Acupuncture for mild cognitive impairment: A systematic review with meta-analysis and trial sequential analysis

This scientific study investigated whether acupuncture can help people with mild cognitive impairment, a condition that may be the first sign of dementia. Mild cognitive impairment affects more than 55 million people worldwide and represents an intermediate stage between normal aging and dementia. Approximately 20% of cases may progress to dementia, making it essential to find effective treatments. Conventional medications currently show limited results and may cause adverse effects, leading many people to seek alternatives such as acupuncture.

The researchers performed a systematic review with meta-analysis, gathering high-quality scientific studies published through August 2022. They searched eight different databases, in both English and Chinese, looking for randomized clinical trials comparing acupuncture with other treatments for mild cognitive impairment. To ensure reliable results, they used a technique called trial sequential analysis, which calculates whether the number of participants in the studies was sufficient to reach definitive conclusions. The researchers analyzed primarily improvements in global cognitive function, measured through standardized tests such as the Mini-Mental State Examination and the Montreal Cognitive Assessment.

They also evaluated memory and activities of daily living.

The analysis included 11 studies with 602 participants, all conducted in China. The results showed that acupuncture had significant positive effects on patients' global cognitive function. When compared with conventional medications or sham acupuncture, acupuncture demonstrated statistically meaningful improvements in cognitive test scores. The sequential analysis confirmed that the number of participants was sufficient to consider these results reliable.

In more detailed analyses, acupuncture proved superior both to conventional medications and to sham acupuncture. However, no significant differences were found between acupuncture and conventional medications for improvements in specific memory and daily activities, so more studies are needed to evaluate these aspects.

For patients and family members, these results suggest that acupuncture may be a valid therapeutic option for mild cognitive impairment, especially for improving global cognitive function. The technique proved at least as effective as conventional medications, with the advantage of generally fewer adverse effects. For health professionals, the study indicates that acupuncture can be considered as a complementary or alternative treatment, particularly for patients who do not respond well to medications or who prefer non-pharmacologic approaches. The acupuncture points most used in the studies were Baihui and Sishencong, with sessions generally daily for periods ranging from 28 to 180 days.

It is important to recognize the limitations of this research. The overall quality of the evidence was considered low to very low due to methodologic problems in the original studies, such as lack of detail on randomization and risk of bias. All studies were conducted only in China, which may limit the applicability of the results to other populations. In addition, no study followed patients after treatment ended to assess long-term effects.

Acupuncture techniques varied between studies, hindering standardization of treatment. Although the results are promising for global cognitive function, more high-quality research is still needed, with larger samples, more rigorous methodology, and prolonged follow-up to definitively confirm the efficacy of acupuncture in the treatment of mild cognitive impairment.