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Decreased Risk of Dementia Among Patients With Traumatic Brain Injury Receiving Acupuncture Treatment

A Population-Based Retrospective Cohort Study

Juan, Ying-Hsu, MD; Livneh, Hanoch, PhD; Huang, Hui-Jun, RN, BS; Lu, Ming-Chi, MD, PhD; Yeh, Chia-Chou, MD, PhD; Tsai, Tzung-Yi, PhD(C)

The Journal of Head Trauma Rehabilitation: February 27, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/HTR.0000000000000464
Original Article: PDF Only

Objective: We conducted a longitudinal cohort study comparing the effect of acupuncture on the risk of dementia in Taiwanese individuals with traumatic brain injury (TBI).

Design and Participants: A national health insurance database was used to identify 15 440 newly diagnosed TBI patients 20 to 70 years old between 1998 and 2007. Of the identified patients, 6308 received acupuncture following the onset of TBI (acupuncture users) and 9132 patients did not receive acupuncture (nonacupuncture users).

Measures: All enrollees were followed until the end of 2012 to record incident cases of dementia. A Cox proportional hazards regression model was used to compute adjusted hazard ratios for the relationship of acupuncture use with dementia.

Results: During the follow-up period, 249 acupuncture users and 810 nonacupuncture users developed dementia, corresponding to incidence rates of 6.11 and 9.64 per 1000 person-years, respectively. Use of acupuncture was significantly associated with a lower risk of dementia. Those who received more than 5 sessions of acupuncture benefited most from it.

Conclusions: Adding acupuncture to the clinical management of patients with TBI may benefit these patients by decreasing their risk of developing dementia.

Department of Chinese Medicine (Drs Juan and Yeh), Department of Nursing (Ms Huang), Division of Allergy, Immunology and Rheumatology (Dr Lu), and Department of Research (Dr Tsai), Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Dalin Township, Chiayi, Taiwan; Graduate Institute of Integrated Medicine, College of Chinese Medicine (Dr Juan), and School of Chinese Medicine (Dr Yeh), China Medical University, Taichung, Taiwan; Rehabilitation Counseling Program, Portland State University, Portland, Oregon (Dr Livneh); Schools of Medicine (Dr Lu) and Post-Baccalaureate Chinese Medicine (Dr Yeh), Tzu Chi University, Hualien, Taiwan; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan (Dr Tsai); and Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan (Dr Tsai).

Corresponding Author: Tzung-Yi Tsai, Department of Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, 2 Minsheng Rd, Dalin Township, Chiayi 62247, Taiwan ( or Chia-Chou Yeh, School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, 701 Jhongyang Road, Section 3, Hualien 97004, Taiwan (

Authors' contributions: Y. H. Juan, H. J. Huang, and H. Livneh contributed equally to this work. Y. H. Juan, H. J. Huang, and T. Y. Tsai aided in the study design and provided comments on the manuscript drafts. H. Livneh helped with the study design and drafted the manuscript. T. Y. Tsai and H. Livneh contributed to the data analysis and revised the manuscript. H. Livneh, H. J. Huang, and C. C. Yeh contributed to the interpretation of data and provided comments on the final draft of the manuscript. M. C. Lu and C. C. Yeh provided administrative support and comments on the manuscript drafts. T. Y. Tsai was responsible for the study conception, design, data analysis, and drafting of the work.

This study is based on data from the National Health Insurance Research Database, provided by the Bureau of National Health Insurance (Department of Health) and managed by the National Health Research Institutes. The interpretation and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health, or the National Health Research Institutes. This research was supported by Dalin Tzuchi Hospital (grant no. DTCRD103 (2)-E-05).

The authors declare no conflicts of interest.

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