Application of auricular therapy on individuals with cognitive impairment and dementia: A systematic review and meta-analysis

Background: Auricular point acupressure (APA) has been used to treat cancer-related pain, chronic lower back pain, headache, and dysmenorrhea and to improve anxiety and sleep quality. However, its application in populations with cognitive impairment and dementia is understudied. This systematic review and meta-analysis aim to summarize APA implementation in these populations, evaluate its effects on cognitive function and Activities of Daily Living (ADLs), provide evidence-based conclusions, and guide future research directions. Methods: We followed the PRISMA guideline to comprehensively search seven electronic English and Chinese databases (PubMed, CINHAL, Scopus, Google Scholar, NCKI, Weipu, and Wangfang). Our search strategy utilized a combination of relevant keywords and MeSH terms related to the topic of interest. Two independent investigators screened the titles and abstracts of the retrieved articles, followed by full-text screening to identify eligible studies. Discussion and consultation with a third investigator resolved disagreements. We used a standardized form for data extraction, including study characteristics, intervention details, outcomes, and risk of bias assessment. The Mixed Methods Appraisal Tool evaluated the quality of evidence. Narrative synthesis and meta-analysis conducted data synthesis. Results: Key findings include: (1) there is a universal APA treatment procedure, (2) most studies that used APA with an adjunct treatment showed positive results, (3) meta-analyses revealed significant improvements with APA treatment: MMSE scores (13 RCTs; SMD = 0.55, 95 % CI: 0.13–0.97) and MoCA scores (10 RCTs; SMD = −1.03, 95 % CI: −1.79 to −0.28). The high heterogeneity (I² = 88 % for MMSE and 89.6 % for MoCA) indicates substantial variability between studies in the magnitude of treatment effects, which may be attributed to differences in study populations, intervention protocols, and treatment durations across the included trials. While analysis of ADLs (4 RCTs) showed no significant between group differences (SMD = 0.95, 95 % CI: −1.27 to 3.16). Conclusion: Our meta-analysis results demonstrate significant improvements in cognitive function with APA intervention, suggesting its potential as an effective nonpharmacological therapeutic approach in clinical practice. These findings emphasize the importance of studying APA's benefits for patients with cognitive impairment and dementia, opening new avenues for research. Healthcare professionals can leverage this understanding to provide patient-centered care, tailor treatments effectively, and enhance patient participation in their healing process.