Abstract
Objectives To explore the relationship between insulin levels and nonpsychotic dementia. Methods Six electronic databases (PubMed, Cochrane, SCI, CNKI, VIP, and Wanfang) were searched from January 1, 2007, to March 1, 2017. Experimental or observational studies that enrolled people with nonpsychotic dementia or abnormal insulin levels in which insulin levels or MMSE scores (events in nonpsychotic dementia) were the outcome measures. Random-effects models were chosen for this meta-analysis. Sample size, mean, s.d., and events were primarily used to generate effect sizes (with the PRIMA registration number CRD42017069860). Results 50 articles met the final inclusion criteria. Insulin levels in cerebrospinal fluid were lower (Hedges' g = 1.196, 95% CI = 0.238 to 2.514, and P = 0.014), while the levels in peripheral blood were higher in nonpsychotic dementia patients (Hedges' g = 0.853 and 95% CI = 0.579 to 1.127), and MMSE scores were significantly lower in the high insulin group than in the healthy control group (Hedges' g = 0.334, 95% CI = 0.249 to 0.419, and P = 0.000). Conclusions Our comprehensive results indicate that blood insulin levels may increase in patients with nonpsychotic dementia.
Highlights
Dementia is a general term for a decline in mental ability severe enough to interfere with daily life, and it is a common clinical syndrome that is a leading cause of death globally and a burden on families and society
A randomeffects meta-analysis was performed, and the results showed that the nonpsychotic dementia patients had significantly lower cerebrospinal fluid (CSF) insulin levels than were observed in the healthy control subjects (HCs)
A random-effects meta-analysis was performed, and the results showed that the nonpsychotic dementia patients had significantly higher insulin levels than were observed in the HCs
Summary
Dementia is a general term for a decline in mental ability severe enough to interfere with daily life, and it is a common clinical syndrome that is a leading cause of death globally and a burden on families and society. Doctors diagnose Alzheimer’s and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function, and behavior associated with each type. As it is harder to determine the exact type of dementia because the symptoms and brain changes of different dementias can overlap, and in some cases, a doctor may diagnose “dementia” and not specify a type. In these cases, we divided the dementia into two aspects (psychotic dementia and nonpsychotic dementia) according to the day-to-day functions, behaviors, and medical history of the patients. Psychotic dementia is caused by mental illness, which means that dementia is caused by depression, schizophrenia, and other mental disorders, while nonpsychotic dementia excludes the dementia caused by mental illness (psychotic dementia)
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