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Bouhaben J, Delgado-Lima AH, Delgado-Losada ML. The role of olfactory dysfunction in mild cognitive impairment and Alzheimer's disease: A meta-analysis. Arch Gerontol Geriatr 2024; 123:105425. [PMID: 38615524 DOI: 10.1016/j.archger.2024.105425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024]
Abstract
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.
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Affiliation(s)
- Jaime Bouhaben
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223 Pozuelo de Alarcon, Spain
| | - Alice Helena Delgado-Lima
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223 Pozuelo de Alarcon, Spain
| | - María Luisa Delgado-Losada
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223 Pozuelo de Alarcon, Spain.
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2
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Yeo BSY, Chan JH, Tan BKJ, Liu X, Tay L, Teo NWY, Charn TC. Olfactory Impairment and Frailty: A Systematic Review and Meta-Analysis. JAMA Otolaryngol Head Neck Surg 2024:2821102. [PMID: 38990553 PMCID: PMC11240234 DOI: 10.1001/jamaoto.2024.1854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
Importance Olfactory impairment (OI) and frailty are prevalent conditions associated with aging, but studies investigating their association with each other have been discordant. Objective To summarize current evidence surrounding the association between OI and frailty. Data Sources PubMed, Embase, Cochrane Library, SCOPUS, and CINAHL from inception to November 28, 2023. Study Selection This study included observational studies investigating the association between objectively or subjectively assessed OI and objectively evaluated frailty among adults. Data Extraction and Synthesis Two independent authors extracted data into a structured template. Maximally adjusted estimates were pooled using a random-effects model, and statistical heterogeneity was evaluated using I2 values. Additional prespecified subgroup and sensitivity analyses were performed. This study used the Newcastle-Ottawa Scale for bias assessment and the Grading of Recommendations Assessment, Development and Evaluation framework for overall evidence quality evaluation. Main Outcomes and Measures The primary outcome was the cross-sectional association between OI and frailty, for which the odds of frailty were compared between participants with and without OI. The secondary outcome was the cross-sectional association between frailty and OI, for which the odds of OI were compared between participants with and without frailty. Results This study included 10 studies with 10 624 patients (52.9% female; mean [SD] age, 62.9 [9.6] years). The Newcastle-Ottawa Scale score of studies ranged from low to moderate. Grading of Recommendations Assessment, Development and Evaluation scores ranged from low to moderate. OI was associated with a 2.32-fold (odds ratio [OR], 2.32; 95% CI, 1.63-3.31; I2 = 0%) greater odds of frailty compared with individuals with healthy olfactory function. The odds of OI was progressively greater with categorical frailty status, with a 1.55-fold (OR, 1.55; 95% CI, 1.32-1.82; I2 = 0%), 2.28-fold (OR, 2.28; 95% CI, 1.96-2.65; I2 = 0%), and 4.67-fold (OR, 4.67; 95% CI, 2.77-7.86; I2 = 0%) increase in odds for individuals with prefrailty, frailty, and the most frailty, respectively, compared with robust individuals. The results demonstrated stability in subgroup analyses (geographical continent of study, objective vs subjective olfactory assessment) and sensitivity tests. Conclusions and Relevance The results of this systematic review and meta-analysis suggest that there is an association between OI and frailty, with an increase in the odds of OI with worsening categorical frailty status among individuals with prefrailty, frailty, and the most frailty. OI may be a potential biomarker for frailty. Future studies could delve into whether OI may be a modifiable risk factor for frailty.
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Affiliation(s)
- Brian Sheng Yep Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jun He Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Xuandao Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore
| | - Laura Tay
- Department of General Medicine, Sengkang General Hospital, Singapore
- SingHealth Duke-NUS Centre of Memory and Cognitive Disorders, Singapore
| | - Neville Wei Yang Teo
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore
- Surgery Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Tze Choong Charn
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore
- Surgery Academic Clinical Programme, Duke-NUS Medical School, Singapore
- Department of Otolaryngology-Head and Neck Surgery, Sengkang General Hospital, Singapore
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3
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Renzetti S, van Thriel C, Lucchini RG, Smith DR, Peli M, Borgese L, Cirelli P, Bilo F, Patrono A, Cagna G, Rechtman E, Idili S, Ongaro E, Calza S, Rota M, Wright RO, Claus Henn B, Horton MK, Placidi D. A multi-environmental source approach to explore associations between metals exposure and olfactory identification among school-age children residing in northern Italy. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00687-6. [PMID: 38802534 DOI: 10.1038/s41370-024-00687-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Metal exposures can adversely impact olfactory function. Few studies have examined this association in children. Further, metal exposure occurs as a mixture, yet previous studies of metal-associated olfactory dysfunction only examined individual metals. Preventing olfactory dysfunctions can improve quality of life and prevent neurodegenerative diseases with long-term health implications. OBJECTIVE We aimed to test the association between exposure to a mixture of 12 metals measured in environmental sources and olfactory function among children and adolescents residing in the industrialized province of Brescia, Italy. METHODS We enrolled 130 children between 6 and 13 years old (51.5% females) and used the "Sniffin' Sticks" test to measure olfactory performance in identifying smells. We used a portable X-ray fluorescence instrument to determine concentrations of metals (arsenic (As), calcium, cadmium (Cd), chromium, copper, iron, manganese, lead (Pb), antimony, titanium, vanadium and zinc) in outdoor and indoor deposited dust and soil samples collected from participants' households. We used an extension of weighted quantile sum (WQS) regression to test the association between exposure to metal mixtures in multiple environmental media and olfactory function adjusting for age, sex, socio-economic status, intelligence quotient and parents' smoking status. RESULTS A higher multi-source mixture was significantly associated with a reduced Sniffin' Sticks identification score (β = -0.228; 95% CI -0.433, -0.020). Indoor dust concentrations of Pb, Cd and As provided the strongest contributions to this association (13.8%, 13.3% and 10.1%, respectively). The metal mixture in indoor dust contributed more (for 8 metals out of 12) to the association between metals and olfactory function compared to soil or outdoor dust. IMPACT STATEMENT Among a mixture of 12 metals measured in three different environmental sources (soil, outdoor and indoor dust), we identified Pb, Cd and As measured in indoor dust as the main contributors to reduced olfactory function in children and adolescents residing in an industrialized area. Exposure to indoor pollution can be effectively reduced through individual and public health interventions allowing to prevent the deterioration of olfactory functions. Moreover, the identification of the factors that can deteriorate olfactory functions can be a helpful instrument to improve quality of life and prevent neurodegenerative diseases as long-term health implications.
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Affiliation(s)
- Stefano Renzetti
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy.
| | - Christoph van Thriel
- Leibniz Research Centre for Working Environment and Human Factors (IfADo), Neurotoxicology and Chemosensation, TU Dortmund, Dortmund, Germany
| | - Roberto G Lucchini
- Department of Biochemical, Biomedical and Neurosciences, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
- Department of Environmental Health Sciences, School of Public Health, Florida International University, Miami, FL, USA
| | - Donald R Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, CA, USA
| | - Marco Peli
- Department of Civil, Environmental, Architectural Engineering and Mathematics, Università degli Studi di Brescia, Brescia, Italy
| | - Laura Borgese
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Brescia, Italy
| | - Paola Cirelli
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Brescia, Italy
| | - Fabjola Bilo
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Brescia, Italy
| | - Alessandra Patrono
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Giuseppa Cagna
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Elza Rechtman
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Stefania Idili
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Elisa Ongaro
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Stefano Calza
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Matteo Rota
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Donatella Placidi
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
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Iannucci V, Bruscolini A, Iannella G, Visioli G, Alisi L, Salducci M, Greco A, Lambiase A. Olfactory Dysfunction and Glaucoma. Biomedicines 2024; 12:1002. [PMID: 38790964 PMCID: PMC11117544 DOI: 10.3390/biomedicines12051002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Olfactory dysfunction is a well-known phenomenon in neurological diseases with anosmia and hyposmia serving as clinical or preclinical indicators of Alzheimer's disease, Parkinson's disease, and other neurodegenerative disorders. Since glaucoma is a neurodegenerative disease of the visual system, it may also entail alterations in olfactory function, warranting investigation into potential sensory interconnections. METHODS A review of the current literature of the last 15 years (from 1 April 2008 to 1 April 2023) was conducted by two different authors searching for topics related to olfaction and glaucoma. RESULTS three papers met the selection criteria. According to these findings, patients with POAG appear to have worse olfaction than healthy subjects. Furthermore, certain predisposing conditions to glaucoma, such as pseudoexfoliation syndrome and primary vascular dysregulation, could possibly induce olfactory changes that can be measured with the Sniffin Stick test. CONCLUSIONS the scientific literature on this topic is very limited, and the pathogenesis of olfactory changes in glaucoma is not clear. However, if the results of these studies are confirmed by further research, olfactory testing may be a non-invasive tool to assist clinicians in the early diagnosis of glaucoma.
