The effects of poco-poco dance on the executive functions of type 2 diabetes mellitus patients with mild cognitive impairment achieved through improvements in neuronal functions and plasticity

Increased production of ROS in T2DM patients causes neuronal cell destruction which reduces cognitive function, especially the executive function which are necessary for completing normal daily activities. Poco-poco dance as a popular folk dance is easy to do, inexpensive, and adheres to Indonesian cultural norms can directly or indirectly achieve this by improving neuroplasticity. This research randomized 32 T2DM patients with mild cognitive impairment, aged 45-59 years old, with more than 9 years of education into two groups, each consisting of 16 patients. This research was performed in Depok between December 2013-July 2014. The intervention group received a 30 minutes biweekly dance therapy for 12 weeks. Both groups received the standard therapy for T2DM. Mild cognitive impairment was assessed using the NDVCI-T2DM form. The patient’s executive function was assessed by the TMT-B. All patients were evaluated for their HbA1c, LDL, triglycerides, total cholesterol, and F2 isoprostane levels. Neuroplasticity was measured by the NAA/Cr ratio through MRS at the beginning and the end of the research. The intervention group experienced significant differences in their executive function (p = 0.016), the neuroplasticity of the right prefrontal (p = 0.001), left prefrontal (p = 0.001), left parietal (p = 0.007), right hippocampus (p = 0.003) and HbA1c (p = 0.02), LDL (p = 0.005), triglycerides (p = 0.002) and F₂ isoprostane (0.001) levels. Although the HbA1c (p = 0.001) and F2 isoprostane (p = 0.001) levels decreased, there were no significant decreases in the NAA/Cr ratio of all lobes. The ABI was 37.5% and the NNT was 3. 37.5% of patients experienced improvements in their executive functions, either by directly or indirectly improving the brains’ neuroplasticity.