The gut–brain–immune axis in aging and neurodegenerative diseases: evidence and candidate mechanisms linking dance-based exercise with neuroplasticity, neuroinflammation, immune homeostasis, and cognitive resilience

Aging is associated with progressive changes in immune regulation, brain function, metabolic homeostasis, and physical performance, which in turn increases susceptibility to neurodegenerative disorders and diminishes quality of life. Emerging evidence indicates that the gut–brain–immune axis is a key biological interface through which lifestyle interventions may influence age-related physiological changes. Dance-based interventions—complex multisystem stimuli that integrate aerobic exercise, motor coordination, cognitive involvement, social engagement, and emotional expression—have attracted growing interest as potential components of healthy aging. This review examines the evidence for and candidate mechanisms linking dance-based exercise with the gut–brain–immune axis, immune homeostasis, neuroplasticity, and cognitive resilience. Particular attention is given to microbiome-related pathways, microbiota-derived metabolites, inflammatory and immune signaling, mitochondrial and redox regulation, and neural mechanisms relevant to cognitive and emotional function. We distinguish direct evidence from human dance interventions from evidence derived from broader exercise research and preclinical mechanistic studies, and evaluate their potential relevance to aging and neurodegenerative diseases. While existing evidence supports potential biological and functional benefits of dance-based interventions, direct evidence for dance-induced microbiome remodeling and its causal contribution to neuroimmune or cognitive outcomes remains limited. Thus, microbiome mediation of dance-associated neuroimmune and cognitive effects has not yet been established. Additional longitudinal, multi-omics, and mechanistically integrated studies are needed to clarify these relationships and determine whether gut–brain–immune pathways contribute to the effects of dance-based exercise during aging.