A Q&A on acupuncture for pain, frailty, and cognitive change in aging patients

In aging patients, acupuncture can play a meaningful role in managing chronic pain and supporting quality of life, rather than simply extending time, says Bonnie D. Wright, DVM, DACVAA, CVMA, CVPP, CCRT, CCRP, an acupuncturist and pain specialist, and CEO of Evidence Based Veterinary Acupuncture.

In this Q&A-style interview, following a lecture Wright led at the 2026 Veterinary Meeting & Expo, Wright discusses which geriatric and frail patients are most likely to benefit from acupuncture, how she determines treatment frequency for chronic pain, and what emerging human research might say about observed changes in improved cognition and behavior among senior animal (and human) patients receiving acupuncture therapy.

Editor’s note: Answers have been lightly edited and consolidated from a verbal interview to better fit a written format while retaining the substance of the original conversation.

dvm360: What types of geriatric cases benefit most from acupuncture therapy?

Wright: We use the concept of "frailty" now, where biological age doesn't always align with numeric age. Once you start adding geriatric diseases, they consider that "geriatric," and then within that population, as you add those diseases, you start to get into "frailty."

There are frailty scales available in people and I think cats right now—I don't think anyone's done them for dogs yet—but [they] really show that decline in strength, ability to get up and walk, and interactiveness. Certainly, once a patient is anywhere on that frailty scale, and really once you get into that geriatric stage where you have age-related diseases, those are excellent patients for acupuncture.

I can't emphasize enough that so much of these aging changes are also painful. As soon as there is chronic pain, I think acupuncture is a really critical piece of the puzzle, because our pharmaceuticals just don't address chronic pain as well as some of the non-pharmaceutical interventions like motion and acupuncture.

dvm360: How often should patients receive these treatments for chronic pain?

Wright:The frequency is dictated by the individual, depending on how severe the pain is. In general, you’re going to cluster a series of at least 3 to 4 treatments about weekly and then start spacing those out. During that first cluster, you identify the specific things that are better so you can monitor the patient. As you space treatments out, potentially to monthly, you try to time it just before they start to decline again so you’re keeping them at a new, good steady state. As they progress and get older, you may find you have to treat a little more frequently.

dvm360: Acupuncture can also enhance cognition. Can you speak more about how that works?

Wright: With senior patients, we are balancing chronic pain with changes in the immune balance that come with aging (immunosenescence). There is an "added bonus" in these patients after treatment in that they become much more cognitively aware and we seem to get more of their "native" behaviors back. Owners often say, "They're acting like they did when they were young."

Research shows that acupuncture helps normalize brainwaves and central programming. In human studies, caregivers of seniors with sundowners and cognitive decline were able to detect which patients were in the active treatment group—even when a knee was the only area being treated. They saw a huge diminishment in cognitive issues that the researchers weren't even looking for.

We see this subjectively in our veterinary species as well, and human data is now measuring these brain patterns and realizing that acupuncture does intervene with them and help normalize them. There is still a lot we don't know on the veterinary side, but this is some pretty exciting data explains what we see clinically: a significant improvement in patients with geriatric cognitive decline.

dvm360: If you could leave practitioners with a few key takeaways from your session on acupuncture for the aging patient, what would they be?

Wright: Recognize the difference between aging, geriatric (when you get age-related diseases), and frailty. These changes are both musculoskeletal and immunologic, and what we’re trying to do is improve the quality of the remaining time, focusing on "health span" rather than just "lifespan," the latter of which is just prolonging time. As you start to develop that vision of what aging is, things like motion and acupuncture become essential for managing pain as well as possible and keeping exercise and activity as high as possible.