The concept of an elderly person varies depending on cultural context and should not be limited solely to chronological age but should also consider factors such as functional independence (4). During this stage of life, physical, cognitive, social, and emotional transformations take place, which can influence overall well-being and may lead to a decline in mental faculties (5, 6). In this sense, the physical and cognitive decline characteristic of this stage can lead to estrangement in family relationships and, subsequently, in the social sphere. This demonstrates that different areas of life influence well-being (7).

This stage of life represents a process experienced by all people, regardless of gender (8). In this context, the importance of providing specialized care to improve quality of life and generate well-being is emphasized. At the same time, aging presents opportunities for older adults to participate in new experiences and recreational activities, strengthen social relationships, and foster personal development (9).

In this review, well-being is conceptualized as a multidimensional construct that includes physical, emotional, cognitive, and social domains of health represents a holistic condition that encompasses all aspects of health (10). It encompasses both subjective components, such as individual satisfaction and emotional experiences, and aspects, including functional capacity and social connectedness (11, 12). In this regard, it is essential to foster and maintain interpersonal relationships as well as to actively contribute to the community.

Well-being facilitates positive physical and mental experiences, leading to pleasurable and satisfying moments (13). It encompasses economic stability, physical and mental health, personal relationships, community and social participation, and, more broadly, all aspects that contribute to an adequate quality of life (14). In this sense, it involves feeling satisfied and balanced in all areas of life, enjoying healthy relationships, maintaining a good quality of life, and experiencing harmony and fulfillment (10).

The WHO recommends that older adults engage in physical activity (PA) through recreational or leisure activities to enhance their physical, emotional, and cognitive health. This approach promotes happiness, vitality, and greater self-esteem while also strengthening their ability to face challenges and adapt to change (15). Dance practice among the elderly is associated with a reduction in symptoms of anxiety and depression, contributing to a more positive perception of life by allowing them to connect with their emotions and express themselves (16, 17).

Specifically, rhythmic movement interventions have demonstrated benefits including improved bone density, circulation, balance, mobility, flexibility, cognitive function, and mood (18). Additionally, it contributes to cardiovascular health and stress reduction, promoting overall well-being (19). Dance has also demonstrated a positive impact on balance, gait, and motor function (20) while regular participation contributes to fall prevention and reduces the need for hospitalization (21). Dance promotes multidimensional well-being, offering benefits for mood, quality of life, and both mental and psychosocial health (22). Consequently, such interventions contribute to well-being by improving physical performance, preventing falls, boosting self-esteem and mood, promoting independence, and fostering a high quality of life (19).

Beyond its individual effects, dance supports active aging by fostering enjoyment, strengthening the sense of connection, and helping to counteract loneliness (23, 24). This approach combines rhythmic and coordinated body movements, typically accompanied by music, integrating movement and melody to facilitate self-expression. In the therapeutic field, it has also proven to be an effective treatment for depression (25, 26).

Recent studies emphasize the importance of implementing structured programs and leveraging technology to overcome barriers such as physical distancing (27, 28). Likewise, research by Hanks et al. (29) highlights that dance helps develop discipline, establish routines, and improve mood. Similarly, significant progress has been made in the use of rhythmic movements in therapies for adults with dementia, enhancing psychosocial interaction (30).

Dance has benefits for the elderly when approached from a multidimensional, holistic, well-being perspective. However, recent evidence has not been systematically reviewed using PRISMA. This systematic review aims to analyze the influence of dance-based interventions on physical, emotional, cognitive, and social dimensions of well-being, considered as integral components of overall well-being, in older adults. We considered studies that assessed one or more of these dimensions as indicators of well-being. This systematic review addresses the following question using the PICOS criteria: In older adults (Population), does participation in dance-based interventions (Intervention), compared to no intervention or alternative physical or recreational activities (Comparison), improvements in at least one of the following dimensions of well-being: physical, emotional, cognitive, or social. (Outcomes), as reported in empirical studies published in peer-reviewed journals (Study Design)?

This study followed the guidelines established in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement (31). Data collection was conducted between October and November 2024 using the Web of Science, Scopus, and SportDiscus databases. These databases were prioritized in this review due to their broad coverage of interdisciplinary research, particularly in the fields of health and physical activity, in which dance-based intervention studies are frequently published.

