Effect of Dancing Interventions on Depression and Anxiety Symptoms in Older Adults: A Systematic Review and Meta-Analysis

Abstract

This systematic review and meta-analysis (PROSPERO CRD42023428105) investigated the effect of dancing on depression and anxiety symptoms in older adults. Conducted up to October 2023, the search across seven databases and gray literature yielded 5020 records. Only randomized trials that analyzed dance interventions for depression and/or anxiety in older adults were included. Nineteen randomized trials, involving 508 participants in dance classes lasting 5 weeks to 18 months, were included and 16 were subjected to meta-analysis. Risk of bias was assessed using the Cochrane tool. The meta-analysis showed a statistically significant reduction in depression among older adults participating in dance interventions (p < 0.01). A decrease in depressive symptoms was significant compared to that in those involved in no other intervention (p = 0.02) but not compared to that achieved with other interventions in control groups (p = 0.96). Subgroup analysis showed no significant differences in depression scores for those with mild cognitive impairment (p = 0.47). These conclusions are associated with moderate bias and very low certainty. Due to heterogeneity and the small number of studies, conclusions for anxiety outcomes could not be drawn. These results underscore the potential clinical relevance of integrating dance into mental health interventions for older adults, thereby highlighting a promising avenue for enhancing the mental well-being of this demographic.

Keywords: aged; aging; anxiety; cognitive impairment; dancing; depression; physical exercise; psychology; quality of life.

Figure 1

Flow diagram for study selection.

Figure 2

(A) Forest plot comparing anxiety symptoms in older adults between intervention (dance) groups and control groups (no interventions and other interventions). CI = confidence interval; df = degrees of freedom; IV, random = inverse variance, random-effects model; SE = standard error; SMD = standardized mean difference [16,40,41,42]. (B) Forest plot comparing depression symptoms in older adults between intervention (dance) groups and control groups (no interventions and other interventions). Subgroups were separated according to the study participants’ comorbidities. CI = confidence interval; df = degrees of freedom; IV, random = inverse variance, random effects model; SE = standard error; SMD = standardized mean difference [17,40,41,44,45,46,47,49,50,51,53,54,55,56]. (C) Forest plot comparing depression symptoms in older adults between intervention (dance) groups and control (no intervention) groups. Subgroups were separated according to the study participants’ comorbidities. CI = confidence interval; df = degrees of freedom; IV, random = inverse variance, random effects model; SE = standard error; SMD = standardized mean difference [17,40,45,46,47,49,54,56]. (D) Forest plot comparing depression symptoms in older adults between intervention (dance) groups and other interventions. Subgroups were separated according to the study participants’ comorbidities. AE = aerobic exercises; CI = confidence interval; df = degrees of freedom; IV, random = inverse variance, random effects model; M = meditation; NDT = neurodevelopment treatment; PC, physician counseling; TT = talk therapy; SE = standard error; SMD = standardized mean difference; WL = weightlifting exercises [41,44,46,50,51,55].

Figure 2

(A) Forest plot comparing anxiety symptoms in older adults between intervention (dance) groups and control groups (no interventions and other interventions). CI = confidence interval; df = degrees of freedom; IV, random = inverse variance, random-effects model; SE = standard error; SMD = standardized mean difference [16,40,41,42]. (B) Forest plot comparing depression symptoms in older adults between intervention (dance) groups and control groups (no interventions and other interventions). Subgroups were separated according to the study participants’ comorbidities. CI = confidence interval; df = degrees of freedom; IV, random = inverse variance, random effects model; SE = standard error; SMD = standardized mean difference [17,40,41,44,45,46,47,49,50,51,53,54,55,56]. (C) Forest plot comparing depression symptoms in older adults between intervention (dance) groups and control (no intervention) groups. Subgroups were separated according to the study participants’ comorbidities. CI = confidence interval; df = degrees of freedom; IV, random = inverse variance, random effects model; SE = standard error; SMD = standardized mean difference [17,40,45,46,47,49,54,56]. (D) Forest plot comparing depression symptoms in older adults between intervention (dance) groups and other interventions. Subgroups were separated according to the study participants’ comorbidities. AE = aerobic exercises; CI = confidence interval; df = degrees of freedom; IV, random = inverse variance, random effects model; M = meditation; NDT = neurodevelopment treatment; PC, physician counseling; TT = talk therapy; SE = standard error; SMD = standardized mean difference; WL = weightlifting exercises [41,44,46,50,51,55].

Figure 3

Risk of bias assessment for the included studies using the Cochrane risk-of-bias tool for randomized trials [16,17,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56].

Figure 4

(A) Funnel plot assessing publication bias for studies on anxiety; (B) funnel plot assessing publication bias for studies on depression.