Acupuncture is associated with lower accidental injury risk among patients with Parkinson's disease: a nationwide retrospective cohort study.

BACKGROUND

Patients with Parkinson's disease (PD) have a high risk of accidental injuries because motor and non-motor symptoms can impair gait, balance, cognition, and autonomic function. Acupuncture has been reported to improve gait and balance, but its association with long-term injury prevention in PD remains unclear.

METHODS

We conducted a nationwide retrospective cohort study using Taiwan's National Health Insurance Research Database. Patients newly diagnosed with PD between 2001 and 2012 were followed through 2018. Propensity score matching (PSM) was used to improve comparability between patients who received acupuncture and those who did not. The PSM cohort was designated as the primary analysis, and a multivariable analysis of the full cohort was supportive. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).

RESULTS

Among 24,467 patients with PD, 7,830 (32.0%) received acupuncture. Accidental injuries occurred in 15.2% of patients in the acupuncture group and 17.1% of patients in the non-acupuncture group. In the primary PSM analysis, acupuncture was associated with a lower risk of hospitalization for accidental injury (aHR, 0.67; 95% CI, 0.42-0.85). The association was strongest for accidental falls, although no simple dose-response relationship was observed across acupuncture-session categories. The supportive full-cohort analysis yielded a similar direction of association (aHR, 0.60; 95% CI, 0.39-0.76).

CONCLUSION

In this nationwide claims-based cohort, acupuncture use was associated with a lower risk of hospitalization for accidental injury among patients newly diagnosed with PD. Because residual confounding and differences in care-seeking may remain, prospective studies with clinical measures of PD severity are warranted.