Abstract
BACKGROUND: Alzheimer’s Disease (AD) is a neurodegenerative disease characterized by the gradual weakening of cognitive function. Patients with mild to moderate AD often present with impaired attention allocation and executive function, significantly affecting daily life. Current pharmacological treatments, mainly cholinesterase inhibitors, provide limited benefits and may cause gastrointestinal side effects. Currently, traditional Chinese medicine (TCM) interventions based on neuroprotection and anti-inflammatory mechanisms have gained attention. Evidence suggests that early intervention before clinical symptom manifestation can delay disease progression, similar to the predictive role of early neurophysiological abnormalities in psychotic risk syndromes such as P300 amplitude reduction. Therefore, this study conducted experimental verification to investigate the cognitive improvement and potential disease-delaying effects of TCM intervention in cases with mild to moderate AD. METHODS: The 180 patients who met the diagnostic criteria for mild to moderate AD were included and then randomly separated into an experimental group (EG, n = 90) and a control group (CG). The EG received a compound TCM preparation containing Gastrodia elata, Salvia miltiorrhiza, Polygala tenuifolia, and Acorus tatarinowii, administered twice daily for 24 consecutive weeks; the CG received standard Western pharmacotherapy. Both groups were provided with health education and routine rehabilitation training. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used to assess cognitive function before and after the intervention, and record behavioral abnormalities and changes in living abilities. Repeated measures ANOVA was taken for statistical comparison (p<.05 considered significant). RESULTS: After the intervention, the MMSE score in the EG increased from 20.4 ± 2.1 to 24.1 ± 2.3 (approx. 18.1% improvement), significantly outperforming the CG score of 21.8 ± 2.5 (approx. 6.4% improvement, p=.004). The MoCA score in the EG increased from 18.6 ± 2.4 to 22.7 ± 2.8 (approx. 22.0% improvement), higher than the CG score of 19.9 ± 2.7 (approx. 7.4% increase, p=.006). The incidence of emotional fluctuation decreased from 36.7% to 18.9% (approx. 48.5% reduction) in the EG, notably better than the reduction from 35.6% to 29.4% (approx. 17.4%, p=.01) observed in the CG. Additionally, the rate of decline in daily living function over six months was approximately 31.2% slower in the EG compared to the CG, indicating that TCM intervention may help delay functional deterioration. DISCUSSION: Findings demonstrate that compound TCM intervention improves cognitive abilities in patients with mild to moderate AD, with statistically significant benefits. It also shows advantages in emotional stabilization and maintaining daily functional capacity. Similar to mechanisms observed in mental health research where early neurophysiological indicators can predict clinical outcomes, TCM may exert effects through modulation of neurotransmitter metabolism, enhancement of cerebral microcirculation, and inhibition of neuroinflammation. Moreover, the results suggest that early intervention is valuable in slowing cognitive decline. Future research may incorporate neuroimaging and longitudinal follow-up to further validate the modulation of brain network plasticity by TCM, and explore combined approaches with cognitive training or neuromodulation techniques to reinforce the clinical value of TCM in AD treatment.