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Affiliation(s)
| | | | | | | | | | | | | | - Alessandro Lambiase
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (V.I.); (A.B.); (G.I.); (G.V.); (L.A.); (M.S.); (A.G.)
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5
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Yamasaki T, Ikeda T. Advances in Research on Brain Health and Dementia: Prevention and Early Detection of Cognitive Decline and Dementia. Brain Sci 2024; 14:353. [PMID: 38672005 PMCID: PMC11048231 DOI: 10.3390/brainsci14040353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Although "brain health" has many definitions, the core definition is the maintenance of optimal brain structure and function [...].
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Affiliation(s)
- Takao Yamasaki
- Department of Neurology, Minkodo Minohara Hospital, Fukuoka 811-2402, Japan
- Kumagai Institute of Health Policy, Fukuoka 816-0812, Japan
| | - Takuro Ikeda
- Department of Physical Therapy, Faculty of Medical Sciences, Fukuoka International University of Health and Welfare, Fukuoka 814-0001, Japan;
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Liu K, Aierken A, Liu M, Parhat N, Kong W, Yin X, Liu G, Yu D, Hong J, Ni J, Quan Z, Liu X, Ji S, Mao J, Peng W, Chen C, Yan Y, Qing H. The decreased astrocyte-microglia interaction reflects the early characteristics of Alzheimer's disease. iScience 2024; 27:109281. [PMID: 38455972 PMCID: PMC10918213 DOI: 10.1016/j.isci.2024.109281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/29/2024] [Accepted: 02/16/2024] [Indexed: 03/09/2024] Open
Abstract
Alzheimer's disease (AD) is the most common neurodegenerative disease often associated with olfactory dysfunction. Aβ is a typical AD hall marker, but Aβ-induced molecular alterations in olfactory memory remain unclear. In this study, we used a 5xFAD mouse model to investigate Aβ-induced olfactory changes. Results showed that 4-month-old 5xFAD have olfactory memory impairment accompanied by piriform cortex neuron activity decline and no sound or working memory impairment. In addition, synapse and glia functional alteration is consistent across different ages at the proteomic level. Microglia and astrocyte specific proteins showed strong interactions in the conserved co-expression network module. Moreover, this interaction declines only in mild cognitive impairment patients in human postmortem brain proteomic data. This suggests that astrocytes-microglia interaction may play a leading role in the early stage of Aβ-induced olfactory memory impairment, and the decreasing of their synergy may accelerate the neurodegeneration.
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Affiliation(s)
- Kefu Liu
- MOE Key Laboratory of Rare Pediatric Diseases & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha 410083, Hunan, China
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Ailikemu Aierken
- MOE Key Laboratory of Rare Pediatric Diseases & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha 410083, Hunan, China
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Mengyao Liu
- Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Nazakat Parhat
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Wei Kong
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Xingyu Yin
- MOE Key Laboratory of Rare Pediatric Diseases & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha 410083, Hunan, China
| | - Gang Liu
- Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Ding Yu
- Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Jie Hong
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Junjun Ni
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Zhenzhen Quan
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Xiaoyun Liu
- Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Simei Ji
- Department of Biology, Shenzhen MSU-BIT University, Shenzhen 518172, China
| | - Jian Mao
- Zhengzhou Tobacco Research Institute of China National Tobacco Company, Zhengzhou 450001, China
| | - Weijun Peng
- Department of Integrated Traditional Chinese & Western Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
- National Clinical Research Center for Metabolic Diseases, Changsha, Hunan 410011, China
| | - Chao Chen
- MOE Key Laboratory of Rare Pediatric Diseases & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha 410083, Hunan, China
| | - Yan Yan
- Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Hong Qing
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
- Department of Biology, Shenzhen MSU-BIT University, Shenzhen 518172, China
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7
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Tang X, Guo Z, Chen G, Sun S, Xiao S, Chen P, Tang G, Huang L, Wang Y. A Multimodal Meta-Analytical Evidence of Functional and Structural Brain Abnormalities Across Alzheimer's Disease Spectrum. Ageing Res Rev 2024; 95:102240. [PMID: 38395200 DOI: 10.1016/j.arr.2024.102240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/18/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Numerous neuroimaging studies have reported that Alzheimer's disease (AD) spectrum have been linked to alterations in intrinsic functional activity and cortical thickness (CT) of some brain areas. However, the findings have been inconsistent and the correlation with the transcriptional profile and neurotransmitter systems remain largely unknown. METHODS We conducted a meta-analysis to identify multimodal differences in the amplitude of low-frequency fluctuation (ALFF)/fractional ALFF (fALFF) and CT in patients with AD and preclinical AD compared to healthy controls (HCs), using the Seed-based d Mapping with Permutation of Subject Images software. Transcriptional data were retrieved from the Allen Human Brain Atlas. The atlas-based nuclear imaging-derived neurotransmitter maps were investigated by JuSpace toolbox. RESULTS We included 26 ALFF/fALFF studies comprising 884 patients with AD and 1,020 controls, along with 52 studies comprising 2,046 patients with preclinical AD and 2,336 controls. For CT, we included 11 studies comprising 353 patients with AD and 330 controls. Overall, compared to HCs, patients with AD showed decreased ALFF/fALFF in the bilateral posterior cingulate gyrus (PCC)/precuneus and right angular gyrus, as well as increased ALFF/fALFF in the bilateral parahippocampal gyrus (PHG). Patients with peclinical AD showed decreased ALFF/fALFF in the left precuneus. Additionally, patients with AD displayed decreased CT in the bilateral PHG, left PCC, bilateral orbitofrontal cortex, sensorimotor areas and temporal lobe. Furthermore, gene sets related to brain structural and functional changes in AD and preclincal AD were enriched for G protein-coupled receptor signaling pathway, ion gated channel activity, and components of biological membrane. Functional and structural alterations in AD and preclinical AD were spatially associated with dopaminergic, serotonergic, and GABAergic neurotransmitter systems. CONCLUSIONS The multimodal meta-analysis demonstrated that patients with AD exhibited convergent functional and structural alterations in the PCC/precuneus and PHG, as well as cortical thinning in the primary sensory and motor areas. Furthermore, patients with preclinical AD showed reduced functional activity in the precuneus. AD and preclinical AD showed genetic modulations/neurotransmitter deficits of brain functional and structural impairments. These findings may provide new insights into the pathophysiology of the AD spectrum.
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Affiliation(s)
- Xinyue Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Zixuan Guo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Shilin Sun
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Shu Xiao
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China.
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8
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Vance DE, Del Bene VA, Kamath V, Frank JS, Billings R, Cho DY, Byun JY, Jacob A, Anderson JN, Visscher K, Triebel K, Martin KM, Li W, Puga F, Fazeli PL. Does Olfactory Training Improve Brain Function and Cognition? A Systematic Review. Neuropsychol Rev 2024; 34:155-191. [PMID: 36725781 PMCID: PMC9891899 DOI: 10.1007/s11065-022-09573-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 12/01/2022] [Indexed: 02/03/2023]
Abstract
Olfactory training (OT), or smell training,consists of repeated exposure to odorants over time with the intended neuroplastic effect of improving or remediating olfactory functioning. Declines in olfaction parallel declines in cognition in various pathological conditions and aging. Research suggests a dynamic neural connection exists between olfaction and cognition. Thus, if OT can improve olfaction, could OT also improve cognition and support brain function? To answer this question, we conducted a systematic review of the literature to determine whether there is evidence that OT translates to improved cognition or altered brain morphology and connectivity that supports cognition. Across three databases (MEDLINE, Scopus, & Embase), 18 articles were identified in this systematic review. Overall, the reviewed studies provided emerging evidence that OT is associated with improved global cognition, and in particular, verbal fluency and verbal learning/memory. OT is also associated with increases in the volume/size of olfactory-related brain regions, including the olfactory bulb and hippocampus, and altered functional connectivity. Interestingly, these positive effects were not limited to patients with smell loss (i.e., hyposmia & anosmia) but normosmic (i.e., normal ability to smell) participants benefitted as well. Implications for practice and research are provided.