For the study search, keywords were used in combination with Boolean operators (“AND” and “OR”), applying the following search strategy:

(“older” OR “older adults” OR “elderly” OR “elder” OR “elders” OR “older person”) AND (Well-being OR “wellbeing”) AND (dance OR danc OR dancing).

The selection of eligible studies was guided by the PICOS criteria (population, intervention, comparison, outcome and study design): •

Population (P): Adults generally aged 60 years and older. Studies with a lower age threshold (minimum age of 50) were also considered eligible if participants were identified as older adults and the outcomes addressed age-related dimensions of well-being.

Studies had to meet the following criteria: (1) be original research articles published in peer-reviewed journals; (2) present original empirical research (quantitative or qualitative) investigating the relationship between dance-based interventions and well-being in older adults; (3) explicitly address well-being by assessing at least one of its dimensions (physical, emotional, cognitive, or social), or by considering it as a holistic construct. This applies regardless of whether the term “well-being” appears in the title, abstract, or full text and (4) no restrictions were applied regarding publication region, language, gender, or participant age.

Those investigations that (1) did not provide a clearly defined methodological design; or (2) were non-original research articles, including conference proceedings, abstracts, books, editorials, reviews, case studies, and doctoral theses were excluded.

Two independent reviewers evaluated the titles and abstracts of the articles to determine their eligibility, removing duplicate documents during the process. The selected articles were then retrieved for full-text review. Each reviewer analyzed the texts individually, and inclusion was determined by consensus. In cases of disagreement, a third reviewer with methodological expertise intervened to resolve discrepancies.

Figure 1 presents the systematic review process flowchart. The initial literature search yielded a total of 389 records, distributed as follows: Web of Science (141), Scopus (181) y SportDiscus (67).

Subsequently, 95 duplicate articles were excluded, resulting in a total of 294 records. After screening the titles and abstracts, 191 records were excluded because they did not meet the inclusion criteria or were incompatible with the focus of this systematic review. A full assessment was conducted on the remaining 103 articles, and 81 were excluded for the following reasons: 24 included participants younger than 50 or did not identify them as older adults, 10 were conference abstracts without full-text access, 16 did not report original research findings (e.g., reviews, commentaries, or editorials), 18 did not describe dance-based interventions, and 13 did not assess any dimension of well-being in older adults. Finally, 22 studies met all eligibility criteria and were included in the final review.

The extracted data, recorded in the analysis table, include the following variables: author's name, year of publication, study objective, country, population, number of participants, gender, age, intervention setting, duration, tools used, follow-up, analyzed variables, and main results.

To assess the methodological quality of the studies, the 16-item checklist developed by Law et al. (32) was applied. This tool is designed to evaluate the rigor of the selected studies. Based on this criterion, the following quality categories were established: low quality (score of 50% or lower), good quality (score between 51% and 75%) and excellent quality (score of 75% or higher).

Among the studies analyzed, 16 were classified as excellent quality, 6 as good quality, and 1 received a regular quality rating. The 5 studies classified as low quality were excluded from the review.

The sample sizes in the reviewed studies varied significantly:

Small samples (≤20 participants): 8 participants: Philip et al. (51), Han & Sa (41). Between 10 and 17 participants: Aliberti & Raiola (48) (14), Silva et al. (37) (17), Thumuluri et al. (44) (10).

While most studies focused on the elderly in general, several investigations examined specific populations with conditions, including Parkinson's disease (mild to moderate stages) (45); Cognitive impairment (38, 39, 44); Mobility difficulties (21, 48); Respiratory diseases (51); Post menopause (40); Leisure and cultural activities (36); Women-only groups (34, 40, 41, 49).

Among the 22 studies analyzed, 18 included mixed-gender populations, whereas 4 focused exclusively on women. The most studied population was individuals with physical, functional, or fitness-related difficulties (n = 8), including two studies (n = 2) on fall prevention. Additionally, four studies (n = 4) explored psychological or psychosocial aspects, while nine studies (n = 9) addressed mental health. Regarding participant age, the recorded range spanned from 55 to 97 years, establishing this interval as the reference population across the analyzed studies.

Although the inclusion criteria aimed to focus on adults aged 60 years and older, two studies with slightly younger participants (minimum ages of 50 and 55, respectively) were retained. These studies were included because they explicitly identified their participants as older adults or seniors, and the average age of participants fell within the typical older adult range. Additionally, both studies addressed aging-related outcomes relevant to the review, such as physical decline, emotional well-being, and social participation.

