Question: In older adults in mental health services, how effective is acupuncture compared to any other treatment in achieving improved participant outcomes?

Answer:

One high quality Cochrane systematic review provided evidence to inform this summary. It should be noted, however, that all of the information included in this summary was derived from trials which did not meet the inclusion criteria of the review. Fifteen of the 35 studies identified and excluded from the Cochrane review reported comparative data for acupuncture alone versus control or another intervention; these studies were deemed to have potential applicability to this evidence summary. Data from these studies indicated that acupuncture had no significant beneficial effects when compared to a control condition not intended to treat dementia (calcium channel blocker or low molecular weight dextran). Other included studies compared acupuncture to huperzine, piracetam or aniracetam, duxil, or hydergine. All comparisons (active and control) indicated that acupuncture may be associated with increased depressive symptoms (Hamilton Depresssion Scale). Comparisons with huperzine and hydergine indicated that acupuncture may be associated with increased cognition (Mini Mental State examination) or decrease in dementia symptoms (Blessed Dementia Scale). Overall, review authors' conclusion, that the evidence is currently inadequate to support the effectiveness of acupuncture for the treatment of vascular dementia, is likely to be reliable.

No studies were identified which assessed the effectiveness of acupuncture for the treatment of any condition other than vascular dementia in older adults in mental health services.

A significant number of non-English studies (11 Chinese studies) were excluded from this evidence summary, due to limited resources. The included systematic review (1), does consider non-English studies. There are published Cochrane Systematic Reviews that consider the evidence for use of

acupuncture with depression and schizophrenia. These reviews also included non-English language studies, however, none reported evidence on the use of the intervention in older adults.

As noted by the authors of the Cochrane review, high quality, randomised, double-blind, placebo-controlled trials are needed to properly assess the efficacy of acupuncture for the treatment of vascular dementia. Trials are also needed to assess the efficacy of acupuncture in other populations of older adults in mental health services.