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Affiliation(s)
- David E Vance
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL, USA.
| | - Victor A Del Bene
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Jennifer Sandson Frank
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL, USA
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Do-Yeon Cho
- Department of Surgery, Veterans Affairs, University of Alabama at Birmingham, & Division of Otolaryngology, Birmingham, AL, USA
| | - Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL, USA
| | - Alexandra Jacob
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joseph N Anderson
- School of Medicine, Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristina Visscher
- Department of Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristen Triebel
- School of Medicine, Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karli M Martin
- School of Medicine, Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Wei Li
- Department of Clinical and Diagnostic Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Frank Puga
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL, USA
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL, USA
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9
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Liu D, Lu J, Wei L, Yao M, Yang H, Lv P, Wang H, Zhu Y, Zhu Z, Zhang X, Chen J, Yang QX, Zhang B. Olfactory deficit: a potential functional marker across the Alzheimer's disease continuum. Front Neurosci 2024; 18:1309482. [PMID: 38435057 PMCID: PMC10907997 DOI: 10.3389/fnins.2024.1309482] [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: 10/08/2023] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Alzheimer's disease (AD) is a prevalent form of dementia that affects an estimated 32 million individuals globally. Identifying early indicators is vital for screening at-risk populations and implementing timely interventions. At present, there is an urgent need for early and sensitive biomarkers to screen individuals at risk of AD. Among all sensory biomarkers, olfaction is currently one of the most promising indicators for AD. Olfactory dysfunction signifies a decline in the ability to detect, identify, or remember odors. Within the spectrum of AD, impairment in olfactory identification precedes detectable cognitive impairments, including mild cognitive impairment (MCI) and even the stage of subjective cognitive decline (SCD), by several years. Olfactory impairment is closely linked to the clinical symptoms and neuropathological biomarkers of AD, accompanied by significant structural and functional abnormalities in the brain. Olfactory behavior examination can subjectively evaluate the abilities of olfactory identification, threshold, and discrimination. Olfactory functional magnetic resonance imaging (fMRI) can provide a relatively objective assessment of olfactory capabilities, with the potential to become a promising tool for exploring the neural mechanisms of olfactory damage in AD. Here, we provide a timely review of recent literature on the characteristics, neuropathology, and examination of olfactory dysfunction in the AD continuum. We focus on the early changes in olfactory indicators detected by behavioral and fMRI assessments and discuss the potential of these techniques in MCI and preclinical AD. Despite the challenges and limitations of existing research, olfactory dysfunction has demonstrated its value in assessing neurodegenerative diseases and may serve as an early indicator of AD in the future.
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Affiliation(s)
- Dongming Liu
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jiaming Lu
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Liangpeng Wei
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Mei Yao
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Huiquan Yang
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Pin Lv
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Haoyao Wang
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yajing Zhu
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Zhengyang Zhu
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xin Zhang
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jiu Chen
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qing X. Yang
- Department of Radiology, Center for NMR Research, Penn State University College of Medicine, Hershey, PA, United States
| | - Bing Zhang
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing, China
- Institute of Brain Science, Nanjing University, Nanjing, China
- Jiangsu Provincial Medical Key Discipline (Laboratory), Nanjing, China
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10
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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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11
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Han K, Liang W, Geng H, Jing X, Wang X, Huo Y, Li W, Huang A, An C. The diagnostic value of cognitive assessment indicators for mild cognitive impairment (MCI). APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-10. [PMID: 38316014 DOI: 10.1080/23279095.2024.2306144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
OBJECTIVE This study aims to evaluate and analyze the standard diagnostic methods for mild cognitive impairment (MCI). METHODS This study used a prospective case-control study to examine baseline data and diagnostic indicators in a population of elderly with MCI. Based on different cognitive abilities, this study divided MCI and healthy control groups. The diagnostic indicators included CDT, MOCA, MMSE, PSQI, MBI, DST, HAMD, AD-related blood markers, and olfactory testing. The diagnostic value of each indicator was done using the ROC curve. RESULTS This study included 240 adult participants, 135 in the health group and 105 in the MCI group. A comparison of baseline data revealed statistically significant differences between the two groups regarding age, blood glucose, MMSE, CTD, MOCA, ability to perform daily living, AD-related blood indices and olfactory tests (all p < 0.05). Logistic regression analysis statistically showed that age, MOCA, and CDT were independent diagnostic factors for MCI (all p < 0.05). Combining these three indicators has the best diagnostic specificity (92.54%). AD-related blood and olfactory tests indices had only moderate diagnostic values (AUC: 0.7-0.8). CONCLUSION Age, MOCA, and CDT are good indicators for diagnosing early-stage MCI. AD-related blood indices and olfactory tests can serve as valuable adjuncts in diagnosing MCI.
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Affiliation(s)
- Keyan Han
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Clinical Research Center for Mental Disorders and Institute of Mental Health, Shijiazhuang, China
- Mental Health Center, Hebei Medical University and Hebei technical Innovation Center for Mental Health assessment and Intervention, Shijiazhuang, China
| | - Wei Liang
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Clinical Research Center for Mental Disorders and Institute of Mental Health, Shijiazhuang, China
- Mental Health Center, Hebei Medical University and Hebei technical Innovation Center for Mental Health assessment and Intervention, Shijiazhuang, China
| | - Hao Geng
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Clinical Research Center for Mental Disorders and Institute of Mental Health, Shijiazhuang, China
- Mental Health Center, Hebei Medical University and Hebei technical Innovation Center for Mental Health assessment and Intervention, Shijiazhuang, China
| | - Xinyang Jing
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Clinical Research Center for Mental Disorders and Institute of Mental Health, Shijiazhuang, China
- Mental Health Center, Hebei Medical University and Hebei technical Innovation Center for Mental Health assessment and Intervention, Shijiazhuang, China
| | - Xuemeng Wang
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Clinical Research Center for Mental Disorders and Institute of Mental Health, Shijiazhuang, China
- Mental Health Center, Hebei Medical University and Hebei technical Innovation Center for Mental Health assessment and Intervention, Shijiazhuang, China
| | - Yaxin Huo
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Clinical Research Center for Mental Disorders and Institute of Mental Health, Shijiazhuang, China
- Mental Health Center, Hebei Medical University and Hebei technical Innovation Center for Mental Health assessment and Intervention, Shijiazhuang, China
| | - Wei Li
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Clinical Research Center for Mental Disorders and Institute of Mental Health, Shijiazhuang, China
- Mental Health Center, Hebei Medical University and Hebei technical Innovation Center for Mental Health assessment and Intervention, Shijiazhuang, China
| | - Anqi Huang
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Clinical Research Center for Mental Disorders and Institute of Mental Health, Shijiazhuang, China
- Mental Health Center, Hebei Medical University and Hebei technical Innovation Center for Mental Health assessment and Intervention, Shijiazhuang, China
| | - Cuixia An
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Clinical Research Center for Mental Disorders and Institute of Mental Health, Shijiazhuang, China
- Mental Health Center, Hebei Medical University and Hebei technical Innovation Center for Mental Health assessment and Intervention, Shijiazhuang, China
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12
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Chen H, Ding Y, Huang L, Zhong W, Lin X, Zhang B, Zheng Y, Xu X, Lou M, Yuan C. The Association of Allergy-Related and Non-Allergy-Related Olfactory Impairment with Cognitive Function in Older Adults: Two Cross- Sectional Studies. Curr Alzheimer Res 2024; 20:811-820. [PMID: 38409711 DOI: 10.2174/0115672050284179240215052257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Evidence on the association of Olfactory Impairment (OI) with age-related cognitive decline is inconclusive, and the potential influence of allergy remains unclear. OBJECTIVE We aimed to evaluate the cross-sectional associations of allergy-related and non-allergy- related OI to cognitive function. METHODS We included 2,499 participants from the Health and Retirement Study (HRS)-Harmonized Cognitive Assessment Protocol (HCAP) sub-study and 1,086 participants from the English Longitudinal Study of Ageing (ELSA)-HCAP. The Olfactory Function Field Exam (OFFE) using Sniffin' Stick odor pens was used to objectively assess olfactory function and an olfactory score <6/11 indicated OI. Mini-Mental Status Examination (MMSE) was used to assess global cognitive function and define cognitive impairment (<24/30). A neuropsychologic battery was used to assess five cognitive domains. RESULTS Compared to non-OI participants, individuals with OI had lower MMSE z-score [βHRS = -0.33, 95% Confidence Interval (CI): -0.41 to -0.24; βELSA = -0.31, -0.43 to -0.18] and higher prevalence of cognitive impairment (Prevalence Ratio (PR)HRS = 1.46, 1.06 to 2.01; PRELSA = 1.63, 1.26 to 2.11). The associations were stronger for non-allergy-related OI (βHRS = -0.36; βELSA = -0.34) than for allergy-related OI (βHRS = -0.26; βELSA = 0.13). Similar associations were observed with domain- specific cognitive function measures. CONCLUSION OI, particularly non-allergy-related OI, was related to poorer cognitive function in older adults. Although the current cross-sectional study is subject to several limitations, such as reverse causality and residual confounding, the findings will provide insights into the OI-cognition association and enlighten future attention to non-allergy-related OI for the prevention of potential cognitive impairment.