The interventions analyzed in the reviewed studies exhibit significant diversity in terms of duration, type of dance, and session frequency. Some studies implemented short-term programs, while others were designed to evaluate the impact over the course of weeks or months.

For instance, in the study by Chipperfield & Stephenson (50), participants attended ballroom dance sessions once per week for one hour. Similarly, O'Toole et al. (46) evaluated a six-week program led by instructors, which included ten-minute warm-up and cooldown sessions. Along the same lines, Clifford et al. (47) analyzed the impact of the Music and Movement for Health (MMH) program, which lasted two months with weekly 90-min sessions, conducted between February-March for participant recruitment and August-September for the intervention.

Other studies implemented medium-duration interventions, structured over several weeks. In the case of Harrison et al. (22), the study analyzed modified virtual ballet classes for the elderly, with 45-min sessions twice a week for 12 weeks, compared to control classes focused on general well-being. Similarly, Han & Sa (41) and Wang et al. (38) developed dance programs with three weekly sessions over the same 12-week period, albeit with different approaches. The former included a modified Chinese square dance program designed to prevent falls, along with a combination of yoga and Korean dance, while the latter focused on the participation of elderly women.

Some interventions took a more specialized approach, such as Philip et al. (51), which incorporated 75-min community dance sessions for individuals with chronic respiratory diseases. Likewise, Holmerová et al. (52) implemented the EXDASE chair-based dance program, consisting of 75-min sessions once per week for three months. In a similar vein, Silva et al. (37) analyzed participation in weekly dance circles over the same period.

Regarding longer-duration programs, De Araujo & Da Rocha (36) examined participation in dance classes and musical gatherings over six months, a structure also followed by Lukach et al. (42). Meanwhile, Pandya (45) evaluated the combined intervention of Dance Movement Therapy (DMT) and Yoga (DMT + Y), whereas Zhao et al. (39) explored the impact of public dance sessions held three times per week for three months. In the case of Thumuluri et al. (44), the study analyzed improvisational dance classes using the IMPROVment® method, structured into twice-weekly sessions over eight weeks.

Some studies applied more traditional approaches, such as Douka et al. (19), which assessed a Greek dance-based program with two weekly sessions over 32 weeks, and Aguiñaga & Márquez (43), who examined a Latin dance program called BAILAMOS, structured with two sessions per week for 16 weeks.

Other studies focused on long-term interventions, allowing for an assessment of prolonged effects on participants' health. Lima & Vieira (35) examined a ballroom dance program that lasted one year, with two classes per week. Other studies explored interventions combining multiple disciplines, such as Poulos et al. (33), which evaluated courses integrating visual arts, photography, dance, theater, singing, and music, taught by professional artists over a period of 8–10 weeks, with weekly classes.

Overall, the reviewed studies highlight the diversity of approaches in implementing dance as a well-being strategy for the elderly. While short-term interventions primarily focus on immediate improvements in physical and emotional health, medium- and long-term programs tend to generate more sustained benefits, particularly in fall prevention, mental health enhancement, and the promotion of psychosocial development.

When we compared the types and durations of interventions with the observed outcomes, we found that short programs improved emotional and social domains, while long-term programs were associated with cognitive, physical, and mental health benefits.

Research on the relationship between dance and well-being in the elderly is reflected in the large number of studies and the diversity of approaches used. The most prominent group of studies explicitly aims to evaluate the impact of dance programs and activities (22, 33–35, 40, 42, 44, 45, 47–49, 52).exploratory studies (38, 39, 51) aimed at identifying patterns and generating hypotheses. Likewise, other studies focus on establishing or examining cause-and-effect relationships (19, 41, 46, 50). Additionally, some research falls into the comprehensive category, aiming for a holistic understanding of the subject (36, 37).

From a methodological perspective, a predominantly quantitative trend is evident, with 15 studies employing measurement batteries for data collection and analysis. This highlights a strong emphasis on the objective measurement of dance's effects on this population.

The methodological strategies and instruments employed in these studies provide insight into how well-being was conceptualized and measured. This section outlines the tools used to assess physical, emotional, cognitive, and social outcomes, offering a clearer understanding of how dance-based interventions impact the multidimensional well-being of older adults.

