EUROPEAN PAPERS ON THE NEW WELFARE

Dance For Life

Dance for the Brain
In a study, Dr. Joe Verghese, professor of neurology at Albert Einstein College of Medicine, New York, and colleagues, followed a group of 469 men and women, ages 75 and older. The participants, who did not have any sign of forgetfulness at the study’s start, were followed between the years 1980 and 2001. Each member of the cohort gave details about how often they participated in six brain stimulating hobbies: reading, writing for pleasure, doing crosswords, playing musical instruments, taking part in group discussions and playing board game; and 11 physical activities including ballroom dancing, team sports, swimming and bicycling.
The researchers developed a scale to assess the frequency of activities each week. For example, for each beneficial activity, the risk reduction was related to how often it was performed. Participating in cognitive-stimulating activity one day a week translated into one point on the cognitive activity level scale.
Each year, for an average of five years, the study cohort was evaluated. During the course of the study, 124 people developed dementia: 61 developed Alzheimer’s disease, 30 vascular dementia (strokes), 25 mixed dementia and 8 had other types of dementia.14
By comparing those who developed dementia with those who did not, the researchers found that for one point on the cognitive activity level scale, there was a 7% reduction in the risk of dementia. People in the highest third had a score of 11 points or higher. That means they participated in mind-stimulating activities more than once a day each week. Their risk of developing dementia was 63% lower than people who scored in the lowest third of the cognitive activity level scale. The researchers found that people who took part in intellectually stimulating hobbies such as reading, playing board games or instruments demonstrated a reduced risk of dementia, but the researchers found no significant association between physical activities and the risk of dementia, except for ballroom dancing. The amazing 76% risk reduction from frequent participation in ballroom dancing by 130 avid dancers was the highest score of all hobbies and physical activities measured in the study.
For example, seniors who did crosswords four days a week had a 47% lower risk of dementia than people who did only once a week. Reading reduces the risk by 35%, playing musical instrument lowers the risk by 69%, and dancing frequently lowers the risk, as stated above, by an amazing 76%.
Verghese offered the theory that the requirements of ballroom dancing—remembering the steps, moving in precise time to the music and adapting to the movement of the partner—are mentally demanding exercises. Therefore ballroom dancing offers both physical and mental stimulations. Verghese says other kinds of dancing may also be healthful for seniors, but because his subjects preferred ballroom, he cannot tell for sure.
Dr. Susanne Sorensen, head of research at the Alzheimer’s Society, says that this research strengthens the “use-it-or-lose-it” school of thought that states that complex brain activity can build up a brain reserve that may protect people from Alzheimer’s disease later in life. So, do not forget to dance.

Dance for the Heart
Exercise is crucial after people suffer heart problems, but getting people to adhere to exercise programs is tough. As many as 70% drop out of traditional programs, said Dr. Romualdo Belardinelli, professor of cardiology at Università Politecnica delle Marche School of Medicine, and director of cardiac rehabilitation at Lancisi Heart Institute in Ancona, Italy.
The group of Italian researchers led by Dr. Belardinelli has come up with a novel way for cardiac rehabilitation patients to exercise their damaged hearts without having to squeeze into spandex or gyrate in a gym, but by waltzing instead. The dance proved to be just as effective as bicycle and treadmill training for improving exercise capacity in a study of 110 participants (89 men and 21 women), average age 59, with mild to moderate heart failure. The condition occurs when weakened hearts can no longer pump blood effectively, making simple activities like climbing stairs and taking the dog for a walk tough to do, let alone enjoy.15
The researchers assigned 44 patients to a supervised exercise training program of cycling and treadmill work three times a week for eight weeks. Another group of 44 took dance classes in the hospital gym, alternating between slow and fast waltzes for 21 minutes, three times a week for eight weeks. A third group of 22 patients had no exercise. Heart rates were checked during both activities, more extensive exercise tests were done at the start and end of the study, and artery imaging exams were performed.
Cardiopulmonary fitness increased at similar rates among those who danced or exercised and did not change in those who did neither. Oxygen uptake increased 16% among exercisers and 18% among dancers. The anaerobic threshold—the point where muscles fatigue—rose 20% among exercisers and 21% among dancers. Other measures, including a general index of fitness, were comparable. Imaging showed that dancers’ arteries were more able to dilate and expand in response to exercise than non-exercisers.
Quality of life was surprisingly more significantly improved in the dancing group versus the exercise group. Dancers reported slightly more improvement in sleep, mood, and the ability to do hobbies, do housework and have sex than the others. In a test in which lower scores mean fewer problems interfering with quality of life, among dancers, scores dropped from an average of 56 to 41; among exercisers, the same scores dropped from an average of 58 to 48.
The researchers chose the Waltz because it is internationally known and is quite aerobic, as the study ultimately verified. The same researchers previously showed that waltzing could help heart attack sufferers regain strength. Part of the benefit may be that dancers had a partner and social companion rather than cycling or walking on a treadmill alone.

