The Effectiveness of Combined Acupuncture and Pharmacotherapy in Improving Cognitive Function in Alzheimer’s Disease

Abstract

Alzheimer’s Disease (AD) merupakan penyakit neurodegeneratif kronis dan progresif yang ditandai oleh penurunan fungsi kognitif dan memori. Walaupun farmakoterapi secara luas digunakan, manfaatnya terbatas karena efek samping. Akupunktur merupakan terapi adjuvan yang aman, namun bukti mengenai efikasi kombinasi terapi tersebut masih diragukan. Tujuan artikel ini menilai efektivitas kombinasi terapi akupunktur manual dengan donepezil dalam memperbaiki fungsi kognitif pada AD.: Seorang laki-laki berusia 70 tahun dengan penurunan fungsi kognitif progresif, skor MMSE 20/30 dan MoCA-Ina 19/30, telah mendapat donepezil 5 mg per hari selama tiga bulan, namun perbaikan fungsi kognitif masih terbatas. Apakah kombinasi akupunktur manual dan donepezil lebih efektif dibandingkan donepezil saja dalam memperbaiki fungsi kognitif pada pasien AD derajat ringan–sedang? Pencarian literatur dilakukan pada Pubmed, Cochrane, dan Scopus pada Maret 2025 menggunakan kerangka PICO. Seleksi artikel dan penilaian kritis dilakukan secara independen oleh dua penelaah menggunakan Covidence. Studi yang terinklusi meliputi empat systematic review/meta-analysis (SR/MA) dan satu randomized controlled trial (RCT). Pencarian dilakukan tanpa pembatasan periode publikasi. Lima artikel terinklusi (4 SR/MA dan 1 RCT) menunjukkan efektivitas kombinasi terapi yang lebih baik dibandingkan donepezil saja dalam memperbaiki skor Mini-Mental State Examination (MMSE) pada pasien Alzheimer. Namun, hanya tiga dari lima artikel yang melaporkan derajat keparahan penyakit secara jelas. Kombinasi akupunktur manual dan donepezil berpotensi memberikan manfaat tambahan terhadap fungsi kognitif pada pasien AD derajat ringan-sedang. 

The Effectiveness of Combined Acupuncture and Pharmacotherapy in Improving Cognitive Function in Alzheimer’s Disease

Abstract 

Alzheimer’s Disease (AD) is a chronic, progressive neurodegenerative disorder characterized by cognitive decline and memory loss. Although pharmacotherapy is widely used, its benefit is limited by adverse effects. Acupuncture has emerged as a safe adjuvant treatment, yet evidence regarding the efficacy of this combined therapeutic approach remains inconclusive. To evaluate the effectiveness of the combination of manual acupuncture with donepezil in improving cognitive function in AD. A 70-year-old man with progressive cognitive decline, a MMSE score of 20/30, and a MoCA-Ina score of 19/30 had been treated with donepezil 5 mg daily for three months, but cognitive improvement remained limited. Is the combination of manual acupuncture and donepezil more effective than donepezil alone in improving cognitive function in patients with mild-to-moderate Alzheimer’s disease (AD)? A literature search was conducted in PubMed, Cochrane, and Scopus in March 2025 using the PICO framework. Article selection and critical appraisal were performed independently by two reviewers using Covidence. The included studies consisted of four systematic reviews/meta-analyses (SR/MAs) and one randomized controlled trial (RCT). No publication date restrictions were applied. Five articles (4 SR/MA and 1 RCT) showed that combination therapy was more effective than donepezil alone in improving MMSE scores in Alzheimer patient. However, only three of the five studies clearly reported disease severity. The combination of manual acupuncture and donepezil may provide additional benefit for cognitive function in mild to moderate AD.