Effects of dance interventions on brain health for older adults with cognitive impairment: an umbrella review

Dementia is increasing globally, expected to affect 153 million people by 2050. Dance is an emerging non-pharmacological evidence-based intervention, that integrates artistic, aesthetic, and physical exercise domains. This umbrella review synthesizes evidence on the effects of dance on brain health in older adults with mild-cognitive impairment (MCI) and dementia. Systematic reviews and meta-analysis were selected according to the PICO (Population, Intervention, Comparison and Outcome): older adults with MCI or dementia; dance interventions; comparison with no intervention or other types of interventions; brain health outcomes (cognitive, physical, and emotional domains). The 10 included systematic reviews indicated potential benefit of dance on cognition, compared to control conditions. The meta-analysis of meta-analysis showed significant effects on global cognition, increasing MoCA (SMD = 0.61, 95% CI: 0.30 to 0.91, p < 0,001) with high heterogeneity (I² = 67%); MMSE scores (SMD = 0.37, 95% CI: 0.27 to 0.47, p < 0.001) with low heterogeneity (I² = 0%); and, combined MMSE (SMD = 0.73, 95% CI: 0.58 to 0.87, p < 0.001) with low heterogeneity (I² = 0%). Significant effects were also observed on cognitive domains, improving TMT-A scores (SMD = 0.23, 95% CI: 0.10 to 0.36, p < 0,01) with moderate heterogeneity (I² = 36.7%); and, TMT-B scores (SMD = 0.21, 95% CI: 0.09 to 0.32, p < 0,01) with low heterogeneity (I² = 8%). The overall quality of evidence remains weak: 3 included systematic reviews were rated as critically low-quality, and 7 as low quality. While dance interventions are promising for supporting brain health in older adults with MCI, few systematic reviews have focused on people with dementia. This umbrella review provides a comprehensive evidence synthesis and highlights critical research gaps. Future work should focus on establishing methodological rigor, expanding studies on dementia, and integrating dance into broader brain health frameworks through global, collaborative efforts. Registration: PROSPERO, CRD42024503578.