Dance Intervention Affects Social Connections and Body Appreciation Among Older Adults in the Long Term Despite COVID-19 Social Isolation: A Mixed Methods Pilot Study

Pil Hansen, Caitlin Main, Liza Hartling, Pil Hansen, Caitlin Main, Liza Hartling

Abstract

The ability of dance to address social isolation is argued, but there is a lack of both evidence of such an effect and interventions designed for the purpose. An interdisciplinary research team at University of Calgary partnered with Kaeja d'Dance to pilot test the effects of an intervention designed to facilitate embodied social connections among older adults. Within a mixed methods study design, pre and post behavioral tests and qualitative surveys about experiences of the body and connecting were administered to thirteen participants along with test instruments of loneliness and body appreciation. In the short-term, no significant changes were found on quantitative tests. Exploratory analysis revealed intervention improvements on individual body appreciation questions only. This indication of change was strongly supported by converging qualitative data and identified as relating to: increased connection through task-based collaboration, increased awareness of interpersonal boundaries, and a shift to experiencing the body as responsive. These indications of increased relational capacity were deemed likely to cause further impact in the long term. Examining this possibility and the subsequently arisen factor of COVID-19 risks and restrictions, test instruments were administered again to 10 participants 4 and 5 months after the intervention. A significant increase in loneliness was found. Despite this negative impact of COVID-19 isolation, several positive intervention changes remained detectable and some continued to increase over time. Seventy percent of the participants, who made new social contacts during the intervention and later sought continued contact, improved significantly across all body appreciation measures over the full study. The qualitative data from the last two time-points revealed both consistent values and new, negative changes. While these preliminary findings speak to the durability of intervention changes, they also identify areas of urgent priority to help older adults restore embodied relational capacity that has declined during COVID-19. Within the limitations of a small-sample pilot study, converging mixed methods results support the hypothesis that dance interventions designed for the purpose can positively affect the social inclusion of older adults. Although we recommend further study, these promising results also indicate that dance interventions can help older adults recover from pandemic isolation.

Keywords: COVID-19; Kaeja; aging; body appreciation; dance; improvisation; loneliness; touch.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Hansen, Main and Hartling.

Figures

FIGURE 1
FIGURE 1
Participant demographic information by group.
FIGURE 2
FIGURE 2
Mean UCLA Loneliness Scale total scores across time (pre-intervention, post-intervention, phase II and phase II follow up).
FIGURE 3
FIGURE 3
Mean Body Appreciation Scale total scores for participants who continued contact across time (pre-intervention, post-intervention, phase II, and phase II follow-up).
FIGURE 4
FIGURE 4
Mean Body Appreciation Scale Q10 scores across time (pre-intervention, post-intervention, pahse II, and phase II follow-up).
FIGURE 5
FIGURE 5
Mean Body Appreciation Scale Q3 scores across time (pre-intervention, post-intervention, pahse II, and phase II follow-up).
FIGURE 6
FIGURE 6
Mean Body Appreciation Scale Q5 scores across time (pre-intervention, post-intervention, pahse II, and phase II follow-up).