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Affiliation(s)
- Hui Chen
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yihong Ding
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Liyan Huang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wansi Zhong
- Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Lin
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Baoyue Zhang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Zheng
- Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai, China
| | - Xin Xu
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min Lou
- Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Changzheng Yuan
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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13
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Agbor Epse Muluh E, McCormack JC, Mo Y, Garratt M, Peng M. Gustatory and olfactory shifts during pregnancy and the postpartum period: A systematic review and meta-analysis. Physiol Behav 2024; 273:114388. [PMID: 37890603 DOI: 10.1016/j.physbeh.2023.114388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/04/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
Pregnancy is a transformative phase marked by significant behavioral and physiological changes. Substantial changes in pregnancy-related hormones are thought to induce changes in chemosensory perception, as often observed in non-human animals. However, empirical behavioral research on pregnancy-related olfactory or gustatory changes has not yet reached a consensus. This PROSPERO pre-registered systematic review and meta-analysis evaluated published data of olfactory and gustatory changes in pregnant individuals, across the three pregnancy trimesters and postpartum period. Our comprehensive search strategy identified 20 relevant studies, for inclusion in the meta-analysis. The meta-analysis revealed that pregnant individuals, regardless of trimester, performed significantly poorer in terms of odour identification, however, no difference was detected between non-pregnant controls and women postpartum. Additionally, pregnant women in the second and third trimester rated olfactory stimuli to be more intense. A slight decline in odour pleasantness ratings was observed amongst those in the second trimester. No major difference was observed between pregnant and non-pregnant subjects in terms of gustatory functions, except the first trimester appeared to be associated with increased pleasantness for the sweet taste. Post-hoc meta-regression analyses revealed that pregnancy stage was a significant predictor for observed effect size for odour intensity ratings, but not for odour identification scores. These findings provide valuable insights into the interplay between pregnancy and chemosensory perception, highlighting systematic physiological changes due to pregnancy. Healthcare providers can also utilize the knowledge of sensory shifts to better support pregnant women in making appropriate dietary choices, managing sense-related discomfort, and leading to potential sensory interventions. Overall, this research enhances our comprehension of sensory shifts during pregnancy, benefiting maternal health and pregnancy-related care.
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Affiliation(s)
- Elizabeth Agbor Epse Muluh
- Sensory Neurosensory and Nutrition Laboratory, Department of Food Science, University of Otago, Dunedin, New Zealand; Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Jessica C McCormack
- Sensory Neurosensory and Nutrition Laboratory, Department of Food Science, University of Otago, Dunedin, New Zealand
| | - Yunfan Mo
- Sensory Neurosensory and Nutrition Laboratory, Department of Food Science, University of Otago, Dunedin, New Zealand
| | - Michael Garratt
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Mei Peng
- Sensory Neurosensory and Nutrition Laboratory, Department of Food Science, University of Otago, Dunedin, New Zealand.
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14
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Gögele M, Emmert D, Fuchsberger C, Frasnelli J. Factors influencing olfactory function in an adult general population sample: the CHRIS study. Chem Senses 2024; 49:bjae011. [PMID: 38452143 PMCID: PMC10956961 DOI: 10.1093/chemse/bjae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Indexed: 03/09/2024] Open
Abstract
The sense of smell allows for the assessment of the chemical composition of volatiles in our environment. Different factors are associated with reduced olfactory function, including age, sex, as well as health and lifestyle conditions. However, most studies that aimed at identifying the variables that drive olfactory function in the population suffered from methodological weaknesses in study designs and participant selection, such as the inclusion of convenience sample or only of certain age groups, or recruitment biases. We aimed to overcome these issues by investigating the Cooperative Health Research in South Tyrol (CHRIS) cohort, a population-based cohort, by using a validated odor identification test. Specifically, we hypothesized that a series of medical, demographic and lifestyle variables is associated with odor identification abilities. In addition, our goal was to provide clinicians and researchers with normative values for the Sniffin' Sticks identification set, after exclusion of individuals with impaired nasal patency. We included 6,944 participants without acute nasal obstruction and assessed several biological, social, and medical parameters. A basic model determined that age, sex, years of education, and smoking status together explained roughly 13% of the total variance in the data. We further observed that variables related to medical (positive screening for cognitive impairment and for Parkinson's disease, history of skull fracture, stage 2 hypertension) and lifestyle (alcohol abstinence) conditions had a negative effect on odor identification scores. Finally, we provide clinicians with normative values for both versions of the Sniffin' Sticks odor identification test, i.e. with 16 items and with 12 items.
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Affiliation(s)
- Martin Gögele
- Institute for Biomedicine (affiliated to the University of Lübeck), Eurac Research, Bozen, Italy
| | - David Emmert
- Institute for Biomedicine (affiliated to the University of Lübeck), Eurac Research, Bozen, Italy
| | - Christian Fuchsberger
- Institute for Biomedicine (affiliated to the University of Lübeck), Eurac Research, Bozen, Italy
| | - Johannes Frasnelli
- Institute for Biomedicine (affiliated to the University of Lübeck), Eurac Research, Bozen, Italy
- Department of Anatomy, University of Québec in Trois-Rivières, Québec, Canada
- Research Center, Sacré-Coeur hospital, Montréal, Québec, Canada
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15
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Jobin B, Boller B, Frasnelli J. Smaller grey matter volume in the central olfactory system in mild cognitive impairment. Exp Gerontol 2023; 183:112325. [PMID: 37952649 DOI: 10.1016/j.exger.2023.112325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 11/14/2023]
Abstract
One of the major challenges in the diagnosis of Alzheimer's disease (AD) is to increase the specificity of the early diagnosis. While episodic memory impairment is a sensitive AD marker, other measures are needed to improve diagnostic specificity. A promising biomarker might be a cerebral atrophy of the central olfactory processing areas in the early stages of the disease since an impairment of olfactory identification is present at the clinical stage of AD. Our goal was therefore, (1) to evaluate the grey matter volume (GMV) of central olfactory processing regions in prodromal AD and (2) to assess its association with episodic memory. We included 34 cognitively normal healthy controls (HC), 92 individuals with subjective cognitive decline (SCD), and 40 with mild cognitive impairment (MCI). We performed regions of interest analysis (ROI) using two different approaches, allowing to extract GMV from (1) atlas-based anatomical ROIs and from (2) functional and non-functional subregions of these ROIs (olfactory ROIs and non-olfactory ROIs). Participants with MCI exhibited smaller olfactory ROIs GMV, including significant reductions in the piriform cortex, amygdala, entorhinal cortex, and left hippocampus compared to other groups (p ≤ 0.05, corrected). No significant effect was found regarding anatomical or non-olfactory ROIs GMV. The left hippocampus olfactory ROI GMV was correlated with episodic memory performance (p < 0.05 corrected). Limbic/medial-temporal olfactory processing areas are specifically atrophied at the MCI stage, and the degree of atrophy might predict cognitive decline in AD early stages.
