Preventing cognitive decline in older adults with mild cognitive impairment using integrated Korean and Western treatments: Initial results

Abstract

AbstractBackgroundDespite the rapidly rising incidence of cognitive impairment, no current medications have proven effective for mild cognitive impairment (MCI). The Integrated dementia clinic at Dongguk University Ilsan Hospital is a nationally recognized Korean‐Western (KW) clinic that provides the integrated medical service via co‐consultation by both neurologists and Korean medicine neuropsychologists.ObjectiveThe purpose of this study is to examine whether the integrated KW treatment prevents cognitive decline in patients with MCI as measured by changes in the Mini Mental State Examination (MMSE) scores over time.MethodWe retrospectively examined the medical records of patients from May 2015 to June 2020. Of 19 patients who were diagnosed as MCI, twelve MCI patients underwent MMSE at their initial visit to the clinic and at least once more over a period of up to 5 years. These twelve MCI patients divided into two groups: MMSE improvement group vs. MMSE worsening group. We performed the Wilcoxon rank sum test to compare the group achieving improvement in MMSE to decrease in MMSE. We also used the same test to assess the difference in the median length of follow‐up between the two groups.ResultThe prevalence of MCI seen during the review period was 23% (19/82). The baseline characteristics of patients with MCI were shown in Table 1. Among those twelve MCI patients who received integrated KW treatment, 67 % (8/12) of them achieved improvement in MMSE score, which was statistically significant (p‐value = 0.008) compared to those showing a decrease in MMSE score while the length of follow‐up was not significantly different between the two groups. The detailed treatment and changes in MMSE presented in Table 2. For treatment from Western medicine, anticonvulsants were most commonly prescribed, and donepezil was given to 63%. Acupuncture (100%), Moxibustion (100%), and herbal medicine (Gagam‐sohabhwangwon: 6/8,62.5 %) were most prescribed Korean medicine.ConclusionsThis study demonstrates, for the first time, that integrated KW treatment positively affects cognitive function in MCI patients with increases in MMSE scores over time. Further research with a larger data set, needs to be conducted to validate the effectiveness of integrative approach.