OBJECTIVES

: Vascular Dementia (VaD) after stroke is a common disease among younger patients. Acupuncture is an alternative therapy for VaD. However, population-based studies evaluating whether acupuncture added to western medicine could improve health outcomes of VaD are scarce. The aim of this study is to examine the effectiveness of adjuvant acupuncture therapy, compared to regular care, on VaD patients in Taiwan.

METHODS

: This was a retrospective cohort study. Stroke patients were identified from the Stroke Registry Data during 2006 to 2009. Patients were linked to the National Health Insurance claims data to identify the VaD after stroke. Patients who were under 20 years old, had been diagnosed as dementia or Alzheimer’s disease before stroke, died in 3 months after stroke were excluded. Primary end point of the study included improvement of daily activity (mRS and the BI) in 3 months and 6 months after VaD. The secondary end point of the study included dementia-related complications (including pneumonia, fall, re-stroke and mortality) and medical utilization in 1-year after VaD. Multivariate mixed model, Cox proportional hazards regression and generalized estimating equation were used to estimate the difference between treatments.

RESULTS

: Total 522 patients diagnosed as VaD in 3 months after stoke and the incidence rate was 1.7%. Compared to regular care group, adjuvant acupuncture therapy group had significant lower risk of pneumonia (HR=0.69, p< 0.01) and death (HR=0.34, p< 0.01) in 1 year after VaD. Both groups of patients had improved daily activity, but the difference between groups were not significant; the difference of medical utilization were also not significant between these two group.

CONCLUSIONS

: VaD patients received adjuvant acupuncture therapy had lower risk of complications while using similar medical utilization; therefore, adjuvant acupuncture therapy could be considered as one of alternative for treating VaD patients whenever available.