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The Effect of Alternative Medicine on Quality-of-Life Outcomes for Dementia Patients: A Systematic Review and Meta-Analysis

정인철|조은|So Young Lee
대한한방신경정신과학회 (The Korean Society Of Oriental Neuropsychiatry)|2022.12|동의신경정신과학회지 (The Korean Society of Oriental Neuropsychiatry)|제33권 제4호|pp. 401-424|DOI 10.7231/jon.2022.33.4.401

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키워드

DementiaQuality of lifeSystematic reviewComplementary and alternative medicineMeta-analysis.
주제분류한의학

초록

Objectives: As effective treatments for dementia are lacking in Western medicine, complementary and alternative medicine (CAM) is considered a useful option. While the quality of life (QoL) is a vital outcome for patients with dementia, the QoL of patients receiving CAM for dementia remains ambiguous. This study aimed to determine the effect of CAM on QoL outcomes in dementia patients. Methods: A search was performed using the keywords “dementia,” “Alzheimer’s,” “cognitive impairment,” “Chinese,” “Korean,” “oriental,” “herbal,” “acupuncture,” and “quality of life”. All quantitative data were synthesized using R version 4.1.1. Results: Twenty-five randomized controlled trials (RCTs), 16 pre-post trials, and two cohort studies were selected for the systematic review. QoL in Alzheimer’s disease (QOL-AD) (n=11, 25.6%) and geriatric QoL in dementia (GQOL-D, n=9, 20.9%) were the most utilized QoL instruments. Significant benefits in QoL were observed after receiving mind, body, combined mind and body, nursing, oriental medicine, and acupuncture therapies. In the meta-analysis, the combined effect was shown to significantly increase QOL-AD compared to before CAM interventions (standardized mean difference, SMD: 0.507; 95% confidence interval (CI), 0.191∼0.824; p<0.01). The overall synthesized estimates in the GQOL-D showed a significantly improved QoL (SMD: 0.537, 95% CI: 0.238∼0.837 p<0.01; one group; SMD: 1.465, 95% CI: 0.934∼1.996, p<0.01). The seven studies assessing the cost-effectiveness of CAM reported uncertain outcomes. Conclusions: This study showed that CAM interventions benefited patients with dementia by improving their QoL. While additional standardized research is required, CAMs are suggested as effective clinical management for patients with dementia. They are also suggested as complementing therapies for these patients.

Abstract

Objectives: As effective treatments for dementia are lacking in Western medicine, complementary and alternative medicine (CAM) is considered a useful option. While the quality of life (QoL) is a vital outcome for patients with dementia, the QoL of patients receiving CAM for dementia remains ambiguous. This study aimed to determine the effect of CAM on QoL outcomes in dementia patients. Methods: A search was performed using the keywords “dementia,” “Alzheimer’s,” “cognitive impairment,” “Chinese,” “Korean,” “oriental,” “herbal,” “acupuncture,” and “quality of life”. All quantitative data were synthesized using R version 4.1.1. Results: Twenty-five randomized controlled trials (RCTs), 16 pre-post trials, and two cohort studies were selected for the systematic review. QoL in Alzheimer’s disease (QOL-AD) (n=11, 25.6%) and geriatric QoL in dementia (GQOL-D, n=9, 20.9%) were the most utilized QoL instruments. Significant benefits in QoL were observed after receiving mind, body, combined mind and body, nursing, oriental medicine, and acupuncture therapies. In the meta-analysis, the combined effect was shown to significantly increase QOL-AD compared to before CAM interventions (standardized mean difference, SMD: 0.507; 95% confidence interval (CI), 0.191∼0.824; p<0.01). The overall synthesized estimates in the GQOL-D showed a significantly improved QoL (SMD: 0.537, 95% CI: 0.238∼0.837 p<0.01; one group; SMD: 1.465, 95% CI: 0.934∼1.996, p<0.01). The seven studies assessing the cost-effectiveness of CAM reported uncertain outcomes. Conclusions: This study showed that CAM interventions benefited patients with dementia by improving their QoL. While additional standardized research is required, CAMs are suggested as effective clinical management for patients with dementia. They are also suggested as complementing therapies for these patients.

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