Exercise and Dance to Heal
Having a bad heart does not mean one can skip exercise, doctors said September 5, 2007. In fact, exercise may even help one’s heart to repair itself. Research presented at the 2007 European Society of Cardiology congress showed that exercise sparks the creation of new heart vessels.16
In a small study of 37 people at Leipzig University in Germany, Dr. Robert Hollriegel found that people with serious heart failure who rode a bike for up to 30 minutes a day for four months produced new stem cells in their bones. They also had more small blood vessels in their muscles. Those who did not exercise had no change in their vessels or muscles.

Most patients with heart failure are over 70 years old, and some can barely walk a few steps without stopping for rest. Doctors think that even these patients would benefit from light exercise such as walking or cycling. To ensure that patients will be able to handle a certain level of physical activity, doctors conduct a test first to determine their maximum limits and to ensure they would not be exceeded.
Physical activity strains the heart’s arteries and muscles by sending 10 times the normal amount of blood to the muscles being used. Stem cells then are dispatched to relieve this stress and may repair any damaged parts. If a patient continues to exercise, these stem cells help the body adapt to the stress, by building new blood vessels and strengthening muscles. But to maintain such benefits, the patient must exercise regularly.
Because no drugs exist to produce new stem cells, exercise may be the only method for some patients to rebuild their hearts. Previous studies have shown that people who do physical therapy after a heart attack live longer than those who do not. Experimental studies in rats have also suggested that exercise can even be more effective than statins, drugs that are commonly used to treat heart disease.17
No wonder why so many seniors are picking up dancing. But it does not have to wait until one has a heart problem before picking up the beneficial and healthful habit of dancing. In fact, dancing should be a form of preventive medicine, instead of only a form of exercise for patients.

Music Please, Maestro
A study conducted at Ohio State University is the first study to look at the combined effects of music and short-term exercise on mental performance, at least for people with coronary artery disease.
It is no secret that exercise improves mood, and improve the cognitive performance of people with coronary artery disease. Listening to music is thought to enhance brain power. This new research suggests that working out to music may give exercisers a cognitive boost. Listening to music while exercising helps to increase scores on a verbal fluency test among cardiac rehabilitation patients.
The study involved 33 men and women, mean age 62.6±10.5 years, in the final weeks of a cardiac rehabilitation program. Most participants had undergone bypass surgery, angioplasty or cardiac catheterization. This cohort was chosen because coronary artery disease may compromise cognitive ability.
The researchers asked participants to complete a verbal fluency test before and after two separate sessions of exercising on a treadmill. The workout were scheduled a week apart and lasted about 30 minutes. Participants listened to classical music, Vivaldi’s “The Four Seasons”, during one of the sessions. “The Four Seasons” was chosen because of its moderate tempo and positive effects on medical patients in previous research. Given the range of music preferences among patients, it is especially important to evaluate the influence of other types of music, such as contemporary or blues, on cognitive outcomes.
As a way to measure anxiety and depression, participants completed a 30-item checklist before and after exercise. The list included adjectives to describe the patient’s current mood. The researchers also tested each patient’s verbal fluency before and after each exercise session by asking participants to generate list of words in specific categories. This kind of task challenges the part of the brain that handles planning and abstract thought as well as a person’s capacity for organized verbal processing.
Participants reported feeling better emotionally and mentally after working out regardless of whether or not they listened to music. But the improvement in verbal fluency test performance after listening to music was more than double that of the non-music condition.
The lead author of the study, Charles Emery, explains that exercise seems to cause positive changes in the nervous system, and these changes may have a direct effect on cognitive ability. Listening to music may influence cognitive function through different pathways in the brain. The combination of music and exercise may stimulate and increase cognitive arousal while helping to organize cognitive output.18
It is not difficult to extend the argument of “exercising while listening to music” to dancing. In dancing, dancers dance to the rhythm of different kinds of music. In fact, dancing is essentially exercising to music. The benefits of dancing to cognitive boost are thus established.

