A randomized trial of dance on mood, balance and brain in Alzheimer's Disease

舞蹈对阿尔茨海默病患者情绪、平衡和大脑影响的随机试验

• 批准号: 10364981
• 负责人: CHRISTINA E HUGENSCHMIDT
• 金额: $ 23.83万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10364981
• 关键词: Address; Affect; Alzheimer' s Disease; Alzheimer' s disease care; Anxiety; Atmosphere; Auditory; Biological Markers; Blood; Brain; Brain imaging; Caregiver Burden; Caregivers; Cause of Death; Chronic Disease; Cognition; Cognitive; Communities; Continuity of Patient Care; Cues; Dancing; Data; Dementia; Disease; Educational workshop; Elderly; Environment; Equation; Equilibrium; Exercise; Fostering; Funding; Gait; Goals; Health Services; Home; Intervention; Knowledge; Learning; Link; Measures; Medical Care Costs; Memory; Mental Depression; Methods; Modeling; Moods; Movement; Music; Neurodegenerative Disorders; Palliative Care; Parkinson Disease; Persons; Physical Function; Physiological; Quality of life; Randomized; Research Design; Scientist; Social Conditions; Stress; Structure; Symptoms; Testing; Training; United States National Institutes of Health; World Health Organization; adjudicate; anxiety symptoms; artist; base; behavioral outcome; body system; body-mind; care systems; depressive symptoms; design; evidence base; graph theory; health care service; improved; instructor; neuroimaging; neuromechanism; neuropsychiatric symptom; patient population; persistent symptom; professor; randomized trial; reduce symptoms; relating to nervous system; response; social; social engagement; social group; social movement; symptom management; uptake

Project Summary Alzheimer’s disease (AD) 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 AD that increase medical costs and decrease quality of life (QoL) for the person with dementia and their caregiver. Care for AD and other dementias in the US was estimated at $203 billion in 2013. Palliative care services are health services that aim to relieve disease symptoms that decrease QoL for people with chronic disease and their caregivers. The World Health Organization has identified a need to integrate evidence-based palliative care services into the continuum of care for serious chronic diseases including AD. However, two recent NIH workshops concluded that lack of evidence limits the broader use of non-pharmacologic activities to relieve secondary symptoms of chronic disease, and identified arts-based mind-body practices as particularly understudied. Dance is an arts- based activity that can improve QoL, decrease symptoms of depression, and improve balance in healthy older adults, those with Parkinson disease, and AD. Thus, dance simultaneously addresses two sets of prominent secondary symptoms in AD: 1) gait and balance and 2) neuropsychiatric symptoms. However, the mechanisms by which dance exerts these effects are unknown. Filling this knowledge gap could increase the use of dance to improve QoL in a large and growing patient population. In addition, a better understanding of the physiological changes that occur during dance that are linked to improved QoL and symptom management could facilitate identification of other interventions that may ameliorate secondary symptoms of AD, and other patient populations that might benefit from dance. We present pilot data to support our hypothesis that dance improves QoL in older adults with AD through changes in brain activity in brain networks related to movement and social engagement. We hypothesize that dance benefits QoL by simultaneously improving balance and gait through movement, and improving apathy and depression through social engagement. We have laid out a rigorous scientific design to test the independent contributions of dance movement and social engagement to QoL. In addition, we propose to collect measures that will allow us to learn about how dance affects different body systems. We will collect brain imaging data to evaluate changes in brain function and structure; detailed measures of balance and gait; and blood biomarkers of stress. Better understanding of how dance affects the body and brain to improve quality of life in people with AD may improve the quality of palliative care services offered to people with AD by helping to understand how to better use non-pharmacologic interventions to target secondary symptoms that affect QoL.

项目摘要 阿尔茨海默病(AD)是痴呆症最常见的形式，也是最常见的神经退行性疾病 在老年人中，是美国第六大死因。神经精神症状(冷漠、抑郁、 焦虑)和步态和平衡改变是AD的突出次要症状，增加了医疗费用 并降低痴呆症患者及其照顾者的生活质量(QOL)。关注AD和其他 2013年，美国的痴呆症患者估计为2030亿美元。姑息治疗服务是旨在 缓解降低慢性病患者及其照顾者生活质量的疾病症状。这个 世界卫生组织已确定有必要将循证姑息护理服务纳入 对包括阿尔茨海默病在内的严重慢性疾病的持续护理。然而，最近的两个NIH研讨会结束了 缺乏证据限制了更广泛地使用非药物活性来缓解继发性肺炎症状。 慢性疾病，并确定以艺术为基础的心身实践尤其未被研究。舞蹈是一门艺术- 基于活动，可以改善健康老年人的生活质量，减少抑郁症状，改善平衡 成人、帕金森病患者和AD患者。因此，舞蹈同时解决了两套突出的 AD的次要症状：1)步态和平衡；2)神经精神症状。然而，这些机制 舞蹈是通过什么发挥这些效果的还不得而知。填补这一知识空白可以增加对舞蹈的使用 以改善庞大且不断增长的患者群体的生活质量。此外，更好地了解 舞蹈过程中发生的与改善生活质量和症状管理相关的生理变化 有助于确定可以改善AD继发性症状的其他干预措施，以及其他 可能从舞蹈中受益的患者群体。我们提供了飞行员数据来支持我们的假设 通过改变与运动相关的脑网络中的脑活动来改善老年AD患者的生活质量 和社交参与度。我们假设舞蹈通过同时改善平衡和 通过运动来走路，通过社交活动来改善冷漠和抑郁。我们已经制定了一项 严格的科学设计，测试舞蹈动作和社会参与度的独立贡献 生活质量。此外，我们建议收集一些措施，让我们了解舞蹈如何影响不同的人 身体系统。我们将收集大脑成像数据，以评估大脑功能和结构的变化；详细 平衡和步态的测量；以及压力的血液生物标记物。更好地理解舞蹈如何影响 身体和大脑改善AD患者的生活质量可能会提高姑息治疗服务的质量 为AD患者提供帮助，帮助了解如何更好地使用非药物干预 影响生活质量的次要症状。

项目成果

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

• DOI: 10.3389/fspor.2021.796101
• 发表时间: 2021
• 期刊: Frontiers in sports and active living
• 影响因子: 2.7
• 作者: Thumuluri D;Lyday R;Babcock P;Ip EH;Kraft RA;Laurienti PJ;Barnstaple R;Soriano CT;Hugenschmidt CE
• 通讯作者: Hugenschmidt CE