References

    1. Andersson L. (1998). Loneliness research and interventions: a review of the literature. Aging Ment. Health 2 264–274. 10.1080/13607869856506
    1. Berg-Weger M., Morley J. E. (2020). Editorial: loneliness and social isolation in older adults during the COVID-19 pandemic: implications for gerontological social work. J. Nutr. Health Aging 24 456–458. 10.1007/s12603-020-1366-8
    1. Cann P. (2016). “Something to get out of bed for”: creative arts for a happily ageing population. Work. Older People 20 190–194. 10.1108/wwop-09-2016-0025
    1. Cloutier-Fisher D., Kobayashi K., Smith A. (2011). The subjective dimension of social isolation: a qualitative investigation of older adults’ experiences in small social support networks. J. Aging Stud. 25 407–414. 10.1016/j.jaging.2011.03.012
    1. Coubard O., Duretz S., Lapalus P., Ferrufino L. (2011). Practice of contemporary dance improves cognitive flexibility in aging. Front. Aging Neurosci. 3:13. 10.3389/fnagi.2011.00013
    1. Coyle C. E., Dugan E. (2012). Social isolation, loneliness and health among older adults. J. Aging Health 24 1346–1363. 10.1177/0898264312460275
    1. Creswell J. W., Plano Clark V. C. (2007). Designing and Conducting Mixed Methods Research. Los Angeles, CA: SAGE Publications.
    1. Crumbie V., Olmos F., Watts C., Avery J., Nelson R. (2015). The impact of dance interventions on mood and depression in older adults. Therap. Recreat. J. 49 187–190.
    1. De Jong-Gierveld J., Havens B. (2004). Cross-national comparisons of social isolation and loneliness: introduction and overview. Can. J. Aging 23 109–113. 10.1353/cja.2004.0021
    1. Duignan D., Hedley L., Milverton R. (2009). Exploring dance as a therapy for symptoms and social interaction in a dementia care unit. Nurs. Times 105 19–22.
    1. Findlay R. (2003). Interventions to reduce social isolation amongst older people: where is the evidence? Age. Soc. 23 647–658. 10.1017/S0144686X03001296
    1. Fong Yan A., Cobley S., Chan C., Pappas E., Nicholson L. L., Ward R. E., et al. (2018). The effectiveness of dance interventions on physical health outcomes compared to other forms of physical activity: a systematic review and meta-analysis. Sports Med. 48 933–951. 10.1007/s40279-017-0853-5
    1. Franco M. R., Tong A., Howard K., Sherrington C., Ferreira P. H., Pinto R. Z., et al. (2015). Older people’s perspectives on participation in physical activity: a systematic review and thematic synthesis of qualitative literature. Br. J. Sports Med. 49 1268–1276. 10.1136/bjsports-2014-094015
    1. Gorenko J. A., Moran C., Flynn M., Dobson K., Konnert C. (2020). Social isolation and psychological distress among older adults related to COVID-19: a narrative review of remotely-delivered interventions and recommendations. J. Appl. Gerontol. 40 3–13. 10.1177/0733464820958550
    1. Guzmán-García A. H. J. C., Hughes J. C., James I. A., Rochester L. (2013). Dancing as a psychosocial intervention in care homes: a systematic review of the literature. Int. J. Geriatr. Psychiatry 28 914–924. 10.1002/gps.3913
    1. Hackney M. E., Kantorovich S., Earhart G. M. (2007). A study on the effects of Argentine tango as a form of partnered dance for those with Parkinson disease and the healthy elderly. Am. J. Dance Ther. 29 109–127. 10.1007/s10465-007-9039-2
    1. Hansen P. (2017). “Research-based practice: facilitating transfer across artistic, scholarly, and scientific inquiries,” in Performance as Research: Knowledge, Methods, Impact, eds Arlander A., Barton B., Dreyer-Lude M., Spatz B. (London: Routledge; ), 32–49.
    1. Hansen P. (2018a). “Dance dramaturgical agency,” in Contemporary Choreography, 2nd Edn, eds Butterworth J., Wildschut L. (London: Routledge; ), 187–202.
    1. Hansen P. (2018b). “Minding implicit constraints in dance improvisation,” in Routledge Companion to Theatre, Performance and Cognition, eds McConachie B., Kemp R. (London: Routledge; ), 75–82. 10.4324/9781315169927-8
    1. Hansen P., Barton B. (2009). Research-based practice: situating vertical city between artistic development and applied cognitive science. TDR 53 120–136. 10.1162/dram.2009.53.4.120
    1. Hansen P., Climie E. A., Oxoby R. J. (2020). The demands of performance generating systems on executive functions: effects and mediating processes. Front. Psychol. 11:1894. 10.3389/fpsyg.2020.01894
    1. Hansen P., Kaeja K., Henderson A. (2014). Self-organization and transition in systems of dance generation. Perform. Res. Turbul. 19 23–33. 10.1080/13528165.2014.958350
    1. Hawkley L. C., Cacioppo J. T. (2003). Loneliness and pathways to disease. Brain Behav. Immun. 17 98–105. 10.1016/S0889-1591(02)00073-9
    1. Holt-Lunstad J., Smith T. B., Layton J. B. (2010). Social relationships and mortality risk: a meta-analytic review. PLoS Med. 7:e1000316. 10.1371/journal.pmed.1000316
