Abstract
In Korea, patients with mild cognitive impairment can choose to receive treatment of Korean medicine, and Korean medicine hospitals provide specialized medical care for the prevention and management of cognitive disorders. The aim of the study is to explore the role of Korean medicine therapy for patients with mild cognitive impairment in a real clinical setting. Fifteen patients with amnestic mild cognitive impairment were enrolled in this prospective observational study in three Korean medicine hospitals. Korean medicine treatments were delivered by experienced professionals and not restricted to standardized treatment. Outcome measures were prospectively planned to examine the Korean-Montreal Cognitive Assessment (K-MoCA), Korean-Mini Mental State Examination (K-MMSE), and other detailed neuropsychological assessment at the baseline and after 12 and 24 weeks of treatment. Korean medicine treatment for MCI treatment in the real-world clinical setting included herbal medicine and acupuncture. The most frequently used herbs in herbal decoctions were Acori Graminei Rhizoma, Polygalae Radix, and Poria Sclerotium Cum Pini Radix. The herbal medicine formulae used in this study were classified into three categories: tonifying Qi (33.3%), tonifying kidney (46.7%), and calming liver (20%) formulae. In the cognitive ability assessment, the K-MoCA score significantly improved after treatment (mean difference 2.6; 95% CI: 1.3 to 3.9, p=0.001). The K-MMSE score slightly increased after treatment; however, the improvement was not statistically significant (mean difference 0.8; 95% CI: −0.5 to 2.0, p=0.195). In detailed neuropsychological assessment, the cognitive domains of executive functions and memory after the treatment were distinctively improved. In this prospective observational case series, we could see the real clinical environments of treating patients with mild cognitive impairment in Korean medicine hospitals. Patients treated with Korean medicine showed improved results in the neuropsychological assessment after 12 and 24 weeks.
Highlights
Mild cognitive impairment (MCI) is a transitional state between normal aging and early dementia. e diagnostic and statistical manual of mental disorders-5 (DSM-5) distinguishes mild neurocognitive disorder from major neurocognitive disorder
Twenty-two participants were screened for eligibility, and fifteen patients diagnosed with MCI were included from the three Korean medicine (KM) universities. e patients visited hospital every two weeks, to be prescribed herbal medicine
In a previous study of MCI patients conducted in Korea [35], the average Korean-Montreal Cognitive Assessment (K-MoCA) score was 18.5 ± 3.7 and the average Korean-Mini Mental State Examination (K-MMSE) score was 24.0 ± 2.9, which were similar to the results of our study. e demographical distribution and baseline neuropsychological assessment score of patients were similar among the three hospitals (Table 1)
Summary
Mild cognitive impairment (MCI) is a transitional state between normal aging and early dementia. e diagnostic and statistical manual of mental disorders-5 (DSM-5) distinguishes mild neurocognitive disorder from major neurocognitive disorder. Mild cognitive impairment (MCI) is a transitional state between normal aging and early dementia. In the elderly aged 65 or older, 46% of people with mild cognitive impairment develop dementia, while 3% of normal people develop dementia within 3 years [4]. Detection of mild neurocognitive impairment and prevention of its progression may ease the burden of major neurocognitive disorder. Ere is no recommended conventional treatment for MCI with sufficient evidence, and representatively, cholinesterase inhibitors did not show consistent effectiveness for MCI patients in the systematic review [1]. Numerous studies have reported that acupuncture is effective in treating MCI and can be an alternative and adjunctive treatment for MCI patients [5,6,7]
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