Yuki Noguchi
(c) 2003, The Washington Post
Oct. 16, 2003 12:00 AM

Synopsis:

In a recent study of nearly 500 people by the Albert Einstein Center in the Bronx, N.Y., dancing was the only regular physical activity associated with a significant decrease in the incidence of dementia, including Alzheimer's disease. Among the participants in the Verghese study, those who danced frequently - three or four times a week - showed 76 percent less incidence of dementia than those who danced only once a week or not at all. The same study showed that doing puzzles, mind games and other mentally stimulating activities also reduce the incidence of dementia, but that purely physical activities - swimming, bicycling, walking, climbing stairs - had no preventive value.

Article:

There's this guy I dance with, Arnold Taylor.  He has firm hands and shoulders, and his favorite eight-step swing move has this merry-go-round feel to it. Everything in the periphery is a blur except his face, which usually bears a broad grin.  He's strong - a fact he underscores by introducing himself, with a wink, simply as "Ahnoldt." This faux Schwarzenegger's dance card is usually pretty full. And when he walks, it's more like he's swaggering to a syncopated beat.  It's easy to mistake this 78-year-old retired reverend for a lady's man. But really, when he's on the dance floor, he's just reflecting the spiritual joy he's gotten out of his favorite form of recreation.

"What do I like most about dance? Oh, well, the sort of happy human relationship. Being with somebody and having fun," he says.

Long-time dancers like Taylor know what the medical community is lately starting to find some evidence of: the realization that dancing is good for you. Particularly, as it turns out, for older people.  In a recent study of nearly 500 people by the Albert Einstein Center in the Bronx, N.Y., dancing was the only regular physical activity associated with a significant decrease in the incidence of dementia, including Alzheimer's disease. Alzheimer's, which slowly degrades brain and memory function, affects 4 million Americans over the age of 60. Dementia, a broader category of diminished mental ability, affects between 6 million and 7 million.

"Dance is not purely physical in many ways, it also requires a lot of mental effort," said Joseph Verghese, the lead researcher of the study, published in June in the New England Journal of Medicine. Though many studies have explored the relationship between activity and dementia, he said, "if you review them, the (activities) that are purely physical do not seem to have any effect reducing dementia."  "Certainly among my patients (who dance), their posture is different and the way they walk is different," Verghese said. Changes in walking patterns, he said, are often symptoms of mental decline.

Among the participants in the Verghese study, those who danced frequently - three or four times a week - showed 76 percent less incidence of dementia than those who danced only once a week or not at all. The same study showed that doing puzzles, mind games and other mentally stimulating activities also reduce the incidence of dementia, but that purely physical activities - swimming, bicycling, walking, climbing stairs - had no preventive value.

The results don't surprise Jamie Platt, 53, an analyst for the Social Security Administration who gets his kicks folk dancing, Balkan, Turkish and Armenian style.  "I have a very sedentary kind of job. But when I go dancing, I get my ya-yas out," said Platt, "It keeps me very vibrant. The dances that we do have very complex footwork. You have to think about the complex rhythms. So it keeps you on the ball," Platt said.

So what is it about dance that might make it life- and brain-enhancing?  The short answer, said Verghese: "I really don't know."  True, it involves movement, and there are dozens of studies that show - even if the Einstein Center study didn't - a positive correlation between physical exercise of all kinds and mental health. Essentially, exercise seems to jazz the brain.  Sustained aerobic activity involves not just those parts of the brain that control motor and sensory functions, but also the hippocampus - the section responsible for memory and many other cognitive functions, said Carl W. Cotman, a neuroscientist at the University of California, Irvine.

"It's surprising, because you'd think, 'What's that got to do with movement?' but it does," said Cotman, who studies the influence of exercise on the brains of rats and mice. In animals that exercise, the connections between brain cells grow stronger, and a protein (brain-derived neurotrophic factor, or BDNF) shown to improve neuron survival increases.  In addition, Cotman says - citing a finding that supports the theory that dance is better for your brain than other fitness activities - physically active animals that have an "emotional support system," like interacting with other animals, see even more benefits in their brains.  Or it's possible that dance may not turn out to be a buffer at all. The Einstein Center study has many critics.

"I think there is nothing unique about dance in particular that is beneficial for Alzheimer's," said Bill Thies, vice president of medical and scientific affairs for the Alzheimer's Association. "The numbers involved in (the Einstein Center) research are too small, and a correlation, or a causal relationship, is difficult to establish."

Verghese's study followed 469 people over the age of 75 - none of whom showed signs of dementia at the start - from 1980 to 2001. The participants underwent a series of clinical and neuropsychological tests at enrollment, and were tested every 12 to 18 months after that. Within this group, 130 people danced frequently (three or more times a week), 83 swam frequently, 26 bicycled frequently and 19 played games frequently.  For Thies, those numbers are problematic. Definitive studies, he said, examine more than 10,000 people for a decade or more.  He's not the only critic.

"There are inherent limitations to these kinds of studies because they are behavioral and self-selected," meaning, in this case, that the group included only those without a condition that would keep them off the dance floor,"said David Bennett, a doctor of neurology and director of the Rush Alzheimer's Disease Research Center in Chicago. "You don't see the people who are not dancing."  "It's difficult to determine whether something is acting on the brain when a person dances that actually reduces the risk of mental decline," said Bennett. "There may be something about dance that attracts a certain type of person who is less depressed, more social and less stressed," all qualities that could also help stave off dementia, he said. More studies are needed to test which qualities actually are affecting the brain, he said.

Research hasn't produced a consensus on what protects against dementia, either.  Some studies show that people with higher levels of education - and therefore, presumably, more developed brains - tend to be less likely to develop dementia. Other studies link brain health with a healthful diet and good circulation. Still others suggest that people with depressive personalities are more prone to dementia later in life.  Dementia usually leaves markers. Brain scans sometimes show deposits of the protein amyloid, which essentially creates roadblocks for brain signals. Other people have plaques and tangles, knots of intertwined, dysfunctional nerve cells. Sometimes there are lesions on the brain tissue. Sometimes the brain shrinks.

A study published in July showed that elderly women who were overweight developed Alzheimer's disease with greater frequency than those of lesser weight. Among 260 Swedish women, those who were overweight or obese at age 70 were more likely than others of similar age to develop dementia or Alzheimer's in their 80s.

"When you're considering a disease of late life, it's never one factor working in isolation," said Deborah Gustafson, whose research on Swedish women appeared in the Archives of Internal Medicine. Other common ailments such as heart disease, high blood pressure and diabetes have also been linked to higher rates of dementia. "But we still found there's an independent effect between high body fat and dementia," said Gustafson. Most dance burns fat.

Research may still be far from being able to prove that dance is, in fact, good for aging minds. But it's difficult to dispute that, on the whole, dancers have a lot of positive energy.  

Like my buddy Arnold Taylor. He danced through what must have been two of the grimmest periods of his youth: the Great Depression and World War II.  But when he tells stories about his past in his usual animated fashion, he's generally talking about how he and his sister showed off their dance moves in the Grange halls of western Massachusetts during the 1930s. Or about spending weekends in England in the 1940s hitting on girls at dances featuring the music of Tommy Dorsey and Duke Ellington. It's the dancing he remembers; somehow, the penny-pinching family budgets and the ravages of wartime London don't steal his story.

Who knows why some things - dance steps or brain power - come back, while others never do?  While science tries to identify whether it's the drugs we take, the diet we eat or the dances we do, maybe the sensible thing to do to stave off dementia is to hit the dance floor. It may not work, but it's lots of fun.