Conclusion
A day has 1,440 minutes. Of these, one needs to schedule only 30 of them, or about 1 fiftieth, for physical activity.
Regular exercise is a critical part of staying healthy. People who are active live longer and feel better. Exercise can help one maintain a healthy weight. It can delay or prevent diseases like diabetes, some cancers and heart problems.
Most adults need at least 30 minutes of moderate physical activity at least five days per week. These physical activities do not have to mean to go to the gym, or sports clubs. They can be as mundane as walking briskly, mowing the lawn, running with one’s pet dog, dancing, swimming for recreation or bicycling. Stretching and weight training can also strengthen an active person’s body and improve fitness level.
The key to finding the right exercise for oneself is to find an activity that is fun. If the activity is fun, it is more likely one will stay motivated. Some fun activities include walking with a friend, join a dance class or plan a group bike ride.19
If you have been inactive for a while, use a sensible approach and start out slowly. Getting hurt or having sores just offers a good excuse to stop exercising.
Because of the nature of dancing, it has the combined benefits of mental and physical exercises—a combination of muscle building plus calisthenics. It is certainly one of the best forms of exercises. Dancing adds new dimensions to one’s life. It is a lifetime skill that will provide much joy, many healthful benefits, and many productive years ahead. As a corollary, ballroom dances, modern dances, ballet and others, that involve “navigating” the dance floor or stage, are ideals forms of dances that deliver both mental and physical exercises at once, and the effects of music on the brain. Others, such as line dances, dancercises including Zumba, Jazzercise… do not involve as much navigation. They do not deliver as much mental exercise though they dance to music. Partner dances, like in ballroom, swing, Hustle and Salsa, have the added wonder of human haptic touch—an act that is known to have many benefits.
Obesity has hogged the limelight. This is partly because being overweight is a problem you can see. Fitness is not a matter of being skinny; it is a matter of being healthy. Experts including Carlos Crespo, professor of social and preventive medicine at the University of New York, Buffalo, identify seven components of fitness: body composition, cardio-respiratory function, flexibility and range of motion, muscle strength, endurance, balance, and agility and coordination. Dancing is one of the few forms of activities that will help develop, in addition to these seven components, a social network.


14 Joe Verghese, et al, “Leisure activities and the risk of dementia in the elderly”, NEJM, 348(25), 2003, pp. 2508–2516.
15 Romualdo Belardinelli, report at the American Heart Association meeting, Chicago, Illinois, USA, November 12, 2006.
16 The European Society of Cardiology Congress, September 1–5, 2007, Vienna, Austria.
17 Maria Cheng, “Exercise may generate new blood vessels”, The Associated Press, September 5, 2007.
18 Chales F. Emery, Evana T. Hsiao, Scott M. Hill, and David J. Frid, “Short-term effects of exercise and music on cognitive performance among
participants in a cardiac rehabilitation program”, Heart & Lung, 32(6), 2003, pp. 368–373.
19 Adapted from Medline Plus, U.S. National Library of Medicine, National Institutes of Health.


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