Abstract
BackgroundAlmost half of mild cognitive impairment (MCI) patients progress to dementia, which is associated with decreased quality of life and obstacles to independent living. Relevant management is expected to prevent MCI patients from progressing to dementia. In recent years, electroacupuncture (EA) has been used to treat various kinds of neurological disorders including MCI. This study evaluates the use of EA for MCI patients to increase cognitive function through a comparison with Western medications.MethodsRandomized controlled trials (RCT) or systematical reviews (SR) of EA versus Western medications for MCI were searched using the following 10 databases: Pubmed, Cochrane Library, CINAHL, EMBASE, China National Knowledge Infrastructure (CNKI), National Digital Science Library (NDSL), Journal of Oriental Neuropsychiatry (JON), Korean Medical Database (KMBASE), KoreaMed, and OASIS, from October 2007 to August 2017, without language restriction. A methodological quality assessment of RCTs or SRs that met inclusion criteria was conducted using Cochrane Risk of bias (RoB) tool and a meta-analysis by RevMan (Review Manager) 5.3.5 version of Cochrane collaboration.ResultsFive RCTs with 257 patients met inclusion criteria and those were randomly divided into two groups: the EA group (n = 103) and Western medications group (n = 154). The methodological quality of the included studies showed high risk or/and unclear of risk of bias. The meta-analysis of five studies reported that the EA group was better than the Western medications group, improving the Mini Mental State Examination (MMSE) score by 0.65 [95% CI 0.28~1.01] higher mean difference, Montreal Cognitive Assessment (MoCA) score by 0.66 [95% CI 0.00~1.32] higher mean difference. Adverse effects were not reported in the selected studies.ConclusionElectroacupuncture was an effective treatment for MCI patients by improving cognitive function. However, the included studies presented a low methodological quality and no adverse effects were reported. Thus, further comprehensive studies with a design in depth are needed to derive significant results.
Highlights
Almost half of mild cognitive impairment (MCI) patients progress to dementia, which is associated with decreased quality of life and obstacles to independent living
Additional databases from Korea were the National Digital Science Library (NDSL), Journal of Oriental NeuroPsychiatry (JON), Korean Medical Database (KMBASE), KoreaMed, and OASIS
In Zhao (2012) [19], a total of 84 patients were treated with electroacupuncture alone, electroacupuncture and syndrome differentiation treatment, and anti-dementia drugs (Nimodipine)
Summary
Almost half of mild cognitive impairment (MCI) patients progress to dementia, which is associated with decreased quality of life and obstacles to independent living. According to statistical results from the National Health Insurance Service (NHIS) of the Republic of South Korea, the number of people who visited hospitals as MCI patients increased from 24,000 to 105,000 between 2010 and 2014. This indicates that the number of patients increased 43.9% every year and became 4.2 times greater within four years. Relevant management is expected to increase the possibility of MCI patients progressing to AD [5]. As the numbers of dementia patients are increasing rapidly and cognitive impairment is the most common symptom of MCI, management should be primarily focused on this aspect [6, 7]
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