Abstract
BACKGROUND: The purpose of this study was to understand whether acupuncture can decrease the risk of dementia in patients with rheumatoid arthritis (RA). METHODS: Using the registry from the National Health Insurance Research Database of Taiwan, we carried out a 1:1 propensity-score matched cohort study to analyze patients with RA diagnosed between 2000 and 2010. The patients who received acupuncture therapy were grouped as acupuncture users (n = 9,919), while the others were grouped as non-acupuncture users (n = 19,331). After propensity-score matching, the final sample included 9,218 matched participants in both groups, and these participants were followed up until the end of 2011. We used a Cox regression model to adjust for age, sex, comorbidiy, and conventional drugs and compared the hazard ratios (HRs) of developing dementia in the acupuncture and non-acupuncture groups. RESULTS: Acupuncture users tended to be more female-dominant and younger than non-acupuncture users. After propensity-score matching, both groups have comparable demographic characteristics. Acupuncture users had a lower risk of dementia than non-acupuncture users (adjusted HR: 0.55, 95% CI: 0.46-0.66). The cumulative incidence of dementia in the acupuncture group was significantly lower than that in the non-acupuncture group (log-rank test, p < 0.001). Patients who received the combinational treatment of conventional drugs and acupuncture had a significantly lower risk of developing dementia (adjusted HR: 0.64, 95% CI: 0.56-0.73) compared to those who only received conventional drugs. CONCLUSION: Acupuncture therapy is associated with a reduced risk of dementia in patients with RA. Further clinical and mechanistic studies are needed.