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Affiliation(s)
- Benoît Jobin
- Department of Psychology, Université du Québec à Trois-Rivières, Qc, Canada; Research Centre of the Institut universitaire de Gériatrie de Montréal, Qc, Canada; Research Centre of the Hôpital du Sacré-Cœur de Montréal, Qc, Canada.
| | - Benjamin Boller
- Department of Psychology, Université du Québec à Trois-Rivières, Qc, Canada; Research Centre of the Institut universitaire de Gériatrie de Montréal, Qc, Canada
| | - Johannes Frasnelli
- Research Centre of the Hôpital du Sacré-Cœur de Montréal, Qc, Canada; Department of Anatomy, Université du Québec à Trois-Rivières, Qc, Canada
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16
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González LM, Bourissai A, Lessard-Beaudoin M, Lebel R, Tremblay L, Lepage M, Graham RK. Amelioration of Cognitive and Olfactory System Deficits in APOE4 Transgenic Mice with DHA Treatment. Mol Neurobiol 2023; 60:5624-5641. [PMID: 37329383 DOI: 10.1007/s12035-023-03401-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/24/2023] [Indexed: 06/19/2023]
Abstract
Olfactory dysfunction and atrophy of olfactory brain regions are observed early in mild cognitive impairment and Alzheimer disease. Despite substantial evidence showing neuroprotective effects in MCI/AD with treatment of docosahexaenoic acid (DHA), an omega-3 fatty acid, few studies have assessed DHA and its effects on the olfactory system deficits. We therefore performed structural (MRI), functional (olfactory behavior, novel object recognition), and molecular (markers of apoptosis and inflammation) assessments of APOE4 and wild-type mice ± DHA treatment at 3, 6, and 12 months of age. Our results demonstrate that APOE4 mice treated with the control diet show recognition memory deficits, abnormal olfactory habituation, and discrimination abilities and an increase in IBA-1 immunoreactivity in the olfactory bulb. These phenotypes were not present in APOE4 mice treated with a DHA diet. Alterations in some brain regions' weights and/or volumes were observed in the APOPE4 mice and may be due to caspase activation and/or neuroinflammatory events. These results suggest that the consumption of a diet rich in DHA may provide some benefit to E4 carriers but may not alleviate all symptoms.
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Affiliation(s)
- Laura Martínez González
- Research Centre on Aging CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada
- Department of Pharmacology and Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, QC, J1H 5N4, Sherbrooke, Canada
| | - Adam Bourissai
- Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Faculty of Medicine and Health Sciences, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Mélissa Lessard-Beaudoin
- Research Centre on Aging CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada
- Department of Pharmacology and Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, QC, J1H 5N4, Sherbrooke, Canada
| | - Réjean Lebel
- Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Faculty of Medicine and Health Sciences, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Luc Tremblay
- Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Faculty of Medicine and Health Sciences, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Martin Lepage
- Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Faculty of Medicine and Health Sciences, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Rona K Graham
- Research Centre on Aging CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada.
- Department of Pharmacology and Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, QC, J1H 5N4, Sherbrooke, Canada.
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17
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Liu S, Jiang Z, Zhao J, Li Z, Li R, Qiu Y, Peng H. Disparity of smell tests in Alzheimer's disease and other neurodegenerative disorders: a systematic review and meta-analysis. Front Aging Neurosci 2023; 15:1249512. [PMID: 37744388 PMCID: PMC10512741 DOI: 10.3389/fnagi.2023.1249512] [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: 06/28/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Background There are discrepancies of olfactory impairment between Alzheimer's disease (AD) and other neurodegenerative disorders. Olfactory deficits may be a potential marker for early and differential diagnosis of AD. We aimed to assess olfactory functions in patients with AD and other neurodegenerative disorders, to further evaluate the smell tests using subgroup analysis, and to explore moderating factors affecting olfactory performance. Methods Cross-sectional studies relating to olfactory assessment for both AD and other neurodegenerative disorders published before 27 July 2022 in English, were searched on PubMed, Embase and Cochrane. After literature screening and quality assessment, meta-analyses were conducted using stata14.0 software. Results Forty-two articles involving 12 smell tests that evaluated 2,569 AD patients were included. It was revealed that smell tests could distinguish AD from mild cognitive impairment (MCI), Lewy body disease (LBD), depression, and vascular dementia (VaD), but not from diseases such as frontotemporal dementia (FTD). Our finding indicated that in discriminating AD from MCI, the University of Pennsylvania Smell Identification Test (UPSIT) was most frequently used (95%CI: -1.12 to -0.89), while the Brief Smell Identification Test (B-SIT), was the most widely used method in AD vs. LBD group. Further subgroup analyses indicated that the methods of smell test used contributed to the heterogeneity in olfactory threshold and discrimination scores in group AD vs. MCI. While the moderating variables including age, MMSE scores, education years in AD vs. LBD, were account for heterogeneity across studies. Conclusion Our finding suggests smell tests have potential value in early differential diagnosis of AD. UPSIT and its simplified variant, B-SIT, are widely used methods in the analyses. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php? RecordID = 357970 (PROSPERO, registration number CRD42022357970).
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Affiliation(s)
- Silin Liu
- Department of Otolaryngology Head and Neck Surgery, General Hospital of Southern Theater Command, Guangzhou, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Zhihui Jiang
- Department of Pharmacy, General Hospital of Southern Theater Command, Guangzhou, China
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Jing Zhao
- Department of Otolaryngology Head and Neck Surgery, General Hospital of Southern Theater Command, Guangzhou, China
- Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhensheng Li
- Department of Neurology, General Hospital of Southern Theater Command, Guangzhou, China
| | - Ruixin Li
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yunyi Qiu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Hua Peng
- Department of Otolaryngology Head and Neck Surgery, General Hospital of Southern Theater Command, Guangzhou, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Mady LJ, De Ravin E, Vohra V, Lu J, Newman JG, Hall DE, Dalton PH, Rowan NR. Exploring Olfactory Dysfunction as a Marker of Frailty and Postoperative Outcomes in Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg 2023; 149:828-836. [PMID: 37498617 PMCID: PMC10375382 DOI: 10.1001/jamaoto.2023.1935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/05/2023] [Indexed: 07/28/2023]
Abstract
Importance Olfactory dysfunction (OD) is increasingly recognized as a robust marker of frailty and mortality. Despite broad recognition of frailty as a critical component of head and neck cancer (HNC) care, there is no standardized frailty assessment. Objective To assess the prevalence of OD and its association with frailty and postoperative outcomes in HNC. Design, Setting, and Participants In this prospective cohort study with enrollment between February 17, 2021, to September 29, 2021, at a tertiary academic medical center, 85 eligible adult patients with primary, treatment-naive HNC of mucosal or cutaneous origin were included. Patients with a history of COVID-19, neurocognitive, or primary smell/taste disorders were excluded. Exposures Prospective olfactory assessments (self-reported, visual analog scale [VAS] and psychophysical, University of Pennsylvania Smell Identification Test [UPSIT]) with concurrent frailty assessment (Risk Analysis Index [RAI]) were used. Olfactory-specific quality of life (QOL) was examined with brief Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS). Main Outcome(s) and Measure(s) The primary outcome was the prevalence of OD as assessed by VAS (0-10, no to normal smell) and UPSIT (0-40, higher scores reflect better olfaction) and its association with frailty (RAI, 0-81, higher scores indicate greater frailty). For surgical patients, secondary outcomes were associations between OD and postoperative length of stay (LOS), 30-day postoperative outcomes, and QOD-NS (0-21, higher scores indicate worse QOL). Results Among 51 patients with HNC (mean [SD] age, 63 [10] years; 39 [77%] male participants; 41 [80%] White participants), 24 (47%) were frail, and 4 (8%) were very frail. Despite median (IQR) self-reported olfaction by VAS of 9 (8-10), 30 (59%) patients demonstrated measured OD with psychophysical testing. No meaningful association was found between self-reported and psychophysical testing (Hodges-Lehmann, <0.001; 95% CI, -2 to 1); a total of 46 (90%) patients did not report decreased olfaction-specific QOL. Median UPSIT scores were lower in frail patients (Hodges-Lehmann, 6; 95% CI, 2-12). Multivariate modeling demonstrated severe microsmia/anosmia was associated with 1.75 (95% CI, 1.09-2.80) times odds of being frail/very frail and approximately 3 days increased LOS (β, 2.96; 95% CI, 0.29-5.62). Conclusions and Relevance Although patients with HNC are unaware of olfactory changes, OD is common and may serve as a bellwether of frailty. In this prospective cohort study, a dose-dependent association was demonstrated between increasing degrees of OD and frailty, and the potential utility of olfaction was highlighted as a touchstone in the assessment of HNC frailty.
