What the nose knows: olfaction and cognitive abilities

The role of olfactory dysfunction in mild cognitive impairment and Alzheimer's disease: A meta-analysis

PURPOSE

This comprehensive meta-analysis investigates the association between olfactory deficits in mild cognitive impairment (MCI) and Alzheimer's disease (AD).

METHODS

A thorough search across databases identified articles analyzing olfactory status in MCI or AD patients. Methodological quality assessment followed PRISMA guidelines. Hedges' g effect size statistic computed standard mean differences and 95% confidence intervals. Moderator analysis was conducted.

RESULTS

Among the included studies (65 for MCI and 61 for AD), odor identification exhibited larger effect sizes compared to odor threshold and discrimination, in both MCI and AD samples. Moderate effect size is found in OI scores in MCI (k = 65, SE = 0.078, CI 95% = [-1.151, -0.844]). Furthermore, compared to MCI, AD had moderate to large heterogeneous effects in olfactory identification (k = 61, g = -2.062, SE = 0.125, CI 95% = [-2.308, -1.816]). Global cognitive status is positively related to olfactory identification impairment in both MCI (k = 57, Z = 2.74, p = 0.006) and AD (k = 53, Z = 5.03, p < 0.0001) samples.

CONCLUSION

Olfactory impairments exhibit a notable and substantial presence in MCI. Among these impairments, odor identification experiences the greatest decline in MCI, mirroring the primary sensory deficit observed in AD. Consequently, the incorporation of a straightforward odor identification test is advisable in the evaluation of individuals vulnerable to the onset of AD, offering a practical screening tool for early detection.

Neuropsychiatric correlates of olfactory identification and traumatic brain injury in a sample of impulsive violent offenders

Background

Olfactory deficits have a diverse etiology and can be detected with simple olfactory tests. Key olfactory pathways are located within the frontal and temporal lobes where they are vulnerable to damage due to head trauma. Orbitofrontal cortex (OFC) integrity is important for olfaction and aspects of behavioral regulation. We measured olfactory identification ability in a sample of impulsive violent offenders to determine its associations with history of traumatic brain injury (TBI) and a range of neuropsychiatric indices, including proxies for cognitive ability, impulsivity and social connectedness.

Methods

Male participants were drawn from the ReINVEST study, a randomized controlled trial of sertraline to reduce recidivism in violent impulsive offenders. Criteria for participation in the study included a minimum age of 18 years, a documented history of two or more violent offenses, and a score of 70 or above on the Barratt Impulsiveness Scale (BIS-11). The 16-item "Sniffin sticks" (SS) odor identification test (OI) was administered as were standardized questionnaires regarding previous TBI, additional measures to screen cognition [word reading test of the Wechsler Individuals Achievement Test (WIAT), social connectedness (the Duke Social Support Scale), and a range of other neuropsychiatric conditions or symptoms]. The sample SS scores were compared against published age-specific norms. Univariate and multivariate analyses were performed with SS score (linear regression, within those without hyposmia) or hyposmia (logistic regression) as the outcome.

Results

The mean OI scores were lower than population norms and 16% of participants were classified as hyposmic. Univariate analyses showed associations of SS score with age, WIAT score, impulsivity, TBI and TBI severity, social connectedness, childhood sexual abuse, suicidality and current use of heroin. In multivariate analyses, age, TBI severity and WIAT remained as significant independent predictors of SS score (within the normosmic range) or hyposmia (logistic regression).

Conclusion

Olfactory performance was associated with multiple behavioral phenomena in a pattern that would be consistent with this serving as a proxy for orbitofrontal functioning. As such, OI testing may have utility in further studies of offenders. In future, we will examine whether olfactory score predicts recidivism or response to the administration of sertraline, in terms of reducing recidivism.

Olfactory training effects in children after mild traumatic brain injury

OBJECTIVE

Mild traumatic brain injury (mTBI) might impair the sense of smell and cognitive functioning. Repeated, systematic exposure to odors, i.e., olfactory training (OT) has been proposed for treatment of olfactory dysfunctions, including post-traumatic smell loss. Additionally, OT has been shown to mitigate cognitive deterioration in older population and enhance selected cognitive functions in adults. We aimed to investigate olfactory and cognitive effects of OT in the pediatric population after mTBI, likely to exhibit cognitive and olfactory deficits.

METHODS

Our study comprised 159 children after mTBI and healthy controls aged 6-16 years (M = 9.68 ± 2.78 years, 107 males), who performed 6-months-long OT with a set of 4 either high- or low-concentrated odors. Before and after OT we assessed olfactory functions, fluid intelligence, and executive functions.

RESULTS

OT with low-concentrated odors increased olfactory sensitivity in children after mTBI. Regardless of health status, children who underwent OT with low-concentrated odors had higher fluid intelligence scores at post-training measurement, whereas scores of children performing OT with high-concentrated odors did not change.

