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.