Controversy continues over whether or not there is any real effect from acupuncture over and above that of placebo. However, this series of case studies may provide us with evidence from an unlikely source. Anticipation of clinical benefit is a major element of placebo, and clearly cognition is needed to experience this. This raises the question of how much placebo effect is experienced by a patient with dementia. These cases document reliably witnessed responses to acupuncture in patients with impaired cognition, which have been reproducible and maintained. Given the similarity of responses, it could be argued that these reports provide evidence of a 'real' effect of acupuncture, and raise the possibility of including patients with dementia in formal studies from which they might routinely be excluded.

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