Danças circulares em cuidadores familiares de idosos com doença de Alzheimer: um estudo controlado e randomizado

Abstract

INTRODUCTION: The task of taking care of an older adult with Alzheimer's disease (AD) is generally performed by middle-aged or older women from the family. Exposure to chronic stress situations, as well as psychosocial and physical changes resulting from the aging process, can trigger negative outcomes for the physical and mental health of this public. Physical, psychological, cognitive and social benefits are associated with dance. In this context, circle dances (CD) as a therapeutic modality could have the potential to improve caregivers’ health who take care of older adults with AD. AIMS: To evaluate the chronic and acute effects of a circle dance program (CircleCare) on physical and mental health of family caregivers of older adults with AD. Furthermore, the aim was to investigate the acute effect of a CD session on participants moods. METHODS: The chronic effects of CircleCare were tested using a randomized controlled clinical trial with 25 family caregivers, aged 50 years and above, allocated to an Intervention Group (IG), n = 13, 60.23 ± 7.07 years (60-minute sessions, twice a week, for 12 weeks) and Control Group (CG), n = 12, 63.83 ± 9.56 years (without intervention). Functional mobility, gait speed and muscle strength were considered primary outcomes. Cognition, burden, stress, depressive symptoms and quality of life were defined as secondary outcomes and the frailty phenotype as a tertiary outcome. The effect of the intervention was analyzed using two-way repeated measures ANOVA and Holm-Sidak post hoc (p < 0.05). For the acute effect of CD on moods, a quasi-experimental design was carried out with a group of 15 caregivers (60.20 ± 7.05 years), analyzed before and after the performance of a single session of CD. A paired t-test with a significance level set at 5% was used to verify the change in moods after CD. RESULTS: Regarding the chronic effect of CircleCare, a group and moment interaction was observed, in which only CG showed a worst performance in gait speed (p = 0.008) and quality of life (p = 0.005) and stress (p = 0.045), while only IG showed improvement in relation to functional mobility (p < 0.001) and burden (p = 0.001). There was no effect on lower limb strength, cognition and depressive symptoms. The transition from pre-fragile to non-fragile occurred at a greater proportion in IG. Regarding the acute effect after a session of CD, the positive moods increased, while the negative states decreased. CONCLUSIONS: The results showed that CircleCare was effective in improving functional mobility, burden, stress and contributes to the transition from pre-fragile to non-fragile. However, it was not enough to induce significant responses on gait speed, lower limb strength, quality of life, depressive symptoms and cognition. Moreover, a single circle dance session was able to positively influence moods. Thus, circle dances prove to be a promising intervention for the physical and mental health of caregivers who take care of elderly people with AD, especially those who are middle-aged and older women.