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Affiliation(s)
- Leila J. Mady
- Department of Otolaryngology–Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Emma De Ravin
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Varun Vohra
- Department of Otolaryngology–Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joseph Lu
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jason G. Newman
- MUSC Hollings Cancer Center, Charleston, South Carolina
- Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Daniel E. Hall
- Wolff Center at UPMC, Pittsburgh, Pennsylvania
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Nicholas R. Rowan
- Department of Otolaryngology–Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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Wang SM, Kang DW, Um YH, Kim S, Lee CU, Lim HK. Olfactory Dysfunction Is Associated with Cerebral Amyloid Deposition and Cognitive Function in the Trajectory of Alzheimer's Disease. Biomolecules 2023; 13:1336. [PMID: 37759734 PMCID: PMC10526796 DOI: 10.3390/biom13091336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/17/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Olfactory dysfunction is consistently observed in individuals with Alzheimer's disease (AD), but its association with beta-amyloid (Aβ) deposition remains unclear. This study aimed to investigate the relationship among olfactory function, cerebral Aβ deposition, and neuropsychological profiles in individuals with no cognitive impairment (NCI), mild cognitive impairment (MCI), and AD dementia. A total of 164 participants were included, and olfactory function was assessed using the brief smell identification test (B-SIT). Cerebral Aβ deposition was measured using [18F]-flutemetamol PET imaging (A-PET). The results show a significant group difference in olfactory function, with the highest impairment observed in the Aβ-positive MCI and AD dementia groups, and the impairment was the lowest in Aβ-negative NCI. Olfactory dysfunction was positively associated with cognitive impairments across multiple domains. Furthermore, individuals with Aβ deposition had lower olfactory function compared to those without Aβ, even within the same neuropsychological stage. The association between olfactory dysfunction and Aβ deposition was observed globally and in specific cortical regions. These findings suggest that olfactory dysfunction is associated with both cognitive function and cerebral Aβ pathology in the trajectory of AD. Olfactory deficits may serve as an additional marker for disease progression and contribute to understanding the underlying mechanisms of AD.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent Hospital, Suwon, Korea, College of Medicine, The Catholic University of Korea, Suwon 16247, Republic of Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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20
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Trapp W, Heid A, Röder S, Wimmer F, Hajak G. "Mmm, Smells like Coffee!": How a Brief Odor Identification Test Could Help to Identify People with Mild Cognitive Impairment and Dementia. Brain Sci 2023; 13:1052. [PMID: 37508984 PMCID: PMC10377169 DOI: 10.3390/brainsci13071052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/26/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Dementia and mild cognitive impairment (MCI) are still underdiagnosed in the general population. Impaired odor identification has been identified as an early marker of MCI and dementia. We aimed to compare the additional diagnostic value of two odor identification tests to a cognitive screening test in detecting MCI or dementia. (2) Methods: The Sniffin' Sticks odor identification test (SS-OIT), a brief odor identification test (B-OIT) requiring the identification of coffee scent, and the Mini-Mental State Exam (MMSE) were administered to a consecutive series of 174 patients (93 with dementia, 42 with mild cognitive impairment, and 39 without cognitive impairment) referred for neuropsychological testing. (3) Results: Both participants with dementia and with MCI exhibited impairments in odor identification. The SS-OIT and the B-OIT were substantially correlated. Complementing MMSE scores with the SS-OIT or the B-OIT similarly improved the diagnostic accuracy of individuals with dementia and MCI. (4) Conclusions: People with suspected dementia or MCI may already benefit from brief odor identification tests. Although these tests require little additional time, they can notably increase sensitivity for dementia or MCI.
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Affiliation(s)
- Wolfgang Trapp
- Department of Psychiatry, Sozialstiftung Bamberg, St.-Getreu-Straße 18, 96049 Bamberg, Germany
- Department of Physiological Psychology, Otto-Friedrich University Bamberg, Markusplatz 3, 96045 Bamberg, Germany
| | - Andreas Heid
- Department of Psychiatry, Sozialstiftung Bamberg, St.-Getreu-Straße 18, 96049 Bamberg, Germany
| | - Susanne Röder
- Department of Psychiatry, Sozialstiftung Bamberg, St.-Getreu-Straße 18, 96049 Bamberg, Germany
| | - Franziska Wimmer
- Department of Psychiatry, Sozialstiftung Bamberg, St.-Getreu-Straße 18, 96049 Bamberg, Germany
| | - Göran Hajak
- Department of Psychiatry, Sozialstiftung Bamberg, St.-Getreu-Straße 18, 96049 Bamberg, Germany
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21
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Audronyte E, Pakulaite-Kazliene G, Sutnikiene V, Kaubrys G. Properties of odor identification testing in screening for early-stage Alzheimer's disease. Sci Rep 2023; 13:6075. [PMID: 37055436 PMCID: PMC10102162 DOI: 10.1038/s41598-023-32878-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/04/2023] [Indexed: 04/15/2023] Open
Abstract
Odor identification (OI) is impaired in the early stages of Alzheimer's disease (AD). However, data regarding the diagnostic properties of OI tests are lacking, preventing their clinical use. We aimed to explore OI and determine the accuracy of OI testing in screening for patients with early AD. In total, 30 participants with mild cognitive impairment due to AD (MCI-AD), 30 with mild dementia due to AD (MD-AD), and 30 cognitively normal elderly participants (CN) were enrolled, and cognitive examination (CDR, MMSE, ADAS-Cog 13, and verbal fluency tests) and assessment of OI (Burghart Sniffin' Sticks odor identification test) were performed. MCI-AD patients scored significantly worse in OI than CN participants, and MD-AD patients had worse OI scores than MCI-AD patients. The ratio of OI to ADAS-Cog 13 score had good diagnostic accuracy in differentiating AD patients from CN participants and in differentiating MCI-AD patients from CN participants. Substitution of ADAS-Cog 13 score with the ratio of OI to ADAS-Cog 13 score in a multinomial regression model improved the classification accuracy, especially of MCI-AD cases. Our results confirmed that OI is impaired during the prodromal stage of AD. OI testing has a good diagnostic quality and can improve the accuracy of screening for early-stage AD.
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Affiliation(s)
- Egle Audronyte
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
| | - Gyte Pakulaite-Kazliene
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Vaiva Sutnikiene
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Gintaras Kaubrys
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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22
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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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23
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Mi Y, Ma X, Du S, Du C, Li X, Tan H, Zhang J, Zhang Q, Shi W, Zhang G, Tian Y. Olfactory function changes and the predictive performance of the Chinese Smell Identification Test in patients with mild cognitive impairment and Alzheimer's disease. Front Aging Neurosci 2023; 15:1068708. [PMID: 36861124 PMCID: PMC9969891 DOI: 10.3389/fnagi.2023.1068708] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023] Open
Abstract
Objectives Olfactory disorder is one of the sensory features that reflects a decline in cognitive function. However, olfactory changes and the discernibility of smell testing in the aging population have yet to be fully elucidated. Therefore, this study aimed to examine the effectiveness of the Chinese Smell Identification Test (CSIT) in distinguishing individuals with cognitive decline from those with normal aging and to determine whether the patients with MCI and AD show changes in their olfactory identification abilities. Methods This cross-sectional study included eligible participants aged over 50 years between October 2019 and December 2021. The participants were divided into three groups: individuals with mild cognitive impairment (MCI), individuals with Alzheimer's disease (AD), and cognitively normal controls (NCs). All participants were assessed using neuropsychiatric scales, the Activity of Daily Living scale, and the 16-odor cognitive state test (CSIT) test. The test scores and the severity of olfactory impairment were also recorded for each participant. Results In total, 366 eligible participants were recruited, including 188 participants with MCI, 42 patients with AD, and 136 NCs. Patients with MCI achieved a mean CSIT score of 13.06 ± 2.05, while patients with AD achieved a mean score of 11.38 ± 3.25. These scores were significantly lower than those of the NC group (14.6 ± 1.57; P < 0.001). An analysis showed that 19.9% of NCs exhibited mild olfactory impairment, while 52.7% of patients with MCI and 69% of patients with AD exhibited mild to severe olfactory impairment. The CSIT score was positively correlated with the MoCA and MMSE scores. The CIST score and the severity of olfactory impairment were identified as robust indicators for MCI and AD, even after adjusting for age, gender, and level of education. Age and educational level were identified as two important confounding factors that influence cognitive function. However, no significant interactive effects were observed between these confounders and CIST scores in determining the risk of MCI. The area under the ROC curve (AUC) generated from the ROC analysis was 0.738 and 0.813 in distinguishing patients with MCI and patients with AD from NCs based on the CIST scores, respectively. The optimal cutoff for distinguishing MCI from NCs was 13, and for distinguishing AD from NCs was 11. The AUC for distinguishing AD from MCI was 0.62. Conclusions The olfactory identification function is frequently affected in patients with MCI and patients with AD. CSIT is a beneficial tool for the early screening of cognitive impairment among elderly patients with cognitive or memory issues.
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Affiliation(s)
- Yan Mi
- Department of Neurology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China
| | - Xiaojuan Ma
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Clinical Medical Research Center, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China
| | - Shan Du
- Department of Neurology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China
| | - Chengxue Du
- Department of Neurology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China
| | - Xiaobo Li
- Department of Neurology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China
| | - Huihui Tan
- Department of Neurology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China
| | - Jie Zhang
- Department of Neurology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China
| | - Qi Zhang
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Clinical Medical Research Center, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China
| | - Wenzhen Shi
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Clinical Medical Research Center, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Wenzhen Shi ✉
| | - Gejuan Zhang
- Department of Neurology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Gejuan Zhang ✉
| | - Ye Tian
- Department of Neurology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, Shaanxi, China,*Correspondence: Ye Tian ✉
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24
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Dong Y, Li Y, Liu K, Han X, Liu R, Ren Y, Cong L, Zhang Q, Hou T, Song L, Tang S, Shi L, Luo Y, Kalpouzos G, Laukka EJ, Winblad B, Wang Y, Du Y, Qiu C. Anosmia, mild cognitive impairment, and biomarkers of brain aging in older adults. Alzheimers Dement 2023; 19:589-601. [PMID: 36341691 DOI: 10.1002/alz.12777] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/14/2022] [Accepted: 07/21/2022] [Indexed: 11/10/2022]
Abstract
Olfactory impairment is a potential marker for prodromal dementia, but the underlying mechanisms are poorly understood. This population-based study included 4214 dementia-free participants (age ≥65 years). Olfaction was assessed using the 16-item Sniffin' Sticks identification test. In the subsamples, we measured plasma amyloid beta (Aβ)40, Aβ42, total tau, and neurofilament light chain (NfL; n = 1054); and quantified hippocampal, entorhinal cortex, and white matter hyperintensity (WMH) volumes, and Alzheimer's disease (AD)-signature cortical thickness (n = 917). Data were analyzed with logistic and linear regression models. In the total sample, mild cognitive impairment (MCI) was diagnosed in 1102 persons (26.2%; amnestic MCI, n = 931; non-amnestic MCI, n = 171). Olfactory impairment was significantly associated with increased likelihoods of MCI, amnestic MCI, and non-amnestic MCI. In the subsamples, anosmia was significantly associated with higher plasma total tau and NfL concentrations, smaller hippocampal and entorhinal cortex volumes, and greater WMH volume, and marginally with lower AD-signature cortical thickness. These results suggest that cerebral neurodegenerative and microvascular lesions are common neuropathologies linking anosmia with MCI in older adults.
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Affiliation(s)
- Yi Dong
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Yuanjing Li
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Keke Liu
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Xiaolei Han
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Rui Liu
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Yifei Ren
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Qinghua Zhang
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Lin Song
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Lin Shi
- BrainNow Research Institute, Shenzhen, China.,Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yishan Luo
- BrainNow Research Institute, Shenzhen, China
| | - Grégoria Kalpouzos
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Bengt Winblad
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.,Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.,Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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25
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Tu L, Wang Z, Lv X, Xie T, Fan Z, Zhang M, Wang H, Yu X. Characteristics of Odor Identification and Hedonics and Their Association with Piriform Cortex-Based Resting-State Functional Connectivity in Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2023; 94:247-258. [PMID: 37212099 DOI: 10.3233/jad-221163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Olfactory identification dysfunction (OID) might be an early sign of amnestic mild cognitive impairment (aMCI). However, odor hedonics, the ability to perceive odor pleasantness, is neglected. Also, the neural substrate of OID remains unclear. OBJECTIVE To explore the characteristics of odor identification and hedonics in aMCI and examine the potential neural correlates of OID by analyzing olfactory functional connectivity (FC) patterns in MCI. METHODS Forty-five controls and 83 aMCI patients were examined. The Chinese smell identification test was used to assess olfaction. Global cognition, memory, and social cognition were assessed. Resting-state functional networks associated with olfactory cortex seeds were compared between the cognitively normal (CN) and aMCI groups, as well as between aMCI subgroups by the degree of OID. RESULTS Compared to controls, aMCI patients had a significant deficit in olfactory identification, mainly reflected in the identification of pleasant and neutral odors. aMCI patients also rated pleasant and neutral odors much lower than controls. A positive correlation between olfaction and social cognition was found in aMCI. The seed-based FC analysis found that aMCI patients had higher FC between the right orbitofrontal cortex and right frontal lobe/middle frontal gyrus than controls. Subgroup analysis showed that, compared to aMCI without OID, aMCI with severe OID had abnormal FC in the bilateral piriform region. CONCLUSION Our results suggest that OID in aMCI primarily refers to the identification of pleasant and neutral odors. The FC alterations in bilateral orbitofrontal cortex and piriform cortices might contribute to the impairment in odor identification.
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Affiliation(s)
- Lihui Tu
- Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health, Sixth Hospital, Haidian District, Beijing, China
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Zhijiang Wang
- Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health, Sixth Hospital, Haidian District, Beijing, China
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Xiaozhen Lv
- Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health, Sixth Hospital, Haidian District, Beijing, China
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Teng Xie
- Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health, Sixth Hospital, Haidian District, Beijing, China
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Zili Fan
- Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health, Sixth Hospital, Haidian District, Beijing, China
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Ming Zhang
- Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health, Sixth Hospital, Haidian District, Beijing, China
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
- Department of Psychiatry, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Huali Wang
- Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health, Sixth Hospital, Haidian District, Beijing, China
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Xin Yu
- Dementia Care and Research Center, Clinical Research Division, Peking University Institute of Mental Health, Sixth Hospital, Haidian District, Beijing, China
- Beijing Dementia Key Lab, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
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Audronyte E, Pakulaite-Kazliene G, Sutnikiene V, Kaubrys G. Odor Discrimination as a Marker of Early Alzheimer's Disease. J Alzheimers Dis 2023; 94:1169-1178. [PMID: 37355894 PMCID: PMC10473073 DOI: 10.3233/jad-230077] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Olfactory dysfunction is an early symptom of Alzheimer's disease (AD). However, olfactory tests are rarely performed in clinical practice because their diagnostic efficacy in detecting early AD is unclear. OBJECTIVE To investigate odor discrimination in patients with early AD and the efficacy of olfactory discrimination tests in differentiating these patients from subjects with normal cognition (CN). METHODS Thirty patients each with mild dementia due to AD (MD-AD) and mild cognitive impairment due to AD (MCI-AD) and 30 older subjects with CN were enrolled. All participants underwent cognitive examinations (CDR, MMSE, ADAS-Cog 13, and verbal fluency) and odor discrimination tests (Sniffin' Sticks test, Burghart®, Germany). RESULTS The MD-AD group achieved significantly worse scores on the olfactory discrimination test than the MCI-AD group, and the MCI-AD group achieved significantly worse results than the CN group (p < 0.05). A cut-off score of≤10 had a diagnostic accuracy of 94.44% (95% CI, 87.51-98.17%) in differentiating patients with MCI-AD/MD-AD from subjects with CN and of 91.67% (95% CI, 81.61-97.24%) in differentiating those with MCI-AD from subjects with CN. Our multinomial logistic regression model with demographic data and ADAS-Cog 13 scores as predictor variables correctly classified 82.2% of the cases (CN, 93.3%; MC-AD, 70%; MD-AD, 83.3%); on adding the olfactory discrimination score to the model, the percentage increased to 92.2% (CN, 96.7%; MCI-AD, 86.7%; MD-AD, 93.3%). CONCLUSION Odor discrimination is impaired in cases of early AD and continues to deteriorate as the disease progresses. The olfactory discrimination test showed good diagnostic efficacy in detecting early AD.
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Affiliation(s)
- Egle Audronyte
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Gyte Pakulaite-Kazliene
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Vaiva Sutnikiene
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Gintaras Kaubrys
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Jobin B, Roy-Côté F, Frasnelli J, Boller B. Olfaction and declarative memory in aging: a meta-analysis. Chem Senses 2023; 48:bjad045. [PMID: 37878784 PMCID: PMC10629936 DOI: 10.1093/chemse/bjad045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Indexed: 10/27/2023] Open
Abstract
Olfactory and declarative memory performances are associated, as both functions are processed by overlapping medial-temporal and prefrontal structures and decline in older adults. While a decline in olfactory identification may be related to a decline in declarative memory, the relationship between olfactory detection threshold and declarative memory remains unclear. In this meta-analysis, we assessed (i) the relationship between olfactory identification/detection threshold and verbal declarative memory in cognitively normal older adults, and (ii) the effect of age on these relationships. We included articles from PsychNet, PubMed, and Academic Search Complete according to the following criteria: (i) inclusion of cognitively normal older adults; (ii) assessment of episodic or semantic memory; and (iii) assessment of olfactory identification or detection threshold. Seventeen studies and 22 effect sizes were eligible and included in this meta-analysis. Olfactory identification was associated with episodic (small effect size: r = 0.19; k = 22) and semantic memory (small effect size: r = 0.16; k = 23). Similarly, the olfactory detection threshold was associated with both episodic (small to medium effect size: r = 0.25; k = 5) and semantic memory (small effect size: r = 0.17; k = 7). Age was found to moderate the relationship between olfactory detection threshold and memory performance. Both olfactory identification and detection threshold performances are associated with declarative memory in older adults, and age only moderates the relationship between olfactory detection threshold and declarative memory performances.
