The effectiveness of social dancing as a strategy to prevent falls in older people

INTERVENTION: Social Dancing (folk and ballroom dancing) in groups delivered by certified dance instructors with particular experience in teaching older adults. The classes are 1‐hour long delivered twice weekly, in total 80 hours over 12 months. CONDITION: Prevention of cognitive decline in older adults Prevention of falls in older adults PRIMARY OUTCOME: Cognitive function ‐ Trail Making Test A and B ; Time to complete the Trail Making Test (TMT, part A and B) will be assessed. The TMT A and B is an executive functioning tests. Part A measures processing speed and involves participants connecting consecutive numbers (e.g., 1‐2‐3), and Part B is a measure of executive function of ?task shifting? and involves participants connecting alternating letters and numbers (e.g.,1‐A‐2‐B). The difference in time between the two parts will be calculated to isolate the executive component of this test. Number of accidental falls per participant. Falls will be recorded monthly for 12 months on a diary (calendar) and be collected by mail. Participants will need to record 'F' (i.e., if a Fall) or 'N' (no fall) every day of the month. Every reported fall will be further contacted by phone to complete details about that fall (where was it, did it ended with injury, type of injury and treatment if applicable). Participants with missing diaries will be contacted by phone, fill the diary with the researcher and will be asked also to mail the diary. ; In addition, the monthly diary will collect information on utilization of health services for economic evaluation using a list of codes that is printed on the calendar; a visit to GP, any use of a specialist (i.e., physiotherapists, consultation with medical specialist) , visit to an outpatient Clinic, Emergency room, use of ambulance and whether there was a change in medications reported at baseline. SECONDARY OUTCOME: $ per fall prevented. ; Costs for total health care resource utilisation, rather than only falls‐related healthcare utilisation will be collected monthly for 12 months. Participants will report on the falls diaries any inpatient hospital admissions, Emergency department visits, Ambulance trips, Doctor and allied health visits, prescribed medications, Home care / nursing care,Nursing home or long term care admission. The cost for each of these item will be extrapolated from the relevant source (e.g., Medicare Benefits Scheme fee for service, PBS for medications, etc..). Participant out‐of‐pocket costs and care provided by family and /or friends will not be included. ; The cost of the trial is itemized in the trial budget. Choice Stepping Reaction Time Tests without and with cognitive load. Three short tests which requires the subject to perform quick, correctly targeted steps in response to visual cues. The tests comprises of arrows appear randomly on a computer screen. The arrows have graphical presentations on a dance MAT (front left, front right, side left, side right). ; Test 1: Participants are asked to step as quickly as possible onto the corresponding arrow of the mat and returned to the centre. The time to react and the time it takes to return to the centre is recorded using a customised software. ; This test measures The tests measure visual attention, central processing, reaction time and movement time. INCLUSION CRITERIA: 1) self care retirement villages with 60 or more residents. 2) resident of a selected self care village ; Test 2: Similar test are then performed but with a no‐go task which determine by the colour of the errors (i.e., blue color to inhibit response). The time it takes to respond and step back plus the number of errors are recorded. This test also measures as above plus response inhibition. ; Test 3: this test is the modification of the Stroop Color‐Word to a motion. Participants are shown "congruent arrow" (i.e., the direction of the arrow and the word "front" are similar) and incongruent step by the word. Time and errors are recorded. This test measures response inhibition and selective attention which is an executive function measure. Colour Choice Reaction Time Test ‐ this test requires minimal locomotion but measures reaction time with response inhibition. The test involves the presentation of targets of different colours in one of four cells in a square grid. Participants respond to targets by using hand buttons or foot pedals. Blue target requires a response inhibition (i.e., not pressing any buttons). The computer recorded reaction times and errors (accuracy). Physiological Profile Assessment (PPA). The PPA comprises of five tests which provide an overall falls risk score: Vision (edge contrast sensitivity), peripheral sensation (proprioception), lower extremity strength (knee extension), simple reaction time using figure press as the response, and body sway when standing on the medium‐density foam rubber mat, which is a measure of balance. Rey Auditory Verbal Learning test (RAVLT). The test evaluates verbal learning and memory, including proactive inhibition, retroactive inhibition, retention, encoding versus retrieval, and subjective organisation. The test starts with a list of 15 words, which an examiner reads aloud at the rate of one per second. The participant's task is to repeat all the words he or she can remember, in any order. This procedure is carried out a total of five times. Then the examiner presents a second list of 15 words, allowing the participant only one attempt at recall. Immediately following this, the patient is asked to remember as many words as possible from the first list. Self‐reported Quality of Life questionnaires‐ SF12/SF6 Self‐reported Quality of life questionnaire ‐ ICECAP‐O The Short Physical Performance Battery (SPPB) measures lower limb functional status by assessing balance, gait, strength and endurance of the lower extremities. The tests include side‐by‐side, semi‐tandem, and tandem standing tests to complete 10 seconds, time to complete 3‐meter walk at normal speed , and a timed sit‐to‐stand 5 repeat.