4, with 4 being the worst outcome and caregiver distress is scored on a scale from 0-5, with 5 being the worst outcome. The sum of all 12 domains is calculated. Severity scores are reported here with a range from 0-36 with a higher score reflecting greater symptom severity.
Time frame: Week 12
Population: Number at baseline and follow-up differ due to withdrawals and due to staff error during data collection.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | NPI-Q | 6.38 score on a scale | Standard Deviation 5.48 |
| Non-group Dance | NPI-Q | 5.22 score on a scale | Standard Deviation 4.66 |
| Social Group | NPI-Q | 5.63 score on a scale | Standard Deviation 5.71 |
| No Contact | NPI-Q | 8.39 score on a scale | Standard Deviation 5.25 |
Secondary
Path Length--PWD
Refers to the number of edges that must be crossed to get from one node to another. Longer path length in people with AD has been associated with slower cognitive performance, beta amyloid deposition, and depression.
Time frame: Baseline
Population: Participants are missing at baseline imaging data due to an undisclosed contraindicated device, aborting scan, refusing scans, or excessive head motion.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Path Length--PWD | 5.29 Number of Edges | Standard Deviation 0.58 |
| Non-group Dance | Path Length--PWD | 5.69 Number of Edges | Standard Deviation 1.17 |
| Social Group | Path Length--PWD | 5.42 Number of Edges | Standard Deviation 0.78 |
| No Contact | Path Length--PWD | 5.52 Number of Edges | Standard Deviation 0.93 |
Secondary
Path Length--PWD
Refers to the number of edges that must be crossed to get from one node to another. Longer path length in people with AD has been associated with slower cognitive performance, beta amyloid deposition, and depression.
Time frame: Week 12
Population: Number at baseline and follow-up differ due to withdrawals, poor data quality, participant refusal of procedure, inability to complete scan.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Path Length--PWD | 5.30 Number of Edges | Standard Deviation 0.93 |
| Non-group Dance | Path Length--PWD | 5.61 Number of Edges | Standard Deviation 0.8 |
| Social Group | Path Length--PWD | 5.36 Number of Edges | Standard Deviation 0.54 |
| No Contact | Path Length--PWD | 5.54 Number of Edges | Standard Deviation 1.09 |
Secondary
Postural Sway--PWD
Center of pressure displacement (area of the 95% confidence ellipse) using an AccuSway forceplate. Center of pressure displacement is one way to characterize postural sway. Increased postural sway is correlated with decreased balance in older adults and increased fall risk. Center of pressure displacement was measured using the area of the 95% confidence ellipse using an AccuSway forceplate. Higher numbers indicate greater levels of postural sway.
Time frame: Week 12
Population: Numbers averaged at baseline and follow-up differ due to withdrawals, technical errors, safety concern, participant unwilling and participant unable to continue.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Postural Sway--PWD | 0.41 centimeter squared | Standard Deviation 0.22 |
| Non-group Dance | Postural Sway--PWD | 0.38 centimeter squared | Standard Deviation 0.2 |
| Social Group | Postural Sway--PWD | 0.41 centimeter squared | Standard Deviation 0.26 |
| No Contact | Postural Sway--PWD | 0.52 centimeter squared | Standard Deviation 0.42 |
Secondary
Postural Sway--PWD
Center of pressure displacement (area of the 95% confidence ellipse) using an AccuSway forceplate. Center of pressure displacement is one way to characterize postural sway. Increased postural sway is correlated with decreased balance in older adults and increased fall risk. Center of pressure displacement was measured using the area of the 95% confidence ellipse using an AccuSway forceplate. Higher numbers indicate greater levels of postural sway.
Time frame: Baseline
Population: Number of participants analyzed at baseline differs due to technical error.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Group | Postural Sway--PWD | 0.42 centimeter squared | Standard Deviation 0.37 |
| Non-group Dance | Postural Sway--PWD | 0.37 centimeter squared | Standard Deviation 0.14 |
| Social Group | Postural Sway--PWD | 0.36 centimeter squared | Standard Deviation 0.21 |
| No Contact | Postural Sway--PWD | 0.49 centimeter squared | Standard Deviation 0.44 |
Other Pre-specified
Blood-based Stress Biomarkers (Covariate or Alternative Hypothesis)
Social engagement may change biomarkers of stress relevant for interpreting outcomes. These stress biomarkers include cortisol and allostatic load, a composite measure of blood-based biomarkers associated with chronically elevated stress. PWD only
Time frame: Baseline, Week 12
Other Pre-specified
Blood Pressure
PWD only
Time frame: Baseline, Week12
Other Pre-specified
Body Mass Index (BMI)
a measure of body fat based on height and weight that applies to adult men and women--PWD only
Time frame: Baseline, Week 12
Other Pre-specified
Caregiver Burden With Zarit Caregiver Burden Scale--Covariate or Alternative Hypothesis
The Zarit Caregiver Burden Scale is administered in interview form to the caregiver. It consists of 22 questions scored 0-4 with 0=Never, 1=Rarely, 2=Sometimes, 3=Quite Frequently, 4=Nearly Always. The total score range is 0-88 with 88 being the worst possible outcome. 0-20 represents little or no burden on the caregiver, 21-40 represents mild to moderate burden, 41-60 represents moderate to severe burden, and 61-88 represents severe burden.
Time frame: Baseline, Week 12
Other Pre-specified
Caregiver Quality of Life With the 36-item Short-Form Health (SF-36)--Covariate or Alternative Hypothesis
The SF-36 consists of 36 questions assessing physical functioning, role functioning difficulties caused by physical problems, bodily pain, general health, vitality, social functioning, role functioning difficulties caused by emotional problems, and mental health. High scores are representative of a great health status and better outcomes, while low scores are representative of a poor health status.
Time frame: Baseline, Week 12
Other Pre-specified
Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI)
A measure of five domains of personality (neuroticism, extraversion, openness, agreeableness, and conscientiousness). A higher score on any scale indicates stronger presence of that trait. PWD only
Time frame: Baseline
Other Pre-specified
White Matter Lesion Burden
The volume of white matter lesions is calculated using the Lesion Segmentation Toolbox. PWD only.
Time frame: Baseline, Week 12