Acupuncture appears to be effective for the mild cognitive impairment that is a precursor for dementia, when used as an alternative or in combination with other treatment, a new study finds.

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Acupuncture may assist with improving the subtle memory loss that precedes the development of dementia.

The review of available published evidence and presented in Acupuncture in Medicine shows promise for clinical effectiveness and safety of acupuncture use for the pre-dementia state. However, the authors caution that further, more rigorously designed studies are needed.

Min Deng, from the Department of Neurology at Zhongnan Hospital of Wuhan University in China, and Xu-Feng Wang, from the Department of General Surgery at Renmin Hospital of Wuhan University, conducted the study.

Mild cognitive impairment (MCI) is an intermediate stage between the expected cognitive decline of normal aging and the most severe decline of dementia.

MCI may increase the risk of later progressing to dementia caused by Alzheimer's disease or other neurological conditions.

Some people with MCI do not experience a decline in the condition, but few get better. MCI may be detected if a person experiences a "slip" in memory or mental function.

Researchers used data from five trials

Cognitive impairment ranging from mild to severe is thought to affect more than 16 million people in the United States. Among older adults with MCI, around 5-10 percent develop dementia every year.

MCI based on memory deficits can be categorized as amnestic (AMCI) and non-amnestic. AMCI is characterized by a decline in memory capacity with retention of mostly intact executive functions.

Previous studies have provided evidence that acupuncture is beneficial for the treatment of dementia or AMCI by reducing the symptoms. The researchers aimed to analyze current evidence to evaluate the comparative effectiveness of acupuncture as a straightforward and reliable technique for AMCI.

Included in the analysis were relevant clinical trials from Western and Chinese databases comparing acupuncture and medical treatment published up to July 2015.

Data from five trials involving 568 people published between 2012-2013 were suitable for inclusion in the study.

There were 288 patients allocated to the acupuncture group, and 280 patients assigned to receive a conventional medicine called nimodipine, a drug that might improve learning and reduce cognitive deficits in Alzheimer's disease.

Three trials likened the comparative effectiveness of acupuncture with nimodipine, and two trials examined the role of acupuncture as an additional treatment to nimodipine.

Participants involved in each study ranged from 26-94 years old. Acupuncture treatment was provided three to five times a week for 8 weeks in four trials, and for 3 months in another.

Acupuncture effective in combination with nimodipine for AMCI

Results from all pooled data showed that participants receiving acupuncture had better outcomes than those receiving nimodipine. They achieved better scores on two of the principal tests used to assess AMCI and dementia: the mini-mental state exam and picture recognition.

Acupuncture in conjunction with nimodipine significantly improved mini-mental state exam scores when compared with nimodipine alone.

Three of the trials reported adverse effects, which included fainting during treatment and slow bleeding (errhysis) at needle sites for acupuncture, and gut symptoms and mild headache for nimodipine.

The authors write:

"In conclusion, the results of this meta-analysis suggest that acupuncture therapy has a significant positive effective on cognitive and memory function in patients with AMCI compared with nimodipine alone. The results also show that acupuncture is effective as an adjunctive treatment to nimodipine for AMCI."

The authors note that with the methodological quality of the included research judged to be generally poor, and the current small number of available studies, further thorough studies with more people involved are needed to assess the effectiveness and safety of acupuncture for AMCI patients.

Other limitations pointed out by the team were that the trial design did not take account of potential placebo effects, and most of the trials were carried out in China, where patients may favor acupuncture to medical treatment.

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