Life expectancy continues to increase worldwide (Eurostat, 2022). While this is a positive development, aging is accompanied by physiological, sensorimotor, and emotional changes that can impact overall well-being (Eurostat, 2020). Emotional changes are particularly relevant, as effective emotional regulation in older adults is important for successful aging (Ulus and Aisenberg-Shafran, 2022).

Interoception plays a key role in emotional regulation, as it involves recognizing internal bodily signals that often reflect emotional states (e.g., breathing, muscle tension, or heart rate) (Mehling et al., 2018). These sensations are often the first indicators of emotional states, and being able to recognize them supports better self-regulation (Hanley et al., 2017). In the context of aging, this becomes especially relevant since older adults often experience a decline in interoceptive awareness (Murphy et al., 2018), which may contribute to reduced self-regulation, emotional awareness, and psychological well-being (Ulus and Aisenberg-Shafran, 2022). Enhancing interoceptive awareness may therefore support emotional stability and promote healthier aging.

Additionally, age-related changes often result in loss of independence, whereby policies and strategies engaging in physical activity to promote healthy aging are needed (Szychowska and Drygas, 2022). Psychomotor interventions, particularly those mediated by dance, may offer a promising approach to enhancing interoceptive awareness in older adults (Lebre et al., 2020). A psychomotor intervention designed for community dwellings uses the body and movement as mediators to promote sensorimotor, neurocognitive, and affective-emotional abilities (Rosado et al., 2022).

Among the expressive modalities that can be incorporated into psychomotor interventions, creative dance is particularly promising for enhancing interoceptive awareness, given its holistic and integrative use of movement, rhythm, and attention to internal body sensations (Giromini and Lesage, 2015; Guzman et al., 2016). This is especially relevant for older adults, who often experience age-related interoceptive decline (Murphy et al., 2018). Beyond physical improvements, creative dance fosters emotional expression and subjective well-being through spontaneous movement (Cruz-Ferreira et al., 2015; Martin-Wylie et al., 2024), and tends to promote adherence due to its enjoyable and socially engaging nature (Fong Yan et al., 2018).

However, despite some studies emphasizing the benefits of creative dance in promoting healthy aging (Cruz-Ferreira et al., 2015; Joung and Lee, 2019), its effects on interoceptive awareness in older adults remain largely unexplored. This study addresses that gap by applying an expressive, body-based approach and assessing its impact using a validated multidimensional tool. In this context, this study aimed to investigate the effects of a psychomotor intervention mediated by creative dance on interoceptive awareness in community-dwelling older adults.

Participants presented similar sociodemographic characteristics at baseline, since no significant differences between groups were found in age (EG: 73.5 ± 5.9 years vs. CG: 75.7 ± 7.2 years), educational level (EG: 6.2 ± 2.9 years vs. CG: 5.3 ± 3.6 years), cognitive status (EG: 19.2 ± 0.4 points vs. CG: 19.2 ± 0.4 points), IMC (EG: 28.8 ± 3.4 years vs. CG: 27.5 ± 3.2 years), and gender (p > 0.05).

Thirty-four participants completed this study. The attendance rate of the intervention (36 sessions) was 89.8%. No adverse events or falls were registered (Figure 1).

Table 1 presents the descriptive results for the MAIA scales. Both groups showed similar results at baseline, with no significant differences observed (p > 0.05). At Δ pre-post-intervention, significant differences between groups were noted in favor of the EG in all scales (p < 0.05), except for the Not-Distracting and Trusting.

Figure 2 shows the differences within and between groups regarding the MAIA scales. Following 12 weeks of intervention, the results showed significant pre-post differences in the EG, with EG presenting significant enhancements in the scales of Noticing (∆%: 39.4, p = 0.002, r = 0.53), Not-Worrying (∆%: 19.9, p = 0.024, r = 0.39), Attention Regulation (∆%: 57.4, p < 0.001, r = 0.62), Emotional Awareness (∆%: 38.8, p < 0.001, r = 0.60), Self-Regulation (∆%: 39.3, p < 0.001, r = 0.59), and Trusting (∆%: 14.4, p = 0.026, r = 0.38). Overall, the CG maintained their results except for the scale Attention Regulation, which slightly increased (∆%: 9.6, p = 0.025, r = 0.38). The respective effect sizes ranged from medium to large.

Concerning differences between groups, the results were similar to those presented previously, highlighting an increase in the EG’s results. Significant differences were found after the intervention in the scales of Noticing (p < 0.001, r = 0.61), Attention Regulation (p < 0.001, r = 0.57), Emotional Awareness (p < 0.001, r = 0.64), Self-Regulation (p < 0.001, r = 0.72), and Trusting (p = 0.013, r = 0.45). The corresponding effect sizes ranged from medium to large.

Our results suggest that a psychomotor intervention mediated by creative dance can effectively enhance interoceptive awareness in community-dwelling older adults. To our knowledge, this was the first study to explore such effects in this population. This is particularly relevant given the decline of interoceptive awareness with advancing age, which affects emotional experiences (Murphy et al., 2018; Ulus and Aisenberg-Shafran, 2022). Significant improvements were observed across all MAIA scales in the EG, except for Not-Distracting. These changes were clinically meaningful, with effect sizes ranging from medium to large. This suggests that creative dance, when integrated into a psychomotor intervention, may promote overall well-being in older adults by enhancing interoceptive and emotional self-regulation, thus contributing to healthy aging.

