Acupoint Therapy for Enhancing Cognitive Function in Patients with Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

Abstract

Introduction:

Mild cognitive impairment (MCI) signifies a transitional phase between normal aging and dementia. As the disease progresses, MCI patients face considerable challenges due to the deterioration in cognitive function, activities of daily living (ADL), and neuropsychiatric symptoms. This study aims to evaluate the evidence regarding the application of acupoint therapy in individuals with MCI based on randomized controlled trials (RCTs).

Methods:

Six databases were searched to September 25, 2025, for RCTs comparing acupoint therapy (alone or combined with nonpharmacological treatments) with health education, blank or waiting groups, sham interventions, and standard treatments (nonpharmacological treatments or oral medications). Outcomes included Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Data on ADL scale, relevant biomarkers, and safety data were extracted where available. After the process of literature review and data collection, risk of bias was assessed with the Cochrane Risk of Bias 2.0. Meta-analyses were performed employing the Review Manager (version 5.4.1).

Results:

Twenty-four trials comprising 2005 patients were analyzed. Acupoint therapy improved the overall cognitive function of MCI patients (MoCA: mean difference [MD] = 1.47, 95% confidence interval [CI]: [0.95, 1.99], p < 0.00001; MMSE: MD = 1.44, 95% CI: [1.03, 1.86], p < 0.00001). MoCA and MMSE scores after acupoint therapy were significantly higher than those of health education control (MoCA: MD = 2.63, 95% CI: [1.19, 4.07], p = 0.0003; MMSE: MD = 2.83, 95% CI: [2.14, 3.51], p < 0.00001), sham control (MoCA: MD = 0.94, 95% CI: [0.18, 1.69], p = 0.01; MMSE: MD = 1.29, 95% CI: [0.51, 2.08], p = 0.001), standard nonpharmacological control (MoCA: MD = 1.42, 95% CI: [0.81, 2.03], p < 0.00001; MMSE: MD = 1.09, 95% CI: [0.79, 1.40], p < 0.00001), and oral-medication control (MoCA: MD = 0.52, 95% CI: [0.06, 0.98], p = 0.03; MMSE: MD = 0.91, 95% CI: [0.22, 1.61], p = 0.01), but no difference versus blank control (MoCA: MD = −1.10, 95% CI: [−4.58, 2.38], p = 0.54; MMSE: MD = 1.80, 95% CI: [−0.92, 4.52], p = 0.20). Auricular acupressure improved ADL scores. Biomarker changes remained nonsignificant. Only nine studies reported safety events with heterogeneous definitions, leaving the risk–benefit ratio unclear.

Conclusion:

Acupoint therapy is beneficial for cognitive function in MCI patients. Additional high-quality research is needed to provide a reliable basis for the management of MCI through acupoint therapy.