Acupuncture for vascular dementia

Zhao H, Weina P, Shi W, Zhishun L

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Summary

There is no evidence from randomized controlled trials to determine whether acupuncture provides any effect when treating people with vascular dementia

Acupuncture is used to treat vascular dementia, but because no randomized controlled trials of acupuncture versus placebo were found, its efficacy and safety could not be analysed in this review. There is a need for randomized placebo controlled trials of acupuncture for people with vascular dementia.

This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 3, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This record should be cited as: Zhao H, Weina P, Shi W, Zhishun L. Acupuncture for vascular dementia. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD004987. DOI: 10.1002/14651858.CD004987.pub2

This version first published online: April 18. 2007

Abstract

Background

Dementia is a widespread condition characterized by acquired global impairment of intellect, memory and personality, but with no impairment of consciousness. There is no definitive medical or surgical treatment for vascular dementia. Acupuncture is an ancient Chinese method which has been used for both the prevention and treatment of diseases for over three thousand years. Preliminary searches revealed more than 105 studies of acupuncture for treating vascular dementia. Benefit was reported in up to 70 to 91% of the treatment group. Body acupuncture and electroacupuncture were the most commonly used techniques. A comparison of electroacupuncture and acupuncture therapy alone suggested that the former was more effective in promoting the recovery of cognitive function.

Objectives

The objective is to assess the efficacy and possible adverse effects of acupuncture therapy for treating vascular dementia.

Search strategy

The trials were identified from a search of the Cochrane Dementia and Cognitive Improvement group's Specialized Register on 2 February 2007 which contains records from all major health care databases and many ongoing trials databases. In addition the Allied and Complementary Medicine Database was searched and the web was searched using the search engine Copernic.

Selection criteria

Randomized controlled trials testing acupuncture therapy in the treatment of vascular dementia were included regardless of language and publication types.
The intervention and control group had to receive identical treatment apart from the acupuncture intervention. In view of possible confounding, studies in which acupuncture was combined with other treatments were subjected to subgroup analyses.

Data collection and analysis

Titles and abstracts identified from the searches were checked by two reviewers. If it was clear that the study did not refer to a randomized controlled trial in vascular dementia, it was excluded. If it was not clear from the abstract and title, then the full text of study was obtained for an independent assessment by two reviewers.
The outcomes measured in clinical trials of dementia and cognitive impairment often arise from ordinal rating scales. Summary statistics were required for each rating scale at each assessment time for each treatment group in each trial for change from baseline.

Main results

In the absence of any suitable randomized placebo-controlled trials in this area, we were unable to perform a meta-analysis.

Authors' conclusions

The effectiveness of acupuncture for vascular dementia is uncertain. More evidence is required to show that vascular dementia can be treated effectively by acupuncture. There are no RCTs and high quality trials are few. Randomized double-blind placebo controlled trials are urgently needed.

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