Abstract
BackgroundCurrent research evidence challenges clinical decision-making when acupuncture is taken into consideration in the treatment of cognitive impairment (CI). Aiming to provide some viable recommendations for acupuncture practitioners in dealing with actual clinic issues, an expert consensus study was conducted.MethodsA clinical question investigation among 47 acupuncturists yielded 24 initial items. Subsequently, systematic reviews on acupuncture for CI were searched within three online databases. A panel of 30 authoritative experts were requested to respond with agreement, neutrality, or disagreement for each item. Consensus establishment was defined as the percentage of agreement on a given item >80%.ResultsFollowing a 2-round Delphi survey, there were 21 items reaching consensus and three items resulting in no consensus; of which 10 items reached 90∼100% agreement, and 80∼90% expert agreement was achieved for 11 items. These items could be roughly categorized into six domains: (1) therapeutic effects of acupuncture, (2) therapeutic principles, (3) acupoint selection and combination, (4) acupuncture parameters, (5) considerable combined therapies, and (6) possible adverse events.ConclusionWithout ready-made guidelines, this expert consensus may be conducive to guide acupuncturists in implementing clinical acupuncture practice for CI. Moreover, given the lack of high-quality research evidence and plenty of unresolved clinical issues in this field, it is of necessity to carry out more studies to better clarify the treatment algorithm.
Highlights
Cognitive impairment (CI) is a common neurological disorder worldwide (Ferri et al, 2005)
A panel of veteran acupuncture experts were invited to provide some viable recommendations on the specific issues for acupuncture practitioners in treating CI
According to the final achieved consensus items, more than 80% of the experts agree that acupuncture can be used to improve cognitive functions of patients with mild or moderate CI caused by Alzheimer’s disease (AD) or cerebrovascular diseases, which has been underpinned by the results of previous studies (Liu et al, 2014; Wang et al, 2020)
Summary
Cognitive impairment (CI) is a common neurological disorder worldwide (Ferri et al, 2005). Alzheimer’s disease (AD) and vascular cognitive impairment (VCI) are the two main causes of CI (Hugo and Ganguli, 2014). Despite the emerging pharmacological treatments that have been developed, such as donepezil, memantine, Acupuncture and Cognitive Impairment and rivastigmine, which are widely recommended by the current guidelines (Sorbi et al, 2012; National Collaborating Centre for Mental Health, 2018), their therapeutic effects vary with different individuals and need further validation for certain types of CI (Van der Flier et al, 2018). Current research evidence challenges clinical decision-making when acupuncture is taken into consideration in the treatment of cognitive impairment (CI). Aiming to provide some viable recommendations for acupuncture practitioners in dealing with actual clinic issues, an expert consensus study was conducted
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