Acupuncture for cognitive impairment in vascular dementia, Alzheimer’s disease and mild cognitive impairment: A systematic review and meta-analysis

Abstract

IntroductionCognitive impairment is a worldwide health problem. Numerous studies have been conducted to evaluate the effect of acupuncture on cognitive impairment. However, it is still unclear that if acupuncture shows the same efficacy on cognitive impairment caused by different diseases. Therefore, we conducted a systematic review and meta-analysis based on the current evidence to evaluate the efficacy and safety of acupuncture for cognitive impairment in vascular dementia (VD), Alzheimer’s disease (AD) and mild cognitive impairment (MCI) patients. MethodsFive databases were searched from their inception to December 2019. Randomized controlled trials (RCTs) involving VD, AD or MCI treated by acupuncture alone or as part of combination therapy were included. The primary outcomes were the Mini-Mental State Examination and the Hierarchic Dementia Scale. ResultsTwenty-one RCTs (N = 2253) were quantitatively analyzed. For VD, compared with Western medicine (WM), acupuncture showed better Hierarchic Dementia Scale scores (P < 0.01), and acupuncture plus WM also showed better Hierarchic Dementia Scale scores (P < 0.01). For MCI, acupuncture showed a significant improvement in Mini-Mental State Examination (P < 0.01) and picture recognition test scores compared with WM. For AD, WM resulted in better Hierarchic Dementia Scale scores than acupuncture (P < 0.01). Eight trials reported adverse events, 15 out of 2253 patients had adverse events related to acupuncture treatment, and 25 out of 2253 patients had adverse events related to WM treatment. ConclusionAcupuncture may be efficacious for improving cognitive function in patients with VD and MCI. However, the evidence is limited, and larger sample size and more rigorous RCTs should be conducted to verify the effectiveness and safety of acupuncture.