By Abby Vogeley
To prevent contagion during the global pandemic, social activities imperative to the lives of many have shuttered to a resounding halt. However, for IMPROVment, an improvisational dance program for those with dementia and their caregivers, the accessibility to community and movement is still possible with a modified online platform.
“You become a community and it is really hard to not be with them,” says Christina Soriano, creator of IMPROVment and an associate professor of dance at Wake Forest University. “But we’ve tried to share some of the online class offerings we’ve had.”
Through temporarily substituting weekly classes virtually, participants living with dementia, or syndromes causing a decline in the ability to process thought, are able to still have the social interaction and increased movement that is predicted by researchers Christina Soriano and Dr. Christina Hugenschmidt to improve quality of life.
This research conducted by Soriano and Dr. Christina Hugenschmidt, the assistant professor of Gerontology and Geriatric Medicine at the Wake Forest School of Medicine, started in 2017 under the IMOVE study after a preliminary trial of the dance program saw an improvement in participant’s movement and reported quality of life. For the past three years, the IMPROVment method has been used to study the significant impact that the combined improvisational movements and social setting of these classes has on motor skills and social skills in those struggling with dementia.
Though dementia, which includes diseases such as Alzheimer’s, is known for its impact on memory loss, secondary symptoms, such as movement and social abilities, are also at jeopardy due to the total deterioration of the brain.
“There’s atrophy throughout the brain,” says Dr. Hugenschmidt. “So basically any function that the brain is undertaking is being affected.”
This atrophy, or destruction of the brain, is unpredictable in which areas it targets. Within patients with memory loss, a decrease of brain matter has been seen in the hippocampus, the location in the brain that is most associated with memory. However, the disease does not only target areas that impact memory, but many other functions, including movement.
“Another thing that is affected is motor function, which again people often don’t realize,” says Dr. Hugenschmidt. “[Those with dementia] are more likely to be injured by a fall, and they have changes in gait and balance that can be detected up to 12 years before the onset of cognitive decline.”
Through Dr. Hugenschmidt and Professor Soriano’s study, the benefits of improvisational movement classes on these two secondary symptoms, movement and quality of life, have been gauged through physical tests for balance, neurologically through brain scans, and through self-reported changes in quality of life.
In the preliminary data collected, it was seen through fMRIs, or images that look at the structure of the brain, that there were improved neural connections within the somatomotor cortex, an area associated with coordination and movement. This change has been hypothesized to contribute to the improvement in balance and movement seen among participants.
“A lot of them have said that they move a lot more when they are home,” says Kamryn King, a Wake Forest senior and an IMPROVment teacher. “They know stretches to do when they’re stiff.”
These secondary symptoms, despite being less acknowledged by the public, can have serious impacts on the wellbeing of those suffering from dementia.
“Memory is the least of it,” says Sharon Marshall, wife and caregiver of her husband, who was recently diagnosed with Alzheimer’s. “Quality of life really takes a nosedive.”
Those with dementia have been reported to struggle more with social interactions partially because of a lack of confidence, a component believed to lead to a decrease in quality of life. Dr. Hugenschmidt and Professor Soriano believe this may be improved through the IMPROVment method.
“Social contact and social engagement is very important for older adults,” says Dr. Hugenschmidt. “It could be possible for people to benefit from just coming in and doing improvisational dance together, having a good time, and forming social bonds.”
Social engagement has been associated with activating the Default Mode Network (DMN), a pathway within the brain. In the preliminary trial, fMRI scans showed better connections between areas in the DMN and was correlated with higher scores on quality of life reports.
Although the final data from the IMOVE study has yet to be reported, King is optimistic about the positive effects the dance classes have made on the participants and continues to see this effect on the online classes.
“They have so much more energy, and they’re so much more engaged,” says King. “I think having these classes gives them a sense of purpose and makes them feel like they’re actually impacting other people.”
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Christina Hugenschmidt, PhD, Assistant Professor of Gerontology and Geriatric Medicine at Wake Forest School of Medicine
Christina Soriano, Director of Dance and Associate Professor of Dance at Wake Forest University
Kamryn King, Senior Wake Forest University Student and IMPROVment Teacher
Sharon Marshall, Wife and Alzhiemer’s Patient Caregiver
http://www.improvment.us/participate-in-a-study-2
https://school.wakehealth.edu/Faculty/H/Christina-Hugenschmidt
https://clinicaltrials.gov/ct2/show/NCT03333837
https://www.alzheimers.org.uk/
https://www.who.int/news-room/fact-sheets/detail/dementia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821835/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3134578/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206840/