    1. Houston S. (2018). “Dancing around exclusion: an examination of the issues of social inclusion within choreographic practice in the community,” in Contemporary Choreography, 2nd Edn, eds Butterworth J., Wildschut L. (London: Routledge; ), 237–250. 10.4324/9781315563596-21
    1. Houston S., McGill A. (2011). English National Ballet Dance for Parkinson’s: An Investigative Study. London: Roehampton University.
    1. Hughes M. E., Waite L. J., Hawkley L. C., Cacioppo J. T. (2004). A short scale for measuring loneliness in large surveys. Res. Aging 26 655–672. 10.1177/0164027504268574
    1. Hurd Clarke L. (2010). Facing Age: Women Growing Older in an Anti-Aging Culture. Toronto, ON: Rowman and Littlefield.
    1. Hurd Clarke L., Korotchenko A. (2011). Aging and the body: a review. Can. J. Aging 30 495–510. 10.1017/S0714980811000274
    1. Hwang T., Rabheru K., Peisah C., Reichman W., Ikeda M. (2020). Loneliness and social isolation during the COVID-19 pandemic. Int. Psychogeriatr. 32 1217–1220. 10.1017/s1041610220000988
    1. Hyvönen K., Pylvänäinen P., Muotka J., Lappalainen R. (2020). The effects of dance movement therapy in the treatment of depression: a multicenter, randomized controlled trial in Finland. Front. Psychol. 11:1687. 10.3389/fpsyg.2020.01687
    1. Jose J. P., Cherayi S. (2017). Social exclusion of older persons: the role of socio-demographic characteristics. Age. Int. 42 447–465. 10.1007/s12126-016-9255-5
    1. Jylha M. (2004). Old age and loneliness: cross-sectional and longitudinal analyses in the tampere longitudinal study on aging. Can. J. Aging 23 157–168. 10.1353/cja.2004.0023
    1. Kattenstroth J. C., Kolankowska I., Kalisch T., Dinse H. R. (2010). Superior sensory, motor, and cognitive performance in elderly individuals with multi year dancing activities. Front. Aging Neurosci. 2:31. 10.3389/fnagi.2010.00031
    1. Keogh J. W., Kilding A., Pidgeon P., Ashley L., Gillis D. (2009). Physical benefits of dancing for healthy older adults: a review. J. Aging Phys. Activ. 17 479–500. 10.1123/japa.17.4.479
    1. Kshtriya S., Barnstaple R., Rabinovich D. B., DeSouza J. F. X. (2015). Dance and aging: a critical review of findings in neuroscience. Am. J. Dance Ther. 37 81–112. 10.1007/s10465-015-9196-7
    1. Laban (2010). Dancing Towards Well-Being in the Third Age: Literature Review on the Impact of Dance on Health and Well-Being Among Older People. London: Trinity Laban Conservatoire of Music and Dance, Dance Science Department.
    1. Lehikoinen K. (2019). Dance in elderly care. J. Dance Educ. 19 108–116. 10.1080/15290824.2018.1453612
    1. Levitas R. (2004). Let’s hear it for humpty: social exclusion, the third way and cultural capital. Cult. Trends 13 41–56. 10.1080/0954896042000267143
    1. Liechty T., Yarnal M. (2010). The role of body image in older women’s leisure. J. Leisure Res. 42 443–467.
    1. Lima M., Vieira A. (2007). Ballroom dance as therapy for the elderly in Brazil. Am. J. Dance Ther. 29 129–142. 10.1007/s10465-007-9040-9
    1. Lötzke D., Ostermann T., Büssing A. (2015). Argentine tango in Parkinson disease: a systematic review and meta-analysis. BMC Neurol. 15:226. 10.1186/s12883-015-0484-0
    1. MacLeod A., Skinner M. W., Wilkinson F., Reid H. (2016). Connecting socially isolated older rural adults with older volunteers through expressive arts. Can. J. Aging 35 14–27. 10.1017/s071498081500063x
    1. Matarasso F. (1997). Use or Ornament? The Social Impact of Participation in the Arts. Stroud: Comedia.
    1. McNeely M. E., Duncan R. P., Earhart G. M. (2015a). A comparison of dance interventions in people with Parkinson disease and older adults. Maturitas 81 10–16. 10.1016/j.maturitas.2015.02.007
    1. McNeely M. E., Duncan R. P., Earhart G. M. (2015b). Impacts of dance on non-motor symptoms, participation, and quality of life in Parkinson Disease and healthy older adults. Maturitas 82 336–341. 10.1016/j.maturitas.2015.08.002
    1. Meng X., Li G., Jia Y., Liu Y., Shang B., Liu P., et al. (2019). Effects of dance intervention on global cognition, executive function and memory of older adults: a meta-analysis and systematic review. Aging Clin. Exp. Res. 32 7–19. 10.1007/s40520-019-01159-w
    1. Moody E., Phinney A. (2012). A community-engaged art program for older people: fostering social inclusion. Can. J. Aging 31 55–64. 10.1353/cja.2012.0007
    1. Morgan D. L. (2017). Integrating Qualitative and Quantitative Methods: A Pragmatic Approach. London: SAGE.
    1. Morrison A. B., Chein J. M. (2011). Does working memory training work? The promise and challenges of enhancing cognition by training working memory. Psychon. Bull. Rev. 18 46–60. 10.3758/s13423-010-0034-0
