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Zhou C, Yang C, Ai Y, Fang X, Zhang A, Wang Y, Hu H. Valid olfactory impairment tests can help identify mild cognitive impairment: an updated meta-analysis. Front Aging Neurosci 2024; 16:1349196. [PMID: 38419646 PMCID: PMC10900519 DOI: 10.3389/fnagi.2024.1349196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Background Olfactory testing is emerging as a potentially effective screening method for identifying mild cognitive impairment in the elderly population. Objective Olfactory impairment is comorbid with mild cognitive impairment (MCI) in older adults but is not well-documented in subdomains of either olfactory or subtypes of cognitive impairments in older adults. This meta-analysis was aimed at synthesizing the differentiated relationships with updated studies. Methods A systematic search was conducted in seven databases from their availability to April 2023. A total of 38 publications were included, including 3,828 MCI patients and 8,160 healthy older adults. Two investigators independently performed the literature review, quality assessment, and data extraction. The meta-analyses were conducted with Stata to estimate the average effects and causes of the heterogeneity. Results Compared to normal adults, MCI patients had severe impairments in olfactory function and severe deficits in specific domains of odor identification and discrimination. Olfactory impairment was more severe in patients with amnestic mild cognitive impairment than in patients with non-amnestic MCI. Diverse test instruments of olfactory function caused large heterogeneity in effect sizes. Conclusion Valid olfactory tests can be complementary tools for accurate screening of MCI in older adults.
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Affiliation(s)
- Chunyi Zhou
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Chongming Yang
- Research Support Center, College of Family, Home, and Social Sciences, Brigham Young University, Provo, UT, United States
| | - Yating Ai
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xueling Fang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ailin Zhang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yuncui Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Engineering Research Center of TCM Protection Technology and New Product Development for the Elderly Brain Health, Ministry of Education, Wuhan, China
- Hubei Shizhen Laboratory, Wuhan, China
| | - Hui Hu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Engineering Research Center of TCM Protection Technology and New Product Development for the Elderly Brain Health, Ministry of Education, Wuhan, China
- Hubei Shizhen Laboratory, Wuhan, China
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Masala C, Solla P, Loy F. Gender-Related Differences in the Correlation between Odor Threshold, Discrimination, Identification, and Cognitive Reserve Index in Healthy Subjects. BIOLOGY 2023; 12:biology12040586. [PMID: 37106786 PMCID: PMC10136322 DOI: 10.3390/biology12040586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Many studies suggested that olfactory function could be associated with semantic memory, executive function, and verbal fluency. However, the gender-related association between olfactory function and the cognitive domain is not well investigated. The aim of this study was to estimate gender-related differences in the relationship between olfactory function and each specific cognitive domain of the Cognitive Reserve Index (CRI) questionnaire, such as education, working activity, and leisure time in healthy subjects. METHODS Two hundred and sixty-nine participants were recruited (158 women and 111 men), with a mean age of 48.1 ± 18.6 years. The CRI questionnaire and Sniffin' Sticks test were used to evaluate the cognitive reserve and the olfactory function, respectively. RESULTS In all subjects, significant associations between the odor threshold versus CRI-Education, between the odor discrimina-tion and identification versus CRI-Working activity and CRI-Leisure Time, were found. In women, odor threshold, discrimination, and identification were associated with CRI-Leisure Time, while in men, only a significant association between odor threshold and CRI-Education was observed. CONCLUSIONS Our data, showing significant gender-related associations between olfactory function and CRI scores, suggested the use of olfactory evaluation and cognitive reserve as an important screening tool for the early detection of mild cognitive impairment.
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Affiliation(s)
- Carla Masala
- Department of Biomedical Sciences, University of Cagliari, SP8 Cittadella Universitaria Monserrato, 09042 Cagliari, Italy
| | - Paolo Solla
- Department of Neurology, University of Sassari, Viale S. Pietro 10, 07100 Sassari, Italy
| | - Francesco Loy
- Department of Biomedical Sciences, University of Cagliari, SP8 Cittadella Universitaria Monserrato, 09042 Cagliari, Italy
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Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, Appenzeller S, Costanzo RM, Croy I, Davis GE, Dehgani-Mobaraki P, Doty RL, Duffy VB, Goldstein BJ, Gudis DA, Haehner A, Higgins TS, Hopkins C, Huart C, Hummel T, Jitaroon K, Kern RC, Khanwalkar AR, Kobayashi M, Kondo K, Lane AP, Lechner M, Leopold DA, Levy JM, Marmura MJ, Mclelland L, Miwa T, Moberg PJ, Mueller CA, Nigwekar SU, O'Brien EK, Paunescu TG, Pellegrino R, Philpott C, Pinto JM, Reiter ER, Roalf DR, Rowan NR, Schlosser RJ, Schwob J, Seiden AM, Smith TL, Soler ZM, Sowerby L, Tan BK, Thamboo A, Wrobel B, Yan CH. International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 2022; 12:327-680. [PMID: 35373533 DOI: 10.1002/alr.22929] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/01/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). METHODS Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. RESULTS The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. CONCLUSION This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.
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Affiliation(s)
- Zara M Patel
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Eric H Holbrook
- Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Justin H Turner
- Otolaryngology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Nithin D Adappa
- Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark W Albers
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aytug Altundag
- Otolaryngology, Biruni University School of Medicine, İstanbul, Turkey
| | - Simone Appenzeller
- Rheumatology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Richard M Costanzo
- Physiology and Biophysics and Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Ilona Croy
- Psychology and Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Greg E Davis
- Otolaryngology, Proliance Surgeons, Seattle and Puyallup, Washington, USA
| | - Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Corciano, Italy
| | - Richard L Doty
- Smell and Taste Center, Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | | | - David A Gudis
- Otolaryngology, Columbia University Irving Medical Center, New York, USA
| | - Antje Haehner
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | - Thomas S Higgins
- Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Claire Hopkins
- Otolaryngology, Guy's and St. Thomas' Hospitals, London Bridge Hospital, London, UK
| | - Caroline Huart
- Otorhinolaryngology, Cliniques universitaires Saint-Luc, Institute of Neuroscience, Université catholgique de Louvain, Brussels, Belgium
| | - Thomas Hummel
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | | | - Robert C Kern
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashoke R Khanwalkar
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Masayoshi Kobayashi
- Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Kenji Kondo
- Otolaryngology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Andrew P Lane
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matt Lechner
- Otolaryngology, Barts Health and University College London, London, UK
| | - Donald A Leopold
- Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Joshua M Levy
- Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Marmura
- Neurology Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisha Mclelland
- Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Takaki Miwa
- Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - Paul J Moberg
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Sagar U Nigwekar
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin K O'Brien
- Otolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Teodor G Paunescu
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Carl Philpott
- Otolaryngology, University of East Anglia, Norwich, UK
| | - Jayant M Pinto
- Otolaryngology, University of Chicago, Chicago, Illinois, USA
| | - Evan R Reiter
- Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - David R Roalf
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas R Rowan
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - James Schwob
- Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Allen M Seiden
- Otolaryngology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Timothy L Smith
- Otolaryngology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Zachary M Soler
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - Leigh Sowerby
- Otolaryngology, University of Western Ontario, London, Ontario, Canada
| | - Bruce K Tan
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew Thamboo
- Otolaryngology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bozena Wrobel
- Otolaryngology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Carol H Yan
- Otolaryngology, School of Medicine, UCSD, La Jolla, California, USA
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Wang L, Song M, Zhao X, Zhu Q, Yu L, Wang R, Gao Y, An C, Wang X. Functional deficit of sense organs as a risk factor for cognitive functional disorder in Chinese community elderly people. Int J Clin Pract 2021; 75:e14905. [PMID: 34547167 DOI: 10.1111/ijcp.14905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/03/2021] [Accepted: 09/19/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To explore the relationship between mild cognitive impairment (MCI) and sense organs functional deficit in community elderly people. METHODS A total of 3095 community elderly people above 60 years in Hebei Province were selected by cross-sectional random cluster sampling method, who were evaluated face-to-face for general demographic data, the condition of sense organs functional deficit (vision, hearing, gustation, olfactory sensation, taste) and cognitive function by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). RESULTS A total of 3075 valid questionnaires were obtained. (a) 1368 old people (44.49%) were defined with sense organs functional deficit (defined as one or more of glaucoma, fundus disease, hearing impairment, olfactory disorder and taste disorder) in 3095 elderly people. According to questionnaires, MCI was diagnosed in 689 of 3075 participants (22.41%). The hearing disorder and glaucoma of MCI group were higher than that of the normal control group (X2 were 5.998 and 7.430, respectively, P were .014 and .006, respectively). (b) The MMSE score of the hearing disorder were significantly lower than those of non-hearing disorder group (t = 2.046, P = .041). (c) Multinomial logistics regression analysis was applied by MCI as the dependent variable and the various sensory organs defects as independent variables. The hearing impairment (Wald = 8.582, P = .003, OR = 1.485, 95% CI: 1.140-1.934) and glaucoma (Wald = 8.020, P = .005, OR = 1.847, 95% CI: 1.208-2.824) were associated with MCI. CONCLUSION The sensory organs functional defects is associated with the mild cognitive impartment in Chinese elderly, especially in vision and hearing disorder.
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Affiliation(s)
- Lan Wang
- Mental Health Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
- The Mental Health Institute of Hebei Province, Shijiazhuang, China
- Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
- Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, China
| | - Mei Song
- Mental Health Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
- The Mental Health Institute of Hebei Province, Shijiazhuang, China
- Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
- Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, China
| | - Xiaochuan Zhao
- Mental Health Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
- The Mental Health Institute of Hebei Province, Shijiazhuang, China
- Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
- Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, China
| | - Qifeng Zhu
- Mental Health Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
- The Mental Health Institute of Hebei Province, Shijiazhuang, China
- Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
- Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, China
| | - Lulu Yu
- Mental Health Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
- The Mental Health Institute of Hebei Province, Shijiazhuang, China
- Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
- Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, China
| | - Ran Wang
- Mental Health Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
- The Mental Health Institute of Hebei Province, Shijiazhuang, China
- Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
- Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, China
| | - Yuanyuan Gao
- Mental Health Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
- The Mental Health Institute of Hebei Province, Shijiazhuang, China
- Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
- Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, China
| | - Cuixia An
- Mental Health Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
- The Mental Health Institute of Hebei Province, Shijiazhuang, China
- Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
- Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, China
| | - Xueyi Wang
- Mental Health Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
- The Mental Health Institute of Hebei Province, Shijiazhuang, China
- Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
- Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang, China
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Xiao Z, Wu W, Zhao Q, Zhang J, Hong Z, Ding D. Sensory impairments and cognitive decline in older adults: A review from a population-based perspective. AGING AND HEALTH RESEARCH 2021. [DOI: 10.1016/j.ahr.2020.100002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Frank C, Murphy C. The Brief Form of the California Odor Learning Test 3. Front Neurosci 2020; 14:173. [PMID: 32265619 PMCID: PMC7105850 DOI: 10.3389/fnins.2020.00173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/17/2020] [Indexed: 12/15/2022] Open
Abstract
This study explored whether a Brief Form of the California Odor Learning Test 3 (COLT), an olfactory analog of the newly released Brief Form of the California Verbal Learning Test (CVLT 3), could retain the ability of the COLT to detect odor memory dysfunctions observed in normal aging. 52 participants, 28 young (18-30 years old) and 24 old (65 years of age and older), were administered the Brief Forms of the CVLT 3 and the COLT 3. Results indicated poorer performance in immediate and delayed odor recall in older than in younger adults. Poorer odor recognition memory performance in older adults than in younger adults was detected. This study suggests that the Brief Form of the COLT can detect differential odor learning and memory between young and older adults. Thus, the current brief test holds promise as a measure that can be incorporated into studies that demand a brief, non-invasive test capable of detecting impairment in olfactory function.