Between-group post-intervention comparisons reinforced the positive effects in the EG, with the CG showing stable or slightly declining results, except for a modest improvement in Attention Regulation. However, the effect size for this scale remained larger in the EG. This slight improvement in the CG might reflect increased self-awareness from study participation, particularly regarding attention-related sensations, which tend to remain stable over time (Tihanyi et al., 2017).

Adherence is often a barrier to the success of physical activity or exercise programs for older adults. Our intervention was considered acceptable, viable, and safe among older adults, with a completion rate of 89.8%, consistent with other creative dance programs (Fong Yan et al., 2018; Fong Yan et al., 2024). Factors such as the minimal requirement for equipment and the pleasant activities proposed in a social environment likely contributed to our higher adherence rate (Fong Yan et al., 2024).

Recent literature has suggested a positive impact of mindfulness practices on interoceptive and body awareness using the MAIA (Pérez-Peña et al., 2022). However, the limited number of studies investigating the effects of interventions involving creative dance and emphasizing body awareness in older adults (Cruz-Ferreira et al., 2015; Joung and Lee, 2019; Marmeleira et al., 2009) restricts comparisons and discussions with other studies, particularly on interoceptive awareness. Nevertheless, the previous studies found significant improvements in physical fitness, proprioception, and quality of life, highlighting the benefits of interventions involving creative dance focused on body awareness, which can contribute to effective emotional regulation (Ulus and Aisenberg-Shafran, 2022).

The observed increases in interoceptive awareness support prior evidence linking body awareness to psychological well-being (Hanley et al., 2017). A recent meta-analysis (Fong Yan et al., 2024) aligns with these results, suggesting that dance-based interventions may surpass other physical activities in enhancing emotional well-being by improving several psychological outcomes, such as physical awareness and self-regulation. Specifically, the enhancements observed in our study suggested that the EG participants achieved a greater awareness of bodily sensations in the capacity to notice (Noticing), not worry when faced with sensations of pain or discomfort (Not-Worrying), distress regulation (Self-Regulation), emotional states and attention regulation (Attention Regulation and Emotional Awareness), and the tendency to experience the body as safe, trustworthy, and predictable (Trusting). The study by Pérez-Pena and colleagues (Pérez-Peña et al., 2022) also showed enhancements in body awareness using MAIA, linking greater body awareness with more positive body sensations. However, they used a younger sample (mean age: 42.1 years) and a Mindfulness-Based Cognitive Therapy program, so this comparison should be interpreted with caution.

Interventions involving dance are associated with neuroplasticity, as the internal and external stimuli of dance can improve functional connectivity and increase brain volumes, promoting neuroplasticity in older adults (Nascimento, 2021). Engaging in dance tasks requires older adults to continuously adapt various neural and motor regions to the specific movements, choreographies, spatial orientations, and rhythms dictated by the music (Nascimento, 2021). Additionally, this process emphasizes the body’s central and active role in emotional and cognitive functioning, involving neural systems underlying movement-cognition and sensorimotor integration, perception, action, and emotion (Foster Vander Elst et al., 2023). This perspective helps explain how embodied and expressive interventions like creative dance can foster improvements in interoceptive awareness and emotional regulation.

Our study’s findings highlight the potential benefits of incorporating creative dance into psychomotor interventions within public health initiatives or community centers aimed at older adults. Given its holistic approach to enhancing physical, cognitive, and mental health (Fong Yan et al., 2018; Podolski et al., 2023; Predovan et al., 2019), interventions involving creative dance that integrate physical activity and emphasize body awareness can offer an effective strategy for promoting healthy aging.

The predominance of female participants in our sample may have influenced the outcomes, as women tend to report higher interoceptive sensibility (i.e., bodily sensations and emotional states) than men (Grabauskaitė et al., 2017). Moreover, women are generally more receptive to expressive and relational modalities such as dance, particularly in older age, which may foster higher engagement, enjoyment, and emotional openness during creative movement sessions. While the findings remain valid, caution is needed when generalizing them to older male populations, who may respond differently.

Future studies should include follow-up assessments—e.g., 12 weeks after program completion, matching the intervention duration—to examine the sustainability of effects on interoceptive awareness, as recent studies have also noted the lack of such data (Pérez-Peña et al., 2022). Additionally, combining self-reported and objective physiological measures (e.g., heartbeat tracking) to evaluate interoceptive awareness may offer a more comprehensive understanding of how participants perceive their internal states.

The present study has some strengths and limitations. Among the strengths, we highlight the innovative and engaging nature of the intervention and a high adherence rate. However, the study also has limitations. The non-randomized controlled trial design and relatively small sample size may limit the statistical power—particularly to detect small effects—and reduce the generalizability of the findings to broader populations. No statistical adjustments were applied to control for allocation bias, although baseline comparability between groups was ensured. Although the CDT accurately discriminates cognitively unimpaired individuals from those with early cognitive decline (Aprahamian et al., 2009), we recommend that future studies include a more comprehensive screening tool to assess cognitive performance. Furthermore, our study had a high prevalence of female participants, despite being consistent with another dance-based intervention (Fong Yan et al., 2024).

This study showed that a psychomotor intervention mediated by creative dance can significantly enhance interoceptive awareness in community-dwelling older adults. These improvements are particularly relevant considering the critical role of interoception in emotional regulation and overall well-being, especially in older adults. The clinical relevance of these findings, with effect sizes ranging from medium to large, supports the potential of this intervention as an effective, accessible, and enjoyable approach. Thus, by promoting physical activity and supporting both physical and mental health, this type of psychomotor intervention may offer a valuable strategy for healthy aging.