Life-long music and dance relationships inform impressions of music- and dance-based movement therapies in individuals with and without mild cognitive impairment

Abstract

Background: No effective therapies exist to prevent degeneration from Mild Cognitive Impairment (MCI) to Alzheimer's disease. Therapies integrating music and/or dance are promising as effective, non-pharmacological options to mitigate cognitive decline.

Objective: To deepen our understanding of individuals' relationships (i.e., histories, experiences and attitudes) with music and dance that are not often incorporated into music- and dance-based therapeutic design, yet may affect therapeutic outcomes.

Methods: Eleven older adults with MCI and five of their care partners/ spouses participated (4M/12F; Black: n=4, White: n=10, Hispanic/ Latino: n=2; Age: 71.4±9.6). We conducted focus groups and administered questionnaires that captured aspects of participants' music and dance relationships. We extracted emergent themes from four major topics, including: (1) experience and history, (2) enjoyment and preferences, (3) confidence and barriers, and (4) impressions of music and dance as therapeutic tools.

Results: Thematic analysis revealed participants' positive impressions of music and dance as potential therapeutic tools, citing perceived neuropsychological, emotional, and physical benefits. Participants viewed music and dance as integral to their lives, histories, and identities within a culture, family, and/ or community. Participants also identified lifelong engagement barriers that, in conjunction with negative feedback, instilled persistent low self-efficacy regarding dancing and active music engagement. Questionnaires verified individuals' moderately-strong music and dance relationships, strongest in passive forms of music engagement (e.g., listening).

Conclusions: Our findings support that individuals' music and dance relationships and the associated perceptions toward music and dance therapy may be valuable considerations in enhancing therapy efficacy, participant engagement and satisfaction for individuals with MCI.

Keywords: Alzheimer’s disease; dance therapy; mild cognitive impairment; motor cognition; music therapy; rehabilitation.

Figure 1:. Overall distribution of mentions within each of 4 a priori defined topics of interest, as specified in the focus group prompt (Table 4).

Frequency of mentions in each topic generally corresponds with the number of questions asked in that topic area. Thematic analysis was performed within each topic.

Figure 2:. Participant responses to the Music Relationship Questionnaire (MRQ).

(A): Divergence plots depicting group responses to each Likert Scale prompt on the MRQ, providing insight into their attitudes towards various aspects of music knowledge, including experience, proficiency, and usage in daily routine and task facilitation. Participants were generally in agreement that music was important to their lives and a part of their typical day, but tended to disagree with questions probing more active roles in music engagement (e.g., singing, instruments). (B): Bead-on-a-wire depicting individual (each black marker) composite scores across Likert Scale responses, representing the overall strength of their music relationships. White bead and black bars represent group mean and variance (±1SD) in composite MRQ scores. Composite score statistics indicate that participants, on average, had moderate relationships with music. (C): Donut plot representing group responses to preferred music genres indicated a preference toward Pop, R&B, Rock, and Blues.

Figure 3:. Participant responses to the Dance Relationship Questionnaire (DRQ).

(A): Divergence plots depicting group responses to each Likert Scale prompt on the DRQ, providing insight into their attitudes towards various aspects of dance knowledge, including experience, proficiency, and usage in daily routine and task facilitation. Participants were generally in agreement that dance is important to their lives and that they often move to music that is playing, but tended to disagree that they only danced in childhood. (B): Bead-on-a-wire depicting individual (each black marker) composite scores across Likert Scale responses, representing the overall strength of their dance relationships. White bead and black bars represent group mean and variance (±1SD) in composite DRQ scores, respectively. Composite score statistics indicate that participants, on average, had moderate relationships with dance. (C): Donut plot representing group responses to preferred dance styles indicated a preference toward Contemporary, Ballroom, Swing, and other styles.

Figure 4:. Distribution of mentions within prescribed Topic #1: “Experience & History” of music and dance.

(A): Main themes pertaining to this topics included “Role of Music” and “Role of Dance,” but memories evoked, as ways that music inspires daily tasks were also recorded. (B): Distribution of mentioned within the “Role of Music” theme. One prominent sub-theme pertaining to this theme included “Exposure Circumstances,” while participants also mentioned how music connects them with others, specific genres to which they were exposed, musicianship and instrumentation experiences and the importance of music in their lives. (C): Distribution of mentioned within the “Role of Dance” theme. Prominent subtheme pertaining to this theme included “Exposure Circumstances” and “Style Exposure,” while participants also mentioned how dance connects them with others. (D-F): Sub-themes were plotted to reflect distribution of mentions detailing participants’ experiences pertaining to their “Music Exposure Circumstances” (D), “Dance Exposure Circumstances” (E) and “Dance Style Exposure” (F).

Figure 5:. Distribution of mentions within prescribed Topic #2: “Enjoyment & Preferences” of music and dance.

(A): Main themes pertaining to this topic including “Music Genre” and “Sentiments,” but specifics of preferred circumstances and environments in which to engage with music and dance, as well as preferred dance style were also discussed (B): “Music Genre” mentions reflect distribution of music genres preferred by participants, where several participants indicated no strong preference and reported Any genre. (C): “Sentiments” reflects mostly Positive, but some Negative, and few Neutral attitudes toward music and dance engagement.

Figure 6:. Distribution of mentions within prescribed Topic #3: “Confidence & Barriers” of music and dance.

(A): Main themes pertaining to this topic included “Barriers to Engagement,” “Feedback” and “Confidence Factors,” while challenges associated with music and dance engagement were also discussed. (B): “Barriers to Engagement” mentions reflect distribution of identified factors limiting participants’ engagement with music and dance. (C): “Feedback” mentions reflect either “Negative,” “Positive” or “Neutral/ None” feedback that participants received regarding the music and/ or dance proficiency from family members, peers, or instructors. (D): “Confidence Factors” include factors impacting participants’ confidence while engaging with music and dance. Many participants noted a current stance of having little self-perceived ability, but having a willingness to engage, anyway.

Figure 7:. Distribution of mentions within prescribed Topic #4: “Therapeutic Impressions” of music and dance.

(A): Main themes pertaining to this topic including “Positive Impressions,” but several neutral and negative impressions were also recorded. (B): “Positive Impressions” mentions reflect specific ways in which music and dance-based therapeutics could be beneficial.