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Affiliation(s)
- Conner Frank
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Claire Murphy
- Department of Psychology, San Diego State University, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
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MacDonald SWS, Keller CJC, Brewster PWH, Dixon RA. Contrasting olfaction, vision, and audition as predictors of cognitive change and impairment in non-demented older adults. Neuropsychology 2019; 32:450-460. [PMID: 29809033 DOI: 10.1037/neu0000439] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study examines the relative utility of a particular class of noninvasive functional biomarkers-sensory functions-for detecting those at risk of cognitive decline and impairment. Three central research objectives were examined including whether (a) olfactory function, vision, and audition exhibited significant longitudinal declines in nondemented older adults; (b) multiwave change for these sensory function indicators predicted risk of mild cognitive impairment (MCI); and (c) change within persons for each sensory measure shared dynamic time-varying associations with within-person change in cognitive functioning. METHOD A longitudinal sample (n = 408) from the Victoria Longitudinal Study was assembled. Three cognitive status subgroups were identified: not impaired cognitively, single-assessment MCI, and multiple-assessment MCI. RESULTS We tested independent predictive associations, contrasting change in sensory function as predictors of cognitive decline and impairment, utilizing both linear mixed models and logistic regression analysis. Olfaction and, to a lesser extent, vision were identified as the most robust predictors of cognitive status and decline; audition showed little predictive influence. CONCLUSIONS These findings underscore the potential utility of deficits in olfactory function, in particular, as an early marker of age- and pathology-related cognitive decline. Functional biomarkers may represent potential candidates for use in the early stages of a multistep screening approach for detecting those at risk of cognitive impairment, as well as for targeted intervention. (PsycINFO Database Record
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8
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Yahiaoui-Doktor M, Luck T, Riedel-Heller SG, Loeffler M, Wirkner K, Engel C. Olfactory function is associated with cognitive performance: results from the population-based LIFE-Adult-Study. ALZHEIMERS RESEARCH & THERAPY 2019; 11:43. [PMID: 31077241 PMCID: PMC6511191 DOI: 10.1186/s13195-019-0494-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/12/2019] [Indexed: 11/20/2022]
Abstract
Background Studies in older adults or those with cognitive impairment have shown associations between cognitive and olfactory performance, but there are few population-based studies especially in younger adults. We therefore cross-sectionally analyzed this association using data from the population-based LIFE-Adult-Study. Methods Cognitive assessments comprised tests from the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD): verbal fluency (VF), word list learning and recall (WLL, WLR), and the Trail Making Tests (TMT) A and B. The “Sniffin’ Sticks Screening 12” test was used to measure olfactory performance. Linear regression analyses were performed to determine associations between the number of correctly identified odors (0 to 12) and the five cognitive test scores, adjusted for sex, age, education, and the presence of depressive symptoms. Receiver operating characteristic (ROC) analysis was carried out to determine the discriminative performance of the number of correctly identified odors regarding identification of cognition impairment. Results A total of 6783 participants (51.3% female) completed the olfaction test and the VF test and TMT. A subgroup of 2227 participants (46.9% female) also completed the WLL and WLR tests. Based on age-, sex-, and education-specific norms from CERAD, the following numbers of participants were considered cognitively impaired: VF 759 (11.2%), WLL 242 (10.9%), WLR: 132 (5.9%), TMT-A 415 (6.1%), and TMT-B/A ratio 677 (10.0%). On average, score values for VF were higher by 0.42 points (p < 0.001), for WLL higher by 0.32 points (p = 0.001), for WLR higher by 0.31 points (p = 0.002), for TMT-A lower by 0.25 points (p < 0.001), and for TMT-B/A ratio lower by 0.01 points (p < 0.001) per number of correctly identified odors. ROC analysis revealed area under the curve values from 0.55 to 0.62 for the five cognitive tests. Conclusions Better olfactory performance was associated with better cognitive performance in all five tests in adults — adjusted for age, sex, education, and the presence of depressive symptoms. However, the ability of the smell test to discriminate between individuals with and without cognitive impairment was limited. The value of olfactory testing in early screening for cognitive impairment should be investigated in longitudinal studies.
