Most people would not consider acupuncture as a possible preventive measure against dementia but this is the finding from a recent Taiwanese research study. They looked at the probability of developing dementia in the years after surviving a stroke. Dementia commonly occurs after a stroke and as well as the effects of this on independent living it also makes another stroke more likely. There has been a substantial amount of research on acupuncture and dementia in China but mainly to investigate possible physiological mechanisms.
This Taiwanese study made use of the fact that very large amounts of data from their National Health Insurance programme (affecting 99% of the population) are available for research purposes. The database records include patient demographics, diagnoses, treatments and expenditures. The researchers identified 226,699 new stroke survivors aged over 50 years in the period 2000-2004. Of these, 5610 had received acupuncture. A control group was formed by selecting non-acupuncture stroke survivors, matched one to one so that their baseline characteristics were almost identical to the acupuncture users (this sort of research is called a retrospective matched cohort study). Each group was analysed up to the end of 2009, and the number of dementia cases diagnosed during that time was recorded.
The acupuncture patients had a lower incidence of newly diagnosed dementia: 26.5 vs 34.6 per 1000 person-years, a significant difference. Acupuncture also appeared to be more effective than standard physical rehabilitation, but combining both treatments was the best option, as shown in the table.
|Treatment||Dementia incidence per 1000 person-years|
|No acu, no rehab||35.9|
|Both acu & rehab||25.0|
This benefit did not hold for the sub-group of patients with haemorrhagic stroke (bleeding from the brain, rather than the more common ischaemic type, where the blood supply gets blocked) but these only made up 8% of the total.
Imaging studies have shown that acupuncture has a stabilising effect on activity in the brain but the evidence that this leads to clinical improvement for neurological conditions like MS, Parkinson’s Disease, stroke and dementia is thin on the ground. Although it has its limitations this present study has the enormous advantages of a large sample size and relevance to the whole population. As such it is an important addition to our knowledge on the possible benefits of acupuncture for stroke and dementia.