Acupressure on Cognitive Function and Quality of Life
Acupressure on Cognitive Function and Quality of Life
The study aims to (1)compare differences of global cognitive function, working memory,
 executive function, language function, and quality of life between institutionalized older
 adults with MCI and with mild AD. Doing so, we can have a better understanding of the
 cognitive performance and life quality at pre-dementia and dementia;(2)explore the effects of
 the interventions with different acupoints(acupoints on head, acupoints on body, and
 acupoints on head and body) on global cognitive function, working memory, executive function,
 language function, and quality of life among institutionalized older adults with MCI and with
 mild AD;(3) further investigate the long-term effects of the interventions on global
 cognitive function, working memory, executive function, language function, and quality of
 life among institutionalized older adults with MCI and with mild AD; doing this, we can
 explore the pathological mechanism of the changes in the cognitive function through
 neuropsychological assessments and the association between the changes in cognitive function
 and in quality of life. We will recruit 32 residential care homes, with 256 older adults with
 MCI and with mild AD for this single blind cluster randomized controlled trial with repeated
 measures study. The facilities will be randomly assigned to the acupoint-on-head group,
 acupoint-on-body group, acupoint-on-head-and-body group and control group, with a ratio of
 1:1:1:1. Interventions are developed based on the theory of Chinese medicine. Except routine
 care, the intervention groups will receive the acupressure once per day, five times per week,
 a total of 12 weeks. Data will be collected at baseline, the 4th and 8th weeks during the
 intervention, the end of the intervention, and the1st, 4th, and 8th months after the
 intervention. The control group only will receive routine care and data collection is the
 same as the intervention groups. Data assessors will not involve in the interventions and not
 know the group allocation. The data analysis will use intent-to-treat analysis. The multiple
 regression analysis, mixed effect model for repeated measure analysis, subgroup analysis, and
 product-of-coefficient test will be performed to examine the effects of the interventions on
 cognitive function and quality of life, and the associations among the changes in the
 dependent variables.
Although evidence has demonstrated that acupressure effectively improves older patients'
 symptoms (e.g., sleep disturbance, behavior and psychological symptoms of dementia, etc.), it
 is still lack of the study to investigate the effect of the acupressure on cognitive function
 and quality of life among older adults with cognitive impairment in long-term care settings
 and its long-term effects. In addition, according to statistical data for epidemiological
 investigation, the majority is people with mild cognitive impairment (MCI) and mild dementia
 (mild AD); hence, it is vital to prevent these two groups from having dementia or getting
 worse. The study aims to (1)compare differences of global cognitive function, working memory,
 executive function, language function, and quality of life between institutionalized older
 adults with MCI and with mild AD. Doing so, we can have a better understanding of the
 cognitive performance and life quality at pre-dementia and dementia;(2)explore the effects of
 the interventions with different acupoints(acupoints on head, acupoints on body, and
 acupoints on head and body) on global cognitive function, working memory, executive function,
 language function, and quality of life among institutionalized older adults with MCI and with
 mild AD;(3) further investigate the long-term effects of the interventions on global
 cognitive function, working memory, executive function, language function, and quality of
 life among institutionalized older adults with MCI and with mild AD; doing this, we can
 explore the pathological mechanism of the changes in the cognitive function through
 neuropsychological assessments and the association between the changes in cognitive function
 and in quality of life. This single blind cluster randomized controlled trial with repeated
 measures study will complete in 2 years. We will recruit 32 residential care homes in Taipei
 City, with 256 older adults with MCI and with mild AD. The facilities will be randomly
 assigned to the acupoint-on-head group, acupoint-on-body group, acupoint-on-head-and-body
 group and control group, with a ratio of 1:1:1:1. Interventions are developed based on the
 theory of Chinese medicine and the trained research assistants, also having traditional
 Chinese nursing training, will perform the interventions. Except routine care, the
 intervention groups will receive the acupressure once per day, five times per week, a total
 of 12 weeks. Data will be collected at baseline, the 4th and 8th weeks during the
 intervention, the end of the intervention, and the1st, 4th, and 8th months after the
 intervention. The control group only will receive routine care and data collection is the
 same as the intervention groups. Data assessors will not involve in the interventions and not
 know the group allocation. The data analysis will use intent-to-treat analysis. The multiple
 regression analysis, mixed effect model for repeated measure analysis, subgroup analysis, and
 product-of-coefficient test will be performed to examine the effects of the interventions on
 cognitive function and quality of life, and the associations among the changes in the
 dependent variables. This study will promote the professional nursing autonomy and improve
 life quality of the institutionalized older adults.
Inclusion Criteria:

 -  Mini-Mental State Examination (MMSE):20~28

 -  Clinical Dementia Rating (CDR): 0.5~1

 Exclusion Criteria:

 -  CDR>1