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Affiliation(s)
- Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04109, Leipzig, Germany. .,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.
| | - Tobias Luck
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Economic and Social Sciences and Institute of Social Medicine, Rehabilitation Sciences and Healthcare Research (ISRV), University of Applied Sciences Nordhausen, Nordhausen, Germany
| | - Steffi G Riedel-Heller
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04109, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Kerstin Wirkner
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04109, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
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Goette W, Schmitt A, Clark A. Relationship between smell identification testing and the neuropsychological assessment of dementia in community-dwelling adults. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 26:201-214. [PMID: 29182360 DOI: 10.1080/23279095.2017.1392303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective of this research was to investigate the relationship of the University of Pennsylvania Smell Identification Test (UPSIT) with neuropsychological tests and identify the utility of the UPSIT in detecting cognitive impairment. This research was an archival study of neuropsychological test results obtained from 70 clients (30 male/40 female) of a community-based memory clinic. The sample had an average age of 69.7 (SD = 9.7) and education of 14.6 (SD = 2.8) years. Hypotheses were tested using correlations, receiver operating characteristic (ROC) curves, and logistic regression. The UPSIT showed significant, weak to moderate correlations with neuropsychological tests. The UPSIT raw score correlated significantly with all but one cognitive ability domain. The UPSIT T-score was significantly correlated with all cognitive domains. Obtained areas under the ROC curve (AUC) for the UPSIT ranged from .60 to .87. The AUCs of the UPSIT did not differ significantly from verbal semantic fluency tests, but the Repeatable Battery for the Assessment of Neuropsychological Status Total Scale and Delayed Memory index tended to produce larger AUCs than the UPSIT. Results from step-wise logistic regressions suggest that the UPSIT raw score provides unique information beyond its relationship to age. Olfaction relates broadly to cognitive ability and may be sensitive to early symptoms of cognitive decline. Further research is needed to explore the relationships between smell identification tests and neuropsychological assessment.
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Affiliation(s)
- William Goette
- a Department of Psychology and Counseling , University of Texas at Tyler , Tyler , Texas , USA
| | - Andrew Schmitt
- a Department of Psychology and Counseling , University of Texas at Tyler , Tyler , Texas , USA
| | - Avery Clark
- a Department of Psychology and Counseling , University of Texas at Tyler , Tyler , Texas , USA
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10
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The Brief Odor Detection Test (B-ODT) for Very Early Diagnosis of Cognitive Decline: A Preliminary Study. BRAIN IMPAIR 2017. [DOI: 10.1017/brimp.2017.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Olfactory impairment in older adults is associated with cognitive decline. This study describes the development of a Brief Odor Detection Test (B-ODT), and its pilot administration in community-dwelling older adults. The study aimed at examining whether the test could differentiate older adults with very mild cognitive impairment from their cognitively healthy counterparts. The sample consisted of 34 older adults (22 women), aged from 65 to 87 years. Participants were divided into two groups according to their general cognitive functioning. Odor detection was measured via vanillin solutions at the following concentrations: 150 mg/L, 30 mg/L, 15 mg/L, 3 mg/L, and .03 mg/L. The first condition of the test involved a scale administration of vanillin solutions. The second condition examined the change in air odour and it required vanillin solution of 30 mg/L and a metric ruler of 30 cm. The examiner had to place the solution at a specific distance point from each nostril. Odour identification sensitivity was secondarily measured. The results showed statistically significant differences in odour detection threshold between the two groups. In the unirhinal testing, left nostril differences of the two groups were definite. Hence, the B-ODT seems a promising instrument for very early cognitive impairment screening in older adult population.
