Effectiveness and Safety of Acupuncture for the Treatment of Alzheimer's Disease: A Systematic Review and Meta-Analysis

Alzheimer's disease represents the most common form of dementia, accounting for more than 60% of all cases and characterized by progressive decline in memory, spatial disorientation, and other neuropsychiatric disturbances. With a rapidly aging world population, it is estimated that the number of people with dementia will double every 20 years, reaching 115.4 million by 2050. This condition not only causes suffering for patients and families but also represents a substantial economic burden on society. Current pharmacological treatments, such as donepezil, rivastigmine, and galantamine, focus on correcting the cholinergic deficit in the central nervous system, but they have significant limitations: they cannot halt disease progression, their therapeutic effects vary across individuals, and they may cause adverse effects such as nausea, vomiting, and dizziness.

In this context, acupuncture emerges as a promising therapeutic alternative, being a relatively safe millennia-old practice that may protect neurons from deterioration and promote the growth of new neural connections.

This study aimed to systematically evaluate the efficacy and safety of acupuncture in the treatment of Alzheimer's disease through a comprehensive review of the scientific literature. The researchers searched eight major databases, including PubMed, Embase, and Chinese databases, looking for randomized controlled studies published through January 2019. Studies were included that compared acupuncture alone or combined with medications against standard treatment, medications alone, or sham acupuncture. The rigorous selection criteria ensured that only patients with confirmed Alzheimer's diagnosis participated in the studies analyzed.

The methodology involved independent data extraction by two researchers, evaluation of the methodological quality of the studies, and statistical analysis using specialized software. The primary outcomes included general cognitive function, activities of daily living, dementia severity, and adverse events, organized into short-term (up to 8 weeks), medium-term (9–12 weeks), and long-term (more than 12 weeks) treatment periods.

The analysis included 30 studies involving 2,045 patients, revealing important findings about the benefits of acupuncture. The results showed that the combination of acupuncture with medications demonstrated superiority over the use of medications alone for improving overall cognitive function, in both the short and medium term. Specifically, patients who received acupuncture combined with drug treatment showed significantly higher scores on cognitive tests, with mean differences of 1.94 points in the short term and 4.41 points in the medium term. For activities of daily living, the combination also proved more beneficial in the medium term, with a mean difference of -2.14 points (indicating better functionality).

However, when acupuncture was compared alone with medications, no statistically significant differences were found in cognitive function, activities of daily living skills, or incidence of adverse events. The most used acupuncture points in the studies were Baihui, Zusanli, Sanyinjiao, and Taixi, reflecting the traditional Chinese approach to neurological disorders.

These findings have important implications for both patients and health professionals. For patients with Alzheimer's and their families, the results suggest that acupuncture may be a valuable complementary therapy when used alongside conventional medications, potentially offering additional benefits in preserving cognitive function and functional independence. Acupuncture proved to be safe, with an adverse-event profile comparable to traditional medications. For health professionals, these findings indicate that integrating acupuncture into the treatment plan may be considered, especially as adjuvant therapy to standard medications.

The integrative approach may provide a more comprehensive therapeutic strategy, addressing different aspects of the disease through complementary mechanisms. The results also suggest that the duration of treatment may not significantly modify the efficacy of acupuncture, providing flexibility in therapeutic planning.

However, it is essential to recognize the important limitations of this study. The methodological quality of the included studies was often inadequate, with problems in the description of randomization methods, allocation concealment, and blinding of participants and assessors. Only one study used sham acupuncture as an adequate control, which is considered the gold standard for acupuncture research. Additionally, the studies varied significantly in technical aspects such as point selection, stimulation techniques, and duration of sessions, making definitive conclusions about the ideal protocol difficult.

The limited number of studies for some comparisons also constrained the robustness of the analyses. Another important aspect is that most studies were conducted in China, which may limit the generalizability of the results to other populations and health-care systems. Despite these limitations, the review provides encouraging evidence on the potential of acupuncture as complementary therapy for Alzheimer's disease, highlighting the need for future studies with higher methodological quality to establish standardized protocols and confirm these promising findings.