Cardio-Dance Exercise to Improve Cognition and Mood in Older African Americans: A Propensity-Matched Cohort Study

Abstract

The current study sought to determine the influence of initial sleep quality and body mass index on the cognitive and mood outcomes of a community-based cardio-dance exercise program. Thirty-two older African Americans who participated in a 5-month cardio-dance exercise program were propensity-matched to 32 no-contact controls. Participants completed neuropsychological tests of attention, executive function, and memory and a self-reported depression measure at baseline and post-test. Among exercise participants, we observed significant improvements in depression (baseline = 6.16 ± 5.54, post-test = 4.66 ± 4.89, ${\eta }_p^2=.12$, p = .009) and attention (baseline = 40.53 ± 14.01, post-test = 36.63 ± 13.29, ${\eta }_p^2=.12$, p = .009) relative to controls. Improvements in executive function and attention were most pronounced among exercise participants with poor sleep quality (baseline = 7.71 ± 1.25, post-test = 8.29 ± 2.06, ${\eta }_p^2=.41$, p = .04) and with obesity (baseline = 38.05 ± 12.78, post-test = 35.67 ± 13.82, ${\eta }_p^2=.30$, p = .001), respectively. This study provides novel evidence that exercise has the potential to improve depression in older African Americans. For those with poor sleep quality or obesity, exercise can also improve some cognitive outcomes.

Keywords: African Americans; cognition; community; depression; exercise; obesity; sleep deficiencies.

Figure 1.

Significant Sleep Quality × Group × Time interaction on Digit Span Backward performance, controlling for baseline Mini-Mental State Examination score: The exercise group with poor sleep quality remained relatively stable (blue line in Panel A) while the control group with poor sleep quality declined on Digit Span Backward performance (blue line in Panel B). a) Exercise group: Digit Span Backward scores at baseline and post-test stratified by baseline sleep quality. b) Control group: Digit Span Backward scores at baseline and post-test stratified by baseline sleep quality. Higher scores indicate better performance. Error bars represent +/− 2 SEs.

Figure 2.

(A) Significant Group × Time interaction on Trail-Making Test—A performance, controlling for baseline Mini-Mental State Examination score: The exercise group improved on TMT-A performance from baseline to post-test (red line in Panel A) while the control group remained relatively stable (blue line in Panel A). (B and C) Significant BMI × Group × Time interaction on Trail-Making Test—A performance, controlling for baseline Mini-Mental State Examination score. In the normal BMI group (blue lines in Panels B and C), whereas the exercise group improved on Trail-Making Test—A performance, the control group remained stable. In the obese BMI group (green lines in Panels B and C), whereas the exercise group remained stable, the control group worsened on Trail-Making Test—A performance. Lower scores indicate better performance. Error bars represent +/− 2 SEs.

Figure 3.

Significant Group × Time interaction on Beck Depression Inventory-II, controlling for baseline Mini-Mental State Examination score: Whereas the control group remained largely stable (blue line), the exercise group showed a decrease in depressive symptomatology (red line). Lower scores indicate lower depressive symptomology. Error bars represent +/− 2 SEs.