An exploration of the influence of social ballroom dancing on health and well-being for older adults

Background The world’s ageing population is frequently cited as presenting economic and social burdens and critical challenges to healthcare systems, with falls and mental health featuring as two of the biggest burdens. Whilst physical activity is recommended for older adults to optimise functional independence and guidelines for the intensity, duration and frequency of physical activity exist, there are few guidelines on the specific types of exercises that are recommended. As a physical activity that incorporates the recommended aspects of aerobic, strengthening and balance work, the aim of this study was to explore the influence of ballroom dancing on the physical, mental and social health of community-dwelling older adults. Method A qualitative-dominant, concurrent mixed-methods design was utilised. Ethical approval was granted via the University of Huddersfield’s research ethics panel. Participants were community-dwelling older adults (over 55 years of age) who were recruited from local ballroom dancing classes in West Yorkshire. They participated in ballroom dancing classes for at least one hour per week for 12 months and were tested during this period at baseline, and after 3, 6, 9 and 12 months. Demographic details were collected at baseline and the incidence of falls, changes to medical history or medications and levels of exercise were recorded at each data collection point. Quantitative measures of physical function were assessed using the Functional Reach Test (FR test), Timed-Up-and-Go Test (TUGT), the Four Square Step Test (FSST) and Tinetti’s test. In addition, balance was specifically assessed using a Biodex Balance System SD (BBS). The Falls Efficacy Scale-International (FES-I) was completed alongside the Clinical Outcomes in Routine Examination-General Population (CORE-GP) for well-being. The qualitative aspect of the study used semi-structured interviews at baseline, 6 and 12 months. Forty-one interviews were performed with participants individually or in dancing pairs. Qualitative data were managed and analysed using the Framework Analysis approach. Results Of the 26 older adult ballroom dancers recruited to the study who consented to participate, 23 (10 male, 13 female) completed the 12-months of data collection (mean age 66.5 years (SD 5.96 years; age range 58-83 years)). Using a Framework Analysis approach, 4 key themes were identified amongst the sample of older adults. ’Active ageing’ considers physical health perceptions, the acceptance, adaptation and frustrations of ageing and maintaining an active body and mind. The theme ‘class commitment and congruence’ highlights factors that were deemed important to the success of a dancing class and would encourage participants to keep dancing. The ‘Social dance community’ theme considers the influence and dynamics of dancing partnerships and the importance of building social networks. Finally, ‘enjoyment’ acknowledges the role of ballroom dancing for well-being. This study demonstrated a low attrition rate, no adverse effects due to ballroom dancing and a low falls risk in this sample of older adults. The primary outcome was assessment of functional changes between baseline and 12 months, with the 3-monthly intervals serving as interim data collection points. Over the 12-month period, whilst not expected in a feasibility study, there were no significant changes in the FR test, TUGT, FSST or Tinetti’s test. For the CORE-GP scale 97.5% of recordings were within the ‘healthy’ well-being score range, and there was a 10% decrease in points-score for the FES-I, indicating a possible substantive finding for clinical practice. The BBS tests demonstrated women had a statistically significant better level of postural stability then men, and as a group, their scores on the FR test were significantly lower than normalised scores for their age group. Discussion The findings suggest that ballroom dancing should be promoted by health professionals as a socially inclusive,safe physical activity that provides considerable pleasure. In addition to the current literature, the ‘pleasure of practice’and the ‘pleasure of community’are two types of pleasure suggested to be associated with ballroom dancing. Ballroom dancing also enhances opportunities for physical, psychological and social resilience in older adults by resisting age-related physical decline, assisting with acceptance of the ageing body, providing a strong sense of enjoyment and well-being and helping to form strong social connections, which are all important factors for resilient ageing. It is recommended that future comparative studies are of an adequate power to detect group differences that may exist in quantitative outcome measures, such as assessing balance with the BBS. A control group should be used for comparison with the ballroom dancing intervention group, with the intervention group all starting ballroom dancing at baseline. Given the findings of this study that the participants appeared to be high functioning when performing physical tests, it is recommended that alternative outcome measures are sought that will discriminate sufficiently amongst community-dwelling older adults.