    1. Pantell M., Rehkopf D., Jutte D., Syme S. L., Balmes J., Adler N. (2013). Social isolation: a predictor of mortality comparable to traditional clinical risk factors. Am. J. Public Health 103 2056–2062. 10.2105/ajph.2013.301261
    1. Perlman D., Peplau L. (1998). “Loneliness,” in Encyclopedia of Mental Health, Vol. 2 ed. Friedman H. S. (San Diego, CA: Academic Press; ), 571–581.
    1. Pinquart M., Sörensen S. (2003). “Risk factors for loneliness in adulthood and old age: a meta-analysis,” in Advances in Psychology Research, ed. Shohov S. (Hauppauge, NY: NOVA Science Publishers; ), 111–143.
    1. Robb C. E., de Jager C. A., Ahmadi-Abhari S., Giannakopoulou P., Udeh-Momoh C., McKeand J., et al. (2020). Associations of social isolation with anxiety and depression during the early covid-19 pandemic: a survey of older adults in London, UK. Front. Psychiatry 11:591120. 10.3389/fpsyt.2020.591120
    1. Rodrigues-Krause J., Farinha J. B., Krause M., Reischak-Oliveira Á. (2016). Effects of dance interventions on cardiovascular risk with ageing: systematic review and meta-analysis. Complement. Ther. Med. 29 16–28. 10.1016/j.ctim.2016.09.004
    1. Ronzi S., Orton L., Pope D., Valtorta N. K., Bruce N. G. (2018). What is the impact on health and wellbeing of interventions that foster respect and social inclusion in community-residing older adults? A systematic review of quantitative and qualitative studies. Syst. Rev. 7:26. 10.1186/s13643-018-0680-2
    1. Russell D., Peplau L. A., Cutrona C. E. (1980). The revised UCLA loneliness scale: concurrent and discriminant validity evidence. J. Pers. Soc. Psychol. 39 472–480. 10.1037/0022-3514.39.3.472
    1. Scharlach A. E., Lehning A. J. (2013). Ageing-friendly communities and social inclusion in the United States of America. Age. Soc. 33 110–136. 10.1017/S0144686X12000578
    1. Schwender T. M., Spengler S., Oedl C., Mess F. (2018). Effects of dance interventions on aspects of the participants’ self: a systematic review. Front. Psychol. 9:1130. 10.3389/fpsyg.2018.01130
    1. Silva P. A., Cochrane A., Farrell H. (2018). The effectiveness of technology-mediated dance interventions and their impact on psychosocial factors in older adults: a systematic review and meta-analysis. Games Health J. 7 347–361. 10.1089/g4h.2017.0197
    1. Skingley A., De’Ath S., Napleton L. (2016). Evaluation of edna: arts and dance for older people. Work. Older People 20 46–56. 10.1108/WWOP-08-2015-0016
    1. Skinner M. W., Herron R. V., Bar R. J., Kontos P., Menec V. (2018). Improving social inclusion for people with dementia and carers through sharing dance: a qualitative sequential continuum of care pilot study protocol. BMJ Open 8:e026912. 10.1136/bmjopen-2018-026912
    1. Smith G. L., Banting L., Eime R., O’Sullivan G., van Uffelen J. G. Z. (2017). The association between social support and physical activity in older adults: a systematic review. Int. J. Behav. Nutr. Phys. Activ. 14 1–21. 10.1186/s12966-017-0509-8
    1. Smith J. M. (2012). Loneliness in older adults: an embodied experience. J. Gerontol. Nurs. 38 45–53. 10.3928/00989134-20210703-08
    1. Smith M. L., Steinman L. E., Casey E. A. (2020). Combatting social isolation among older adults in a time of physical distancing: the COVID-19 social connectivity paradox. Front. Public Health 8:403. 10.3389/fpubh.2020.00403
    1. Taylor H. O., Taylor R. J., Nguyen A. W., Chatters L. (2018). Social isolation, depression, and psychological distress among older adults. J. Aging Health 30 229–246. 10.1177/0898264316673511
    1. Tylka T. L., Wood-Barcalow N. L. (2015). The body appreciation scale-2: item refinement and psychometric evaluation. Body Image 12 53–67. 10.1016/j.bodyim.2014.09.006
    1. Victor C., Scambler S., Bond J., Bowling A. (2000). Being alone in later life: loneliness, social isolation and living alone. Rev. Clin. Gerontol. 10 407–417. 10.1017/S0959259800104101
    1. Watt A. D., Konnert C. A., Speirs C. E. C. (2017). The mediating roles of primary and secondary control in the relationship between body satisfaction and subjective well-being among middle-aged and older women. J. Gerontol. Ser. B Psychol. Sci. Soc. Sci. 72 603–612. 10.1093/geronb/gbv098
    1. Weiss R. S. (1973). Loneliness: The Experience of Emotional and Social Isolation. Cambridge, MA: MIT Press.
    1. Wenger G. C., Davies R., Shahtahmasebi S., Scott A. (1996). Social isolation and loneliness in old age: review and model refinement. Age. Soc. 16 333–358. 10.1017/S0144686X00003457
    1. White T. R., Rentschler R. (2005). “Toward a new understanding of the social impact of the arts,” Paper Presented at the 8th International Conference on Arts and Cultural Management, Montreal, QC.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren