The course of cognitive functions in geriatric patients with musculoskeletal pain receiving acupuncture therapy

During the aging process, degenerative changes occur in the musculoskeletal system. Hence, this could cause chronic pain. Chronic pain is related to many geriatric conditions, such as decline in the cognitive functions, behavioral problems, depression, decline in the functional capacity and polypharmacy. Acupuncture could be considered for treating older patients with chronic musculoskeletal pain as an integrative therapy method. In our study, we evaluated the effect of acupuncture on the pain level, cognitive function, behavioral disturbances, depression, activities of daily living, instrumental activities of daily living in geriatric patients with chronic musculoskeletal pain. Material and Methods: We performed the study at Ankara Yıldırım Beyazıt University Ankara Atatürk Teaching and Research Hospital geriatrics outpatient clinic between October 2017 and October 2018. Comprehensive geriatric assessment was performed to patients who admitted to the geriatrics outpatient clinic and eligible patients for this research were recruited into the study according to their willingness. Results: Twenty-three geriatric patients whose musculoskeletal pain was treated with acupuncture were included in the study. 78.3% of them were female and 21.7% were male patients. Mean age of the patients were 73.39±6.47 and mean number of the acupuncture sessions were 9.48±1.95. Mean Visual Analogue Scale (VAS) score before treatment was 7.65±1.82 which decreased significantly to 4.36±2.24 after treatment (p<0.001). Mini Mental State Examination (MMSE) mean score before treatment was 23.26±5.50 and increased significantly after treatment reaching 25.45±3.98 (p<0.001). Geriatric Depression Scale mean score was 11.65±8.83 pretreatment which reduced significantly to 8.45±6.83 afterward (p<0.001). Cohen Mansfield Agitation Inventory (CMAI) mean score before treatment was 40.87±10.21 which decreased significantly to 35.86±8.45 after treatment (p<0.001). !vii Activities of Daily Living (ADL) mean score before treatment was 5.35±0.71 and significantly increased to 5.77±0.43 afterward (p=0.002). Instrumental Activites of Daily Living (IADL) mean score before treatment was 6.70±2.08 which did not change significantly and was 6.73±2.07 after treatment (p=0.317). Conclusion: Pain, agitation, depression, cognitive function and functional capacity are intertwined geriatric conditions which must be evaluated in together. Using acupuncture as an analgesic method for geriatric patients with chronic musculoskeletal pain, could have a positive impact on cognitive functions and on behavioral problems which are due to decrease in cognitive functions. Activities of Daily Living may improve in older patients due to the acupuncture's positive effect on the urinary incontinence. 10 sessions of acupuncture to reduce chronic musculoskeletal pain did not make a difference on the Instrumental Activities of Daily Living. To specify acupuncture's effect on cognitive function, depression, behavioral problems, agitation, ADL and IAD long-term randomized controlled studies including more number of participants should be designed. Keywords: Cognitive functions, acupuncture, chronic pain.