This excerpt from the British Acupuncture Council:  About 80% of people with dementia will have behavioural changes or psychological symptoms at some time (Overshott 2005), which can reduce quality of life for both patients and carers, and often result in transfer to residential care and higher costs(Finkel 2000; O’Donnell 1992; Lawlor 2002; Donaldson 1997). The symptoms can include anxiety, depressed mood, psychotic symptoms, and behavioural symptoms such as aggression, agitation, wandering, sexual disinhibition, and screaming and swearing(Finkel 1997). Psychotic symptoms such as delusions and hallucinations occur in 30–50% of all patients with dementia(Jeste 2000), and in about 80% of patients with dementia with Lewy bodies(McKeith 2006).

How acupuncture can help

What is the evidence for acupuncture in dementia. One systematic review found that the evidence available for acupuncture does not demonstrate effectiveness in Alzheimer’s disease (Lee 2009),although only three randomised controlled trials (RCTs) were located for this. By contrast, a review for dementia in general found 22 RCTs, which demonstrated a significant positive advantage for acupuncture over control groups (Gu 2008). Since most of the trials were for vascular dementia, it’s notable that a Cochrane review one year earlier had found no suitable RCTs at all for this condition (Peng 2007)

There have been several randomised controlled trials published since these systematic reviews, all with promising results. All are for vascular dementia (not Alzheimers) and all are from China. All of them compared acupuncture to medication; two also used a combined acupuncture plus medication group. In five trials, acupuncture was significantly better than medication (Zhang 2011, Chen 2011, Wang 2010, Zhang 2008, Liu 2008b) and in three it was similar in effect (Zhao 2009, Chen 2009, Liu 2008a). Various different acupuncture treatment modalities were used: manual needling (Zhang 2011, Liu 2008a), electroacupuncture (Zhao 2009, Zhang 2008, Liu 2008b), moxibustion (Chen 2011, Wang 2010) and ear taping/pressing (Chen 2009). Most studies used recognised outcomes measures relevant to dementia and some also investigated possible biochemical mechanisms.

Despite this, there is certainly a need for larger, better quality trials, preferably from a wider range of countries.

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