Acupuncture for vascular dementia: Cochrane systematic review
Assessed as up to date: 2011/04/27
Dementia is a widespread condition characterized by acquired global impairment of intellect, memory and personality, but without impairment of consciousness. There is no definitive treatment for vascular dementia. Acupuncture is an ancient Chinese method that has been used for the prevention and treatment of diseases over three-thousand years. Many kinds of acupuncture methods such as body acupuncture, scalp acupuncture and electroacupuncture are in use for the treatment of vascular dementia in hospitals in China. Body acupuncture and electroacupuncture are the most commonly used.Objectives
To assess the efficacy and possible adverse effects of acupuncture therapy for treating vascular dementia.Search methods
We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group Specialized Register, on 24 January 2011 using the terms and tags created for records of studies in dementia using acupuncture. ALOIS contains records of clinical trials identified from monthly searches of a number of major healthcare databases, numerous trial registries and grey literature sources.
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 (RCTs) testing acupuncture therapy in the treatment of vascular dementia were eligible for inclusion, regardless of language and publication type. Studies with inadequate randomisation were excluded.
Studies were excluded if participants were receiving any treatment for their vascular dementia other than the acupuncture intervention or control treatment.Data collection and analysis
Studies were selected for inclusion and data were extracted by two review authors working independently.
Comparisons were made between patients treated with acupuncture and controls, on an intention-to-treat basis where possible. If possible, data from different trials were pooled and overall estimates of the treatment difference were calculated. Weighted or standardised mean differences or odds ratios were used, as appropriate.
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.
Peng Weina, Wang Yang, Zhang Yan, Liang Cui Mei
Acupuncture to treat vascular dementia
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.
Implications for practice
There is currently no evidence available from sufficiently high quality randomized controlled trials (RCTs) to allow assessment of the efficacy of acupuncture in the treatment of vascular dementia.
Implications for research
Although acupuncture is widely used to treat vascular dementia in China, and many relevant clinical studies were completed and published, true RCTs and high quality trials are non-existent. Randomised double-blind controlled trials are urgently needed. It is important to design trials with placebo and no intervention as control interventions in acupuncture clinical trials.
Outcome measures that include cognition, behaviour, quality of life, activities of daily living and mood outcomes should be evaluated. Adverse events should be critically assessed by standardized monitoring and more attention should be paid to the possible long-term adverse effects of acupuncture.
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