The IMOVE trial: Behavioral and imaging results of an arts-based intervention in people with AD

TL;DR

The IMOVE trial tested arts-based interventions for people with Alzheimer's and found that movement and social activities had separate benefits on balance, cognition, and brain connectivity.

Contribution

This study is novel in showing distinct benefits of movement and social engagement in Alzheimer's patients using a factorial design and brain imaging.

Findings

Movement interventions improved balance and postural stability in participants.

Social engagement enhanced cognitive performance and reduced depression scores.

Brain imaging showed changes in white matter pathways linked to movement and social factors.

Abstract

The IMOVE study was a randomized, single-blind trial in dyads (n = 101) of people with MCI or early-stage Alzheimer’s disease (PWAD) and their caregivers. IMOVE used a factorial design with four arms designed to test a Movement factor (MOV) and a Social Engagement factor (SOC): the Movement Group (MG) used a dance intervention (MOV+/SOC+); the Movement Alone (MA) arm used the same dance stimulus, but not in a group (MOV+/SOC-); the Social Group (SG) included arts-based social games (MOV-/SOC+); and a Usual Care (UC) control arm (MOV-/SOC-). The primary outcome was quality of life (QOL). Secondary outcomes included physical function, mood, cognition, and structural and functional brain imaging. Behavioral outcomes were assessed using nonparametric methods. Brain imaging outcomes were tested in SPM. Models tested the effects of factors, interactions between factors, and switch to virtual intervention in response to COVID. No significant effects of MOV or SOC were observed for QOL. For secondary outcomes, randomization to a MOV study arm resulted in significant improvements in postural sway on a foam mat (P < 0.05) and the Fullerton Advanced Balance Scale (P < 0.05). Randomization to a SOC study arm resulted in improved cognitive performance using the RBANS (P < 0.05) and depression scores (P < 0.05). Diffusion imaging results showed associations with MOV and SOC factors and their interactions in the superior longitudinal fasciculus, posterior limb of the internal capsule, and corticospinal tracts. Overall results suggest that 12 weeks of arts-based movement and social engagement may have separate and beneficial effects in PWAD.