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11
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Affiliation(s)
- Bonnie C. Sachs
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Beth K. Rush
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - Otto Pedraza
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
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Hwang YK, Kim H. Utility of the Boston Naming Test in Differentiating between Mild Cognitive Impairment and Normal Elderly: A Meta-Analysis. COMMUNICATION SCIENCES & DISORDERS 2014. [DOI: 10.12963/csd.14177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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13
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Olfactory Dysfunction in the Elderly: Basic Circuitry and Alterations with Normal Aging and Alzheimer's Disease. CURRENT GERIATRICS REPORTS 2014; 3:91-100. [PMID: 25045620 DOI: 10.1007/s13670-014-0080-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Preclinical detection of Alzheimer disease is critical to determining at-risk individuals in order to improve patient and caregiver planning for their futures and to identify individuals likely to benefit from treatment as advances in therapeutics develop over time. Identification of olfactory dysfunction at the preclinical and early stages of the disease is a potentially useful method to accomplish these goals. We first review basic olfactory circuitry. We then evaluate the evidence of pathophysiological change in the olfactory processing pathways during aging and Alzheimer disease in both human and animal models. We also review olfactory behavioral studies during these processes in both types of models. In doing so, we suggest hypotheses about the localization and mechanisms of olfactory dysfunction and identify important avenues for future work.
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Corby K, Morgan CD, Murphy C. Abnormal event-related potentials in young and middle-aged adults with the ApoE ε4 allele. Int J Psychophysiol 2012; 83:276-81. [PMID: 22100309 PMCID: PMC4343300 DOI: 10.1016/j.ijpsycho.2011.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Revised: 06/23/2011] [Accepted: 11/03/2011] [Indexed: 11/23/2022]
Abstract
The largest genetic susceptibility factor for Alzheimer's disease is the Apolipoprotein E (ApoE) ε4 allele. Cognitive decline and olfactory impairment are greater in those positive for the ε4 allele. This study sought to determine if the olfactory event-related potential (OERP), compared to the visual ERP, would be sensitive to these subtle declines. Participants included 40 individuals from two age groups, half of each group were ε4 allele positive and half were ε4 negative. Visual ERPs did not demonstrate significant differences between ApoE groups. OERPs demonstrated robust age by ApoE interactions. P3 latencies were significantly longer in ε4 young and middle age participants. These findings suggest that very early olfactory and cognitive changes related to ApoE status are detectible via the OERP.
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Affiliation(s)
- Krystin Corby
- San Diego State University, Department of Psychology, San Diego, CA, 92120, USA
| | - Charlie D. Morgan
- San Diego State University, Department of Psychology, San Diego, CA, 92120, USA
| | - Claire Murphy
- San Diego State University, Department of Psychology, San Diego, CA, 92120, USA
- University of California Medical Center, San Diego, CA, 92120, USA
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Abstract
AbstractResearch results indicate systemic odor identification deficits in patients with Alzheimer’s disease (AD). The aims of this study were: 1) to compare the ability to identify different odors and to compare cognitive status among patients with AD, patients with vascular dementia (VaD) and a comparison group of elderly persons; 2) to test the efficiency of olfactory and neuropsychological measures to classify patients and 3) to relate the odor identification ability with cognitive functioning for each group, respectively. The participants were 15 patients with AD, 11 patients with VaD and 30 non-demented elderly persons, age range 58 to 90. To assess olfactory function, we used the Scandinavian Odor-Identification Test. To assess cognitive functions, we used the Dementia Rating Scale-2, the Clock Drawing Test, the Boston Naming Test and the Category Fluency Test. The ANOVA showed that patients with AD correctly identifed significantly fewer odors presented to them compared to patients with VaD and control group. Patients with AD achieved significantly lower scores on all neuropsychological measures compared to the control group and differ in the DRS-2 total score, initiation/perseveration, constructive and naming abilities comparing to patients with VaD. Discriminant analysis showed that category fluency and olfactory identification were the best predictors of AD. Significant correlations were found between the olfactory and initiation/perseveration, memory and animal naming abilities for patients with AD. Differences among patients with AD, VaD and elderly persons exist in their abilities to identify odors. The findings suggest that olfactory functional testing in combination with memory testing are important.
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