TCM-NPIs show cognitive score improvements in MCI patients in network meta-analysis
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Key Takeaway
Consider TCM-NPIs for cognitive scores in MCI, but evidence is observational with limitations.
This systematic review and network meta-analysis evaluated the effects of traditional Chinese medicine non-pharmacological interventions (TCM-NPIs) on cognitive outcomes in patients with mild cognitive impairment (MCI). The analysis included 4,895 MCI patients, assessing interventions such as physical and mental exercise, massage, acupoint catgut embedding (ACE), transcutaneous electrical acupoint stimulation (TEAS), and moxibustion, compared to unspecified comparators. Primary outcomes were MMSE and MoCA scores, with MBE ranking top for MMSE improvement (mean difference=2.18, 95% credible interval: 0.86 to 3.55) and TEAS ranking top for MoCA improvement (mean difference=3.31, 95% credible interval: 1.87 to 4.75). Other interventions like TN and ACE also showed top rankings, but effect sizes were not reported for these.
Safety and tolerability data, including adverse events, serious adverse events, and discontinuations, were not reported in the study. Key limitations include that intervention duration and the MCI population did not have a significant impact on cognitive outcomes, and the method of moxibustion had a moderating effect on MMSE scores. Additionally, the analysis does not distinguish between association and causation or between surrogate and clinical outcomes, which may affect interpretation.
In terms of practice relevance, the review suggests no clear optimal plan yet for TCM-NPIs in clinical practice for MCI. Clinicians should interpret these findings cautiously, as the evidence is based on observational data with incomplete safety profiles and methodological constraints. Further research is needed to establish causal effects and clinical applicability.
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View Original Abstract ↓
With the intensification of population aging, the incidence of mild cognitive impairment (MCI) continues to rise, and the risk of developing dementia is high, making it a global public health challenge. Traditional Chinese medicine non-pharmaceutical interventions (TCM-NPIs) is an important means of treating MCI. However, in clinical practice, there are various therapies, and there is no clear optimal plan yet. This study aims to evaluate the intervention effects of different TCM-NPIs on the cognitive function of MCI patients through network meta-analysis (NMA) and rank their effectiveness.
The system retrieved randomized controlled trials (RCTs) related to TCM-NPIs in the treatment of MCI from 7 databases, with the search time frame from database inception to December 26, 2025. Bayesian NMA was performed on the included articles using R 4.4.3 software.
A total of 76 RCTs were included, involving 4,895 MCI patients and 9 types of TCM-NPIs. The NMA results showed that in terms of improving the Mini-Mental State Examination (MMSE) score effect, physical and mental exercise (MBE), massage (TN), and acupoint catgut embedding (ACE) ranked the top three. Among them, MBE (MD = 2.18, 95% CrI: 0.86 to 3.55) had the best effect, with a SUCRA of 82.56%. Regarding improvements in Montreal Cognitive Assessment (MoCA) scores, TEAS, TN, and ACE ranked in the top three, with TEAS (MD = 3.31, 95% CrI: 1.87 to 4.75) showing the best effect and a SUCRA of 88.16%. Subgroup analysis and meta-regression indicated that intervention duration and the MCI population did not have a significant impact on cognitive outcomes. In the analysis of internal difference characteristics of intervention measures, the method of moxibustion had a moderating effect on MMSE scores (p
Existing evidence suggests that different types of TCM-NPIs have varying therapeutic effects in improving cognitive function. Among them, MBE shows the most significant in the improvement of MMSE scores, and TEAS has the best effect in the improvement of MoCA scores.
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251248307, PROSPERO registration number: CRD420251248307.
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