Acupuncture Therapy for Cognitive Impairment: A Delphi Expert Consensus Survey

Abstract

BackgroundCurrent research evidence challenges clinical decision-making when acupuncture is taken into consideration in the treatment of cognitive impairment (CI). Aiming to provide some viable recommendations for acupuncture practitioners in dealing with actual clinic issues, an expert consensus study was conducted.MethodsA clinical question investigation among 47 acupuncturists yielded 24 initial items. Subsequently, systematic reviews on acupuncture for CI were searched within three online databases. A panel of 30 authoritative experts were requested to respond with agreement, neutrality, or disagreement for each item. Consensus establishment was defined as the percentage of agreement on a given item >80%.ResultsFollowing a 2-round Delphi survey, there were 21 items reaching consensus and three items resulting in no consensus; of which 10 items reached 90∼100% agreement, and 80∼90% expert agreement was achieved for 11 items. These items could be roughly categorized into six domains: (1) therapeutic effects of acupuncture, (2) therapeutic principles, (3) acupoint selection and combination, (4) acupuncture parameters, (5) considerable combined therapies, and (6) possible adverse events.ConclusionWithout ready-made guidelines, this expert consensus may be conducive to guide acupuncturists in implementing clinical acupuncture practice for CI. Moreover, given the lack of high-quality research evidence and plenty of unresolved clinical issues in this field, it is of necessity to carry out more studies to better clarify the treatment algorithm.

Effectiveness and Safety of Acupuncture for Vascular Cognitive Impairment: A Systematic Review and Meta-Analysis

“…is highly consistent with the TCM theory. In addition, flexible formulas according to different phases, TCM syndromes, and personal characteristics, namely tailored diagnosis and treatment, were allied in 18 trials, which are kept in line with the recommendation from our expert consensus survey (Su et al, 2020a). Given that VCI is a progressive geriatric disease, most researchers preferred a longer retention time, more frequent sessions, and a longer therapeutic course to ensure adequate acupuncture stimulation.…”

“…Additionally, many medical societies show a rising interest in how non-pharmacological interventions could help patients with dementia to maintain daily functional independence (Yao S. et al, 2020). Physical approaches such as acupuncture seem to be desirable for patients with cognitive disorders, especially for those who ask for long-term treatment (Su et al, 2020a). According to the clinical evidence, acupuncture is a relatively resource-intensive intervention, which is particularly suitable for chronic diseases (Lothgren and Zethraeus, 2000;Raftery, 2001;Wonderling et al, 2004).…”

“…There are many categories of acupuncture approaches such as manual acupuncture (MA), electroacupuncture (EA), and scalp acupuncture (SA), which have turned out to be relatively less expensive with few adverse effects (Witt et al, 2009). As a non-pharmacological intervention with the intention to make patients recover to the postulated equilibrium state prior to illness (Endres et al, 2007), acupuncture has already been extensively used for VCI in plenty of Chinese medical institutions (Peng et al, 2007;Su et al, 2020a). A considerable number of emerging clinical trials demonstrated that acupuncture can serve as a promising treatment in improving the global cognitive status of patients with VCI (Chen et al, 2016(Chen et al, , 2020Yang et al, 2019).…”

Personalized treatment interventions: nonpharmacological and natural treatment strategies in Alzheimer’s disease

“…However, acupuncture treatment carries several limitations. It is a sophisticated treatment, with different acupoint selections, session duration, and frequency, so current protocols for cognitively impaired patients need standardization and optimization given that current research evidence is relatively insufficient to establish clinical guidelines [76]. Acupuncture may also produce focal adverse events, such as subcutaneous hematoma, numbness, and in some studies, intolerable pain in elderly patients with MCI [77].…”

Clinical Effect of Electroacupuncture on Acute Sleep Deprivation and Event-Related Potential Affecting the Inhibition Control of the Brain: Study Protocol for a Randomized Controlled Trial

“…Compared with the central nervous system stimulant caffeine, acupuncture is a safe alternative therapy with minimal side effects (17). A Delphi expert consensus survey (18) shows that more than 80% of experts agree that acupuncture can be used to improve cognitive function, which has been underpinned by the results of previous studies (19,20). Although acupuncture has been studied for a long time, there is still a lack of knowledge of the effects of acupuncture on the human brain.…”