Acupuncture is associated with reduced dementia risk in patients with insomnia: A propensity-score-matched cohort study of real-world data

Cheng-Hao Huang; Shun-Ku Lin; Mei-Chen Lin; Ching-Liang Hsieh

doi:10.1016/j.jtcme.2023.02.003

Acupuncture is associated with reduced dementia risk in patients with insomnia: A propensity-score-matched cohort study of real-world data

J Tradit Complement Med. 2023 Feb 21;13(3):297-305. doi: 10.1016/j.jtcme.2023.02.003. eCollection 2023 May.

Authors

Cheng-Hao Huang¹, Shun-Ku Lin^{2

3

4}, Mei-Chen Lin^{5

6}, Ching-Liang Hsieh^{1

7

8}

Affiliations

¹ Department of Chinese Medicine, China Medical University Hospital, Taichung City, 40447, Taiwan.
² Institute of Public Health, National Yang Ming Chiao Tung University, Taipei City, 112304, Taiwan.
³ Department of Chinese Medicine, Taipei City Hospital, Renai Branch, Taipei City, 106243, Taiwan.
⁴ General Education Center, University of Taipei, Taipei City, 111036, Taiwan.
⁵ Management Office for Health Data, China Medical University Hospital, Taichung, 40447, Taiwan.
⁶ College of Medicine, China Medical University, Taichung, 40402, Taiwan.
⁷ Chinese Medicine Research Center, China Medical University, Taichung City, 40402, Taiwan.
⁸ Graduate Institute of Acupuncture Science, China Medical University, Taichung City, 40402, Taiwan.

Abstract

Background and aim: Insomnia is a subjective illness that has been identified as a risk factor for dementia. In this study, we investigated the association of acupuncture treatment for insomnia with the risk of dementia. We collected data from the National Health Insurance Research Database (NHIRD) of Taiwan to analyze the incidence of dementia in patients with insomnia who received acupuncture treatment.

Experimental procedure: This retrospective matched-cohort study included 152,585 patients, selected from the NHIRD, who were newly diagnosed with insomnia between 2000 and 2010. The follow-up period ranged from the index date to the date of dementia diagnosis, date of withdrawal from the insurance program, or December 31, 2013. A 1:1 propensity score method was used to match an equal number of patients (N = 18,782) in the acupuncture and non-acupuncture cohorts. We employed Cox proportional hazards models to evaluate the risk of dementia. The cumulative incidence of dementia in both cohorts was estimated using the Kaplan-Meier method, and the difference between them was assessed through a log-rank test.

Results and conclusion: Patients with insomnia who received acupuncture treatment were observed to have a lower risk of dementia (adjusted hazard ratio = 0.54, 95% confidence interval = 0.50-0.60) than those who did not undergo acupuncture treatment. The cumulative incidence of dementia was significantly lower in the acupuncture cohort than in the non-acupuncture cohort (log-rank test, p < 0.001). The results suggest that acupuncture treatment significantly reduced or slowed the development of dementia in patients with insomnia.

Keywords: Acupuncture; Cohort; Dementia; Insomnia; National health insurance research database (NHIRD); Propensity score.