Abstract
Background: Given the limited effectiveness of pharmacological treatments in mitigating cognitive decline in individuals with mild cognitive impairment (MCI), there is a pressing need for developing effective non-pharmacological intervention programs to counteract MCI-related cognitive decline. Acupressure and cognitive training are safe and cost-effective; however, evidence of the effect of acupressure or the combined effect of acupressure and cognitive training on cognitive functions of older adults with MCI is limited.Objective: To evaluate both the individual and combined effects of acupressure and cognitive training on cognitive functions of older adults with MCI.Methods: One hundred and eighty older adults with MCI were recruited and randomly assigned to combined acupressure and cognitive training group (n = 45), acupressure group (n = 45), cognitive training group (n = 45), or control group (n = 45). Participants in the experimental groups received self-administered and group-based training sessions, while those in the control group received routine community education. The intervention lasted for 6 months. The cognitive functions of all the participants were assessed at multiple stages, including pre-intervention, at the end of the third and sixth months.Results: One hundred and fifty-one participants completed the study, and all participants analyzed in intervention groups completed at least 85% of all practice sessions recommended. Repeated measures analysis of variance of the scores of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at different time points among the four groups revealed that the group effect, time effect, and interaction effect were all significant (p < 0.01). Pairwise comparisons with Bonferroni correction showed that the scores of MMSE and MoCA in acupressure group, cognitive training group, and combined group were significantly raised compared with control group (p < 0.01). Compared with acupressure or cognitive training groups, the scores of MMSE and MoCA in combined group were significantly higher (p < 0.05). The scores of MMSE and MoCA in acupressure group had no significant differences with those in cognitive training group (p > 0.05).Conclusion: Acupressure and cognitive training both could improve the cognitive functions of older adults with MCI, and when used together, the effects were enhanced.Clinical Trial Registration: This study was registered in the Chinese Clinical Trial Registry (No.ChiCTR2100049955).
Highlights
Mild cognitive impairment (MCI) is a condition in which individuals demonstrate cognitive impairment with minimal impairment of instrumental activities of daily living (IADL) (Petersen et al, 2018)
According to the participants’ practice diaries, the group leaders’ reports, and the researchers’ monitoring records, all participants analyzed in intervention groups completed at least 85% of all practice sessions recommended, and chisquare test showed that the differences among the intervention groups were insignificant (p > 0.05)
Pairwise comparisons with Bonferroni correction, which compared the average values of all repeated measurements among groups, showed that the scores of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in acupressure group, cognitive training group, and combined group were significantly raised compared with control group (p < 0.01)
Summary
Mild cognitive impairment (MCI) is a condition in which individuals demonstrate cognitive impairment with minimal impairment of instrumental activities of daily living (IADL) (Petersen et al, 2018). Pharmacological interventions have been suboptimal in slowing the cognitive decline and preventing the transition of patients with MCI to dementia (Andrieu et al, 2015; Petersen et al, 2018). Cognitive training is an increasingly popular, non-pharmacological intervention for improving cognitive functioning in neurodegenerative diseases and healthy aging (Van Balkom et al, 2020). The 2018 American Academy of Neurology (AAN) guideline on MCI recommended cognitive training as a non-medication approach to improve cognitive function (Petersen et al, 2018). Given the limited effectiveness of pharmacological treatments in mitigating cognitive decline in individuals with mild cognitive impairment (MCI), there is a pressing need for developing effective non-pharmacological intervention programs to counteract MCI-related cognitive decline. Acupressure and cognitive training are safe and cost-effective; evidence of the effect of acupressure or the combined effect of acupressure and cognitive training on cognitive functions of older adults with MCI is limited
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