Study On The Effect Of Square Dance On The Elderly And Young Patients With Cognitive Impairment And Depressive Symptoms

Background:Mild Cognitive Impairment(MCI)is the most important and appropriate stage of dementia preventive treatment.Studies have shown that depressive symptoms,one of the most common neuropsychiatric symptoms of MCI,is of the impact of accelerating the progression of MCI to dementia.Preliminary results shows that the exercise therapy can improve cognitive function in patients with MCI,but because of its strength,poor safety and more boring,is not suitable for the elderly,by contrast,dance movement therapy(DMT)is simple,safe,easy to operate,and interesting.It is more suitable for elderly people whose body function is gradually declining.However,DMT is a kind of psychotherapy that needs to be carried out by professional psychotherapists and has poor operability in community nursing services.Square dance is an aerobic exercise,it also incorporates dance,music,social interaction and other elements.However,current studies on the effect of square dancing on MCI patients,specifically on those who are with depressive symptom,are very limited.Objectives:To investigate the effects of square dance on cognitive function and depression level of elderly MCI patients(≥60 years old)with depressive symptom.Methods:From January to August,2018,cognitive function screening was conducted in elderly people who complained of memory loss living in two communities in Beijing.A total of 107 elderly MCI patients with depressive symptoms were diagnosed by doctors.With informed consent 35 patients were selected from each community to be included in the study as the control group and the intervention group.Both groups received health education,and the intervention group received square dance intervention on this basis(at least 3 times a week,60 min each time,for 3 months).MoCA-P and GDS-30 were chosen to estimate the cognitive function and depressive symptoms of two groups before intervention,three months after the start of intervention,and three months after the end of intervention,SEES was used for the assessment of the subjective exercise experience of the intervention group three months after the start of intervention,and three months after the end of intervention.Group interview method was applied to collect the opinions,feelings,and suggestions of the intervention group’s to square dance intervention three months after the end of intervention.Results:Of the 70 patients who participated in the study,63 participants(31 from intervention group,32 from control group)completed data collection after 6 months.The results showed that:(1)After 3 months of square dance intervention,for the intervention group,the MoCA-P score was shown to be 26.00(3.00).the GDS-30 score was9.00(6.00),and for the control group,the MoCA-P score appeared to be 22.00(1.00)points,GDS-30 score was 13.50(6.00)points.The scores of cognitive function and depressive symptoms of these two compared groups were noticed to be significantly different(ZMoCA-P=-4.68,ZCDS-30=5.01,P<0.05).After 3 months of follow-up,the MoCA-P score of the intervention group was 26.00(2.00),the GDS-30 score was 6.00(5.00),and remarkably the MoCA-P score of the control group was noticed to be 23.00(2.00),the score of GDS-30 was 13.00(6.00),the difference between the scores of the two indicators:cognitive function and depressive symptoms,was noticed to be considerably significant(ZMoCA-P=-5.18,ZGDS-30=-5.65,P<0.05).(2)After 3 months of square dance intervention,the MoCA-P score of the intervention group was 26.00(3.00),and the GDS-30 score was 9.00(6.00),Comparing with the previous scores of cognitive function scores and depressive symptom,after the square dance intervention,the scores were witnessed to be comparatively significant(ZMoCA-P=-4.66,ZGDS-30=-4.47,P<0.05).After 3 months of follow-up,the MoCA-P score of the intervention group was 26.00(2.00),and the GDS-30 score was 6.00(5.00),compared with the pre-intervention,the differences in cognitive function scores and depressive symptoms scores were statistically significant as well(ZMoCa-P=-4.64,ZGDS-30=-4.87,P<0.05),however,the trend of significant difference stopped at the results after 3 months of intervention:there was no significant difference in cognitive function scores before and after the square dance intervention(Z=-1.31,P>0.05),while for the indicator of depression symptom,the scores are still observed to be statistically significant(Z=-2.76,P<0.05).(3)The changes of cognitive function and depressive symptoms in the two groups were different at each time point.The MoCA-P score of the intervention group gradually increased with time(Fgroup=32.09,Ftime=52.82,Finteraction=19.18,P<0.05),and the GDS-30 score gradually decreases with time(Fgroup=40.67,Ftime=44.37,Fiinteraction=25.73,P<0.05).At the same time,the MoCA-P score and GDS-30 score of the control group did not change with time.(4)In the intervention group,the scores of positive well-being and perceived fatigue in the Subjective Exercise Experience Scale(SEES)were significantly increased after three months of intervention(tPositive well-being=-6.58,Zperceived fatigue=-4.09,P<0.05).(5)In this study,a total of 3 group interviews were conducted,and 15 elderly MCI patients with depressive symptom were interviewed.Square dance is recognized by the interviewees to be of positive influences on their physical and psychological conditions.The interviewees consider square dancing an easy approach for them to release stress,exercising the brain,regulating emotions,and alleviating loneliness,despite the fact the square dancing is close to life and has strong collective participation.Therefore,the attitude of the square dance intervention changed from doubt to active participation,but the respondents indicated that whether the square dance intervention can be smoothly carried out in the community environment is influenced by factors such as personal concept,objective environment,intervention plan and organizational factors.Conclusion:This study shows that square dance intervention has a positive impact on cognitive function and depressive symptoms in elderly patients with MCI with depressive symptoms,but this effect will be affected by factors such as length,frequency and intensity of dancing.Therefore,in the specific practice process,a simple,safe and moderate intensity square dance intervention plan should be formulated according to the individual conditions,needs and preferences of elderly MCI patients,and the intervention plan should be flexibly adjusted according to environmental factors to promote elderly MCI patients to maintain a good compliance with the square dance intervention.In addition,elderly MCI patients with depressive symptoms recognized and accepted square dance intervention,indicating that square dance may be an early intervention for dementia prevention worthy of promotion in Chinese communities.