Background: Alzheimer’s disease is a progressive neurodegenerative disease. Numerous cases have illustrated that the acupuncture method could improve Alzheimer’s disease patients’ cognitive function and daily living ability. However, the optimal acupuncture treatments remain controversial. Therefore, we aimed to conduct a systematic review to compare the efficacy of multiple acupuncture therapies for Alzheimer’s disease and identify the optimal acupuncture intervention for delaying Alzheimer’s disease progression.
Methods: To select potentially concerned randomized controlled trials (RCTs), we searched four English databases, four Chinese databases, and additional sources from 1 May 2021. Two independent reviewers conducted study screening, data extraction, and methodological quality assessment. The primary outcome was global cognitive function improvement. Pairwise and Bayesian network meta-analyses were performed using STATA v15.0 and ADDIS v1.16.8. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to assess the quality of evidence.
Results: This study included 34 RCTs with 2,071 participants. Regarding global cognitive function improvement, the pairwise meta-analysis confirmed that electroacupuncture plus conventional medicine and manual acupuncture plus conventional medicine were statistically significantly different from conventional medicine, and electroacupuncture plus conventional medicine was ranked as the best combination in the network meta-analysis.
In terms of response rate, manual acupuncture outperformed conventional medicine statistically significantly; warm acupuncture was ranked as the best in the network meta-analysis. Regarding activity of daily living improvement, electroacupuncture plus conventional medicine, manual acupuncture plus conventional medicine, and fire acupuncture plus conventional medicine, manual acupuncture, and scalp acupuncture were statistically significantly different from conventional medicine, and electroacupuncture plus conventional medicine was ranked as the best combination in the network meta-analysis. However, the evidences were ranked as low to critically low.
Conclusions: Acupuncture, as a monotherapy or an adjuvant therapy, may have a beneficial effect on efficacy for Alzheimer’s disease. Electroacupuncture plus conventional medicine may be the optimal acupuncture therapy for Alzheimer’s disease and should be administered to Alzheimer’s disease patients. It may aid and support patient, operative, and societal decision-making.