CONCLUSION

Our study suggests that OT with low-concentrated odors might accelerate rehabilitation of olfactory sensitivity in children after mTBI and support cognitive functions in the area of fluid intelligence regardless of head trauma.

Olfaction and Executive Cognitive Performance: A Systematic Review

Objective tests of olfaction are widely available to aid in the assessment of olfaction. Their clearest role is in the characterization of olfactory changes, either reported by or suspected in a patient. There is a rapidly growing literature concerned with the association of olfactory changes with certain neuropsychiatric conditions and the use of olfactory testing to supplement conventional assessments in clinical and research practice is evolving. Neural pathways important for olfactory processing overlap extensively with pathways important for cognitive functioning, and especially those important for executive functioning, many of which are concentrated in the frontal lobes. Previous work has identified associations between performance on certain olfactory tests (most frequently olfactory identification) and executive functioning and behavioral measures (e.g. of impulsivity). More recently, similar associations have also been identified in non-clinical samples, raising new questions as to the utility of olfactory test scores as proxy measures for non-olfactory phenomena. In this systemic review, we sought to identify studies, both clinical and non-clinical, that investigated the associations of olfaction with performance on tasks sensitive to frontal lobe functioning. Our search criteria led to the identification of 70 studies published in English. We examined in detail and tabulated the data from these studies, highlighted each study's key findings, and critically evaluated these studies. We use the results of this review to reflect on some of the current and future challenges concerning the use of olfactory testing in clinical neuropsychiatric practice and research and speculate on the potential benefits of administering phonemic fluency in combination with olfactory testing to enhance its predictive value.

An olfactory display for virtual reality glasses

Olfaction has not been explored in virtual reality environments to the same extent as the visual and auditory senses. Much less research has been done with olfactory devices, and very few of them can be easily integrated into virtual reality applications. The inclusion of odor into virtual reality simulations using a chemical device involves challenges such as possible diffusion into undesired areas, slow dissipation, the definition of various parameters (e.g., concentration, frequency, and duration), and an appropriate software solution for controlling the diffusion of the odor. This paper aims to present a non-intrusive, mobile, low cost and wearable olfactory display, and a software service that allows the developer to easily create applications that include olfactory stimuli integrated with virtual reality headset glasses. We also present a case study conducted with 32 people to evaluate their satisfaction when using the olfactory display. Our findings indicate that our solution works as expected, producing odor properly and being easy to integrate to applications.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s00530-022-00908-8.

Development of the Spanish Version of Sniffin's Sticks Olfactory Identification Test: Normative Data and Validity of Parallel Measures

The Sniffin' Sticks Olfactory Identification Test is a tool for measurement of olfactory performance developed in Germany and validated in several countries. This research aims to develop the Spanish version of the Sniffin' Sticks Olfactory Identification Test and obtain normative values for the Spanish population. The parameters are free recall and subjective intensity of odorants are included. The influence of possible demographic covariates such as sex, age, smoking, or educational level are analyzed, and the items that best discriminate are studied. In addition, the internal structure validity of the blue and purple versions is studied as a parallel measure, and a cultural adaptation of the purple version is carried out. For this, three independent samples of normosmic healthy volunteers were studied. To obtain normative values, the sample was of 417 participants (18-89 years). For the internal structure validity study of both versions, the sample was 226 (18-70 years), and for familiarity of the purple version, the sample was 75 participants (21-79 years). Results indicated that men and women and smokers and non-smokers perform equally. However, differences were found as age progresses, being more pronounced after 60 years old in all three measurements of the identification test. This research also provides the items that best discriminate in the blue version and a cultural adaptation for the purple version. In conclusion, the Sniffin' Sticks Odor Identification Test is a suitable tool for olfactory assessment in the Spanish population. The instrument has been expanded with two new scores, and normative data as a function of age are provided. Its parallel version also seems appropriate for testing, as items have been culturally adapted and evidence of internal structure validity for both versions is reported.

Olfactory Dysfunction in Neurodevelopmental Disorders: A Meta-analytic Review of Autism Spectrum Disorders, Attention Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder

Olfactory dysfunction is recognized in neurodevelopmental disorders and may serve as an early indicator of global dysfunction. The present meta-analysis measures olfaction effect sizes in attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders (ASDs), and obsessive-compulsive disorder (OCD). Meta-analysis included 320 ADHD, 346 ASD, and 208 OCD individuals as compared to 910 controls. Olfactory performance deficits were small-to-moderate and heterogeneous (d =  - 0.42, 95% CI =  - 0.59 < δ <  - 0.25). Meta-analytic results indicate that olfactory dysfunction is evident in individuals with ASD and OCD, with small-to-negligible effects in ADHD. These findings imply olfactory dysfunction is related to clinical phenotype in ASD and OCD, but not ADHD, and warrant inclusion in clinical assessment and evaluation of certain neurodevelopmental disorders.