All included studies used validated instruments to assess at least one dimension of well-being. Evaluative studies have developed rigorous methodologies to measure the impact of dance on the well-being of the elderly. For instance, Clifford et al. (47) assessed the feasibility of a dance program using instruments such as the Incidental and Planned Exercise Questionnaire (IPEQ), the Timed Up and Go (TUG) test, the 30-Second Sit-to-Stand (30CST) test, the Short Physical Performance Battery (SPPB), and the Single-Leg Stance (SLS) test to evaluate static postural control.

Similarly, Harrison et al. (22) examined the effectiveness of virtual ballet classes compared to Well-being sessions, employing self-report questionnaires and functional tests such as the Two-Minute Walk Test, the Timed Up and Go test, and the Mini-BESTest to assess balance and mobility confidence.

Also, some studies have adopted specialized methodologies to assess the impact of dance on elderly individuals with specific conditions. For instance, Pandya (45) investigated the effects of Dance Movement Therapy (DMT) and yoga on elders with Parkinson's disease, utilizing a range of assessment tools, including the Balance Confidence Scale, the Geriatric Anxiety Scale (GAS-10), and the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Additionally, the Mini-Mental State Examination (MMSE) was employed to evaluate cognitive function.

In a similar vein, Chipperfield & Stephenson (50) explored the influence of ballroom dancing on well-being and fall risk. Their research incorporated the CORE-GP questionnaire, the Falls Efficacy Scale–International (FES-I), and the Timed Up and Go Test (TUGT) to obtain a comprehensive understanding of its effects. Beyond these, other investigations have focused on refining assessment protocols, aiming to capture the multifaceted benefits of dance therapy in elderly populations.

Consequently, some other studies have explored the feasibility and impact of dance interventions in different contexts. For instance, Zhao et al. (39) examined the viability of public dance sessions for individuals with mild cognitive impairment and depressive symptoms, utilizing the Subjective Exercise Experience Scale (SEES) alongside heart rate monitoring to assess responses. Meanwhile, Philip et al. (51) focused on perceived well-being experiences among elders with chronic respiratory diseases, conducting semi-structured interviews and thematic analysis to gain deeper insights.

Based on this concern, Wang et al. (38) investigated the effects of Chinese square dancing in individuals with mild cognitive impairment, employing a combination of standardized assessments, including the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) for cognitive function, the Geriatric Depression Scale (GDS-15) for depressive symptoms, and the Berg Balance Scale (BBS) for postural stability.

Then, from an explanatory perspective, researchers have investigated how dance participation influences various aspects of life among elders. Han & Sa (41) analyzed the involvement of elderly women in dance activities and its impact on quality of life, health, and happiness, using participant interviews and on-site observations to gather qualitative insights. In another study, O'Toole et al. (46) explored the effects of dance on activity engagement, fall prevention, and overall well-being, employing the Falls Efficacy Scale and the EQ-5D-3l to assess perceived health and quality of life.

Finally, in the qualitative domain, several studies have explored the role of dance as a tool for health promotion and cultural expression. Silva et al. (37) examined circle dance as a strategy for health promotion, employing the qualitative research model by Schatzman and Strauss (Consolidated Criteria for Reporting Qualitative Research - COREQ) to structure their analysis. De Araujo & Da Rocha (36) investigated the meanings elders attribute to group leisure activities, specifically dance and musical gatherings. Their study applied participant observation, in-depth interviews, and ethnographic analysis to capture the participants' lived experiences.

Therefore, Lukach et al. (42) detailed the protocol of a multicenter study assessing the effects of African dance on cognition, mood, quality of life, and physical fitness among African American elders.

Literature reveals a limitation in the conceptualization of well-being, as many studies address it through specific dimensions, such as physical or emotional health, without integrating them into a holistic framework. To effectively assess well-being, a more comprehensive evaluation of interventions requires the adoption of multidimensional approaches.

One limitation related to the databases used was the exclusion of Google Scholar, due to its broad interdisciplinary coverage. This may have limited the inclusion of grey literatura (53). Finally, we highlight that a key limitation of this review is the restriction to studies that used the term well-being. We may have excluded studies by not using emotional, physical, social, or cognitive descriptors, which could limit the scope of the review. Some studies do not comprehensively assess well-being, and there is methodological heterogeneity. This underscores the need to implement tools that measure well-being from a multidimensional perspective.