Acupressure Improves Cognition and Quality of Life Among Older Adults With Cognitive Disorders in Long-Term Care Settings: A Clustered Randomized Controlled Trial

Author: Yen-Kuang Lin1, Hsien-Yin Liao2, Karen Watson3, Tzu-Pei Yeh4, I-Hui Chen5
Affiliation: <sup>1</sup> Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan. <sup>2</sup> College of Chinese Medicine, School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan; Department of Acupuncture, China Medical University Hospital, Taichung, Taiwan. <sup>3</sup> Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia. <sup>4</sup> School of Nursing, China Medical University, Taichung, Taiwan; Department of Nursing, China Medical University Hospital, Taichung, Taiwan. <sup>5</sup> School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wang Fang Hospital, Taipei Medical University, Taipei, Taiwan. Electronic address: ichen4@tmu.edu.tw.
Conference/Journal: J Am Med Dir Assoc
Date published: 2023 Mar 15
Other: Special Notes: doi: 10.1016/j.jamda.2023.02.011. , Word Count: 295


Objective:
To examine the effectiveness of acupressure on cognition and quality of life (QoL) among older adults with cognitive disorders residing in long-term care (LTC) settings.

Design:
A clustered, randomized, assessor-blinded, controlled trial with a repeated measures design.

Setting and participants:
Participants were recruited from residential care facilities in Taiwan from August 2020 to February 2021. Ninety-two older residents in 18 facilities were randomized to either the intervention arm (9 facilities, n = 46) or the control arm (9 facilities, n = 46).

Methods:
Acupressure was performed at Baihui (GV20), Sishencong (EX-HN1), Shenting (GV24), Fengchi (GB20), Shuigou (GV26), Neiguan (PC6), Shenmen (HT7), and Zusanli (ST36). The duration for pressing each acupoint was 3 minutes. The acupressure force was maintained at 3 kg. Acupressure was performed once a day 5 times a week for 12 weeks. The primary outcome measure was the Cognitive Abilities Screening Instrument (CASI). Secondary outcomes included the digit span backward test, the Wisconsin Card Sorting Test (perseverative responses, perseverative errors, and categories completed), semantic fluency tests of categories of animals, fruits, and vegetables, and the Quality of Life-Alzheimer's Disease (QoL-AD). Data were collected at preintervention and postintervention. Three-level mixed effects models were performed. This study complied with the CONSORT checklist.

Results:
After adjusting for covariates, there was a significant increase in CASI scores, the digit span backward test, perseverative responses, perseverative errors, categories completed, semantic fluency tests of categories, and QoL-AD scores in the intervention versus control arm at 3 months.

Conclusions and implications:
This study provides support for the use of acupressure to improve cognition and QoL during care among older residents with cognitive disorders in LTC settings. Acupressure can be integrated into aged care practice to improve cognition and QoL of older residents with cognitive disorders in LTC settings.

Keywords: Cognitive disorders; acupressure; long-term care; older adults; quality of life.

PMID: 36933568 DOI: 10.1016/j.jamda.2023.02.011