The Influence of Cognitive Parameters on Olfactory Assessment in Healthy Children and Adolescents

Olfactory threshold and odor identification tests are frequently used for assessment of olfactory function in children and adolescents. Whether olfactory test results are influenced by cognitive parameters or sex in children and adolescents is largely unknown. The aim of this study was to investigate the influence of cognition, age and sex on "Sniffin' Sticks" olfactory threshold and "U-Sniff" odor identification performance in a pediatric population. A total of 200 participants between age 6 and 17 years were included. Olfactory function (olfactory threshold and odor identification) was assessed using the "Sniffin' Sticks." In addition, age appropriate cognitive testing was applied. The results of this study indicate that odor identification test performance is positively correlated with age (r = 0.31) and verbal abilities of children (r = 0.24). Olfactory threshold results are only marginally influenced by age (r = 0.18) and are not associated with cognitive test performance. Olfactory assessment using olfactory threshold and "U-Sniff" odor identification testing is suitable for children and adolescents when considering age in the interpretation of test results.

Meta-Analysis of the Effects of Computerized Cognitive Training on Executive Functions: a Cross-Disciplinary Taxonomy for Classifying Outcome Cognitive Factors

The growing prevalence of neurodegenerative disorders associated with aging and cognitive decline has generated increasing cross-disciplinary interest in non-pharmacological interventions, such as computerized cognitive training (CCT), which may prevent or slow cognitive decline. However, inconsistent findings across meta-analytic reviews in the field suggest a lack of cross-disciplinary consensus and on-going debate regarding the benefits of CCT. We posit that a contributing factor is the lack of a theoretically-based taxonomy of constructs and representative tasks typically used. An integration of the Cattell-Horn-Carroll (CHC) taxonomy of broad and narrow cognitive factors and the Miyake unity-diversity theory of executive functions (EF) is proposed (CHC-M) as an attempt to clarify this issue through representing and integrating the disciplines contributing to CCT research. The present study assessed the utility of this taxonomy by reanalyzing the Lampit et al. (2014) meta-analysis of CCT in healthy older adults using the CHC-M framework. Results suggest that: 1) substantively different statistical effects are observed when CHC-M is applied to the Lampit et al. meta-analytic review, leading to importantly different interpretations of the data; 2) typically-used classification practices conflate Executive Function (EF) tasks with fluid reasoning (Gf) and retrieval fluency (Gr), and Attention with sensory perception; and 3) there is theoretical and practical advantage in differentiating attention and working-memory tasks into the narrow shifting, inhibition, and updating EF domains. Implications for clinical practice, particularly for our understanding of EF are discussed.

CHC Model According to Weiss

Abstract. The Italian version of the Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV) – was standardized using a sample of 2,174 participants, aged between 16 and 90 years. The WAIS-IV consists of 10 core subtests and 5 supplemental subtests. While the 70–90 yr group is usually excluded from three of the five supplemental subtests (Letter-Number Sequencing, Figure Weights, and Cancellation), we administered all 15 subtests both to adults and elderly people. The aim of the present study was to investigate the factorial invariance of the Weiss and colleagues’ hierarchical five-factor CHC (Cattell-Horn-Carroll) model in Italian adults and elders. The overall results of this study generally support both the configural and factorial invariance of the WAIS-IV, and hence the five-factor CHC model of Weiss is equivalent in adults and elderly people. However, for the elderly sample we found higher loadings of WAIS-IV subtests on the second-order g factor.

Overemphasized "g"

In this paper I argue that the emphasis on “g” has become a hindrance to the study of broadly defined human cognitive abilities. Abilities captured by the first- and second-stratum factors in the Cattel-Horn-Carroll (CHC) theory have been neglected. The focus has been on a narrow range of cognitive processes that excludes those common to some sensory modalities and a host of new tasks and constructs that have become available through recent conceptual analyses and technological developments. These new areas have emerged from psychology itself (complex problem solving tasks and emotional intelligence) and from disciplines related to psychology like education and economics (economic games and cognitive biases in decision-making).

Beyond ‘the Eye’ of the Beholder: Scent innovation through analogical reconfiguration

The current paper examines analogical processes as drivers of innovation in the creative industries. Based on a longitudinal case study of a signature perfume label, we argue that analogies embody cultural schemas in diverse material modalities, a process commonly referred to as analogical schematization. We highlight the role of materiality to ground these analogical processes, bridging embodied cognition and material products. We extend knowledge in this area by showing, among perfumers, how analogies work not only vertically from idea to concrete product but also horizontally across modalities, leveraging material affordances in a process that we label analogical reconfiguration. We discuss the implications of understanding innovation as being driven by analogical processes where materiality is key in creating novel, yet seemingly familiar, products in the creative industries.

The influence of semantic processing on odor identification ability in schizophrenia

Despite the well-documented observation of odor identification deficits in schizophrenia, less is known about where the disruption in the process of correctly identifying an odor occurs. This study aimed to determine the potential moderating effects of semantic processing on the observed olfactory dysfunction in schizophrenia. Schizophrenia patients and healthy comparison subjects completed two versions of the University of Pennsylvania Smell Identification Test (UPSIT): an uncued free-response version and the standard multiple-choice paradigm, as well as three semantic measures: The Boston Naming Test, Animal Naming, and Pyramids and Palm Tree Test. Schizophrenia patients yielded significantly lower scores than the comparison group on the standard UPSIT and on semantic measures. No relationship was observed between olfactory and semantic task performance in patients. These data suggest that odor identification deficits may not be primarily due to semantic processing deficits in schizophrenia.

Correspondence Between the General Ability to Discriminate Sensory Stimuli and General Intelligence

For more than a century the veracity of Spearman’s postulate that there is a nearly perfect correspondence between general intelligence and general sensory discrimination has remained unresolved. Most studies have found significant albeit small correlations. However, this can be used neither to confirm nor dismiss Spearman’s postulate, a major weakness of previous research being that only single discrimination capacities were considered rather than general discrimination. The present study examines Spearman’s hypothesis with a sample of 1,330 5- to 10-year-old children, using structural equation modeling. The results support Spearman’s hypothesis with a strong correlation (r = .78). Results are discussed in terms of the validity of the general sensory discrimination factor. In addition, age-group-specific analyses explored the age differentiation hypothesis.

Assessment of the influence of cognition and cognitive processing speed on three tests of olfaction

The extent to which measures of working memory, cognitive speed, and verbal retrieval are associated with performance on tests of olfaction was evaluated in a sample of 138 older adults. Structural equation modeling techniques indicated that verbal retrieval difficulties significantly affect performance on the University of Pennsylvania Smell Identification Test (UPSIT). Further, poor working memory and slow cognitive speed significantly affect performance on the UPSIT and the phenyl ethyl alcohol threshold test. The Sniff Magnitude Test was not influenced by any of the cognitive variables. Odor threshold and identification tasks may overestimate olfactory loss when cognitive impairment is not taken into account.

Capturing product experiences: a split-modality approach

When people interact with products, all sensory modalities are open to receive information. To assess each modality's potential contribution to overall product experiences, we developed a split-modality approach, in which subjects experienced real-life products through only one modality: vision, touch, audition, or olfaction. Responses focused on (1) description of the sensory experience, (2) product identification, and (3) descriptions of associations and memories linked to this experience. Visual and tactual information were most detailed, made product identification easiest, and yielded the clearest memories of past events, associations to persons, and associations with other products. Because vision may have an advantage over touch by the speed with which information is processed, vision is likely to dominate product experiences in real-life situations.

A mnemonic theory of odor perception

The psychological basis of odor quality is poorly understood. For pragmatic reason, descriptions of odor quality generally rely on profiling odors in terms of what odorants they bring to mind. It is argued here that this reliance on profiling reflects a basic property of odor perception, namely that odor quality depends on the implicit memories that an odorant elicits. This is supported by evidence indicating that odor quality as well as one's ability to discriminate odors is affected by experience. Developmental studies and cross-cultural research also point to this conclusion. In this article, these findings are reviewed and a model that attempts to account for them is proposed. Finally, the model's consistency with both neurophysiological and neuropsychological data is examined.

The role of individual differences in the accuracy of confidence judgments

Generally, self-assessment of accuracy in the cognitive domain produces overconfidence, whereas self-assessment of visual perceptual judgments results in underconfidence. Despite contrary empirical evidence, in models attempting to explain those phenomena, individual differences have often been disregarded. The authors report on 2 studies in which that shortcoming was addressed. In Experiment 1, participants (N= 520) completed a large number of cognitive-ability tests. Results indicated that individual differences provide a meaningful source of overconfidence and that a metacognitive trait might mediate that effect. In further analysis, there was only a relatively small correlation between test accuracy and confidence bias. In Experiment 2 (N = 107 participants), both perceptual and cognitive ability tests were included, along with measures of personality. Results again indicated the presence of a confidence factor that transcended the nature of the testing vehicle. Furthermore, a small relationship was found between that factor and some self-reported personality measures. Thus, personality traits and cognitive ability appeared to play only a small role in determining the accuracy of self-assessment. Collectively, the present results suggest that there are multiple causes of miscalibration, which current models of over- and underconfidence fail to encompass.