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Affiliation(s)
- Benoît Jobin
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Centre of the Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
- Research Centre of the Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Frédérique Roy-Côté
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Johannes Frasnelli
- Research Centre of the Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Benjamin Boller
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Centre of the Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
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Touliou K, Maglaveras N, Bekiaris E. Olfactory discrimination and identification as prognostic markers of fitness-to-drive in older drivers. Sci Rep 2022; 12:21803. [PMID: 36526731 PMCID: PMC9757633 DOI: 10.1038/s41598-022-26262-3] [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: 11/09/2021] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The necessity for reliable, standardized and validated fitness to drive assessment tools for older drivers have been highlighted and discussed for over three decades. Existing neuropsychological tests of driving performance are focusing mostly on visuo-spatial attention and executive functioning rather than other senses. Over the last decade, olfactory deterioration has been found to be associated with cognitive decline and predicting transition from mild cognitive impairment to dementia. The AGILE fitness to drive battery is standardized for older drivers. In this study it was adapted to include the olfactory Sniff' and Stick's test. The aim was to investigate the value of relevant deficits as predictive markers of driving ability in three driving groups (older drivers with: (a) no impairment (controls), (b) with Mild Cognitive Impairment (MCI) and (c) MCI and other chronic conditions, i.e., comorbidities). So far, no other study has investigated the predictive value of olfactory deficits in driving ability. The findings revealed that discrimination is important for the first year of the examination and as the decline progresses, identification becomes the better olfactory marker. The latter is also evident in the literature. Hence, the results showed that less indicators are required compared to the initial battery. The olfactory markers were dominant over the neuropsychological tests, apart from alertness, for predicting the older driver's fitness to drive regardless of the presence of cognitive impairment and other chronic conditions.
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Verification of the association between cognitive decline and olfactory dysfunction using a DEmentia screening kit in subjects with Alzheimer's dementia, mild cognitive impairment, and normal cognitive function (DESK study): A multicenter, open-label, interventional study. eNeurologicalSci 2022; 29:100439. [DOI: 10.1016/j.ensci.2022.100439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/10/2022] [Accepted: 11/27/2022] [Indexed: 12/05/2022] Open
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Kravatz NL, Ayers E, Bennett DA, Verghese J. Olfactory Dysfunction and Incidence of Motoric Cognitive Risk Syndrome: A Prospective Clinical-Pathologic Study. Neurology 2022; 99:e1886-e1896. [PMID: 36240083 PMCID: PMC9620808 DOI: 10.1212/wnl.0000000000201030] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 06/13/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To examine associations between olfactory dysfunction, Alzheimer disease (AD) pathology, and motoric cognitive risk syndrome (MCR), a predementia syndrome characterized by cognitive complaints and slow gait that is associated with risk for AD and other dementias. METHODS We conducted a retrospective analysis of a prospective cohort study to examine whether baseline olfactory function was associated with the risk of incident MCR in 1,119 adults aged 60 years and older (75.1% female). The association between performance on the Brief Smell Identification Test (BSIT) and incident MCR risk was computed using Cox models and reported as the hazard ratio (HR) with 95% CIs adjusted for demographic, comorbidity, and cognitive factors. Furthermore, we assessed the relationship between postmortem AD pathology and non-AD pathology and olfactory function at the time of MCR diagnosis using linear regression models adjusted for sex, education, age at death, and time from diagnosis to death. RESULTS There were 544 (48.6%) incident cases of MCR over a median follow-up of 3.94 years. Lower BSIT scores (poor olfaction) at baseline were associated with an increased risk of incident MCR (HR for a 1-point increase in BSIT score 0.92; 95% CI 0.88-0.96) in fully adjusted models. Those with hyposmia (scores of ≤8 on the BSIT) at baseline (26.6%) were at an increased risk of MCR (HR 1.44; 95% CI 1.19-1.74) compared with those with normal olfactory function. Higher levels of the composite measure of global AD pathology and presence of Lewy body pathology were associated with lower BSIT scores at the time of incident MCR diagnosis (n = 118). τ tangle density, a specific component of AD pathology, was inversely associated with olfactory function, and the correlation remained after controlling for mild cognitive impairment syndrome and the presence of Lewy body pathology. DISCUSSION The results provide evidence that olfactory dysfunction precedes MCR incidence and is related to Alzheimer pathology, providing a clinical approach to risk stratify and subtype MCR.
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Affiliation(s)
- Nigel L Kravatz
- From the Department of Neurology (N.L.K., E.A., J.V.), Albert Einstein College of Medicine, Bronx, NY; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Medicine (J.V.), Albert Einstein College of Medicine, Bronx, NY
| | - Emmeline Ayers
- From the Department of Neurology (N.L.K., E.A., J.V.), Albert Einstein College of Medicine, Bronx, NY; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Medicine (J.V.), Albert Einstein College of Medicine, Bronx, NY.
| | - David A Bennett
- From the Department of Neurology (N.L.K., E.A., J.V.), Albert Einstein College of Medicine, Bronx, NY; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Medicine (J.V.), Albert Einstein College of Medicine, Bronx, NY
| | - Joe Verghese
- From the Department of Neurology (N.L.K., E.A., J.V.), Albert Einstein College of Medicine, Bronx, NY; Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Medicine (J.V.), Albert Einstein College of Medicine, Bronx, NY
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Yap AC, Mahendran R, Kua EH, Zhou W, Wang DY. Olfactory dysfunction is associated with mild cognitive impairment in community-dwelling older adults. Front Aging Neurosci 2022; 14:930686. [PMID: 36004001 PMCID: PMC9393534 DOI: 10.3389/fnagi.2022.930686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Olfactory impairment is aging related and is associated with cognitive decline in older adults. However, it remains unclear if an olfactory impairment is associated with mild cognitive impairment (MCI) and the degree of impairment in the MCI subtypes. Materials and methods In a cohort of community-living older adults aged 60 years and above, 670 participants were recruited from the Community Health and Intergenerational (CHI) Study. Olfactory function was assessed using a locally developed nine-item smell test in association with neurocognitive assessments. Analysis of covariance (ANCOVA) was used to examine the association of smell identification score and clinical cognitive status while considering demographic, clinical, and neuropsychological factors with Bonferroni correction for group comparisons. Results Age-related smell detection between normal aging (NA) and MCI participants had no significant difference. The overall mean smell identification score in older adults was negatively correlated with age. The mean smell identification score of MCI participants was also not significantly different as compared with NA, but an amnestic MCI multiple domain (aMCI_MD) subgroup had significantly lower (impaired) mean smell identification scores compared with the NA and MCI single domain (amnestic and non-amnestic) group. Conclusion This study demonstrated that olfactory identification impairment is a comorbidity in older adults with amnestic MCI (aMCI) and is a potential marker associated with an early stage of a neurocognitive disorder. The smell test could act as a screening tool to help in the early detection of smell impairment for heterogeneous syndromes of MCI among community-dwelling older adults. Clinicians and researchers could benefit from utilizing the locally developed smell test to screen their patients or research participants before the initiation of an appropriate health intervention or in a clinical trial.
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Affiliation(s)
- Ai Che Yap
- Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
- *Correspondence: Ee Heok Kua,
| | - Weibiao Zhou
- Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
- Weibiao Zhou,
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- De Yun Wang,
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Tan Z, Wang Y, Lu H, Tian W, Xu K, Fan M, Zhao X, Jin L, Cui M, Jiang Y, Chen X. The Effects of Brain Magnetic Resonance Imaging Indices in the Association of Olfactory Identification and Cognition in Chinese Older Adults. Front Aging Neurosci 2022; 14:873032. [PMID: 35865748 PMCID: PMC9294318 DOI: 10.3389/fnagi.2022.873032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Olfactory identification dysfunction frequently occurs in individuals with cognitive decline; however, a pathological mechanism linking the two has not been discovered. We aimed to study the association between olfactory identification and cognitive function, and determine the effects of brain regions atrophy therein. Methods A total of 645 individuals (57.5% were female) from the Taizhou Imaging Study, who underwent cognitive and olfactory identification measurements, were included. A subsample of participants underwent brain magnetic resonance imaging (n = 622). Cognition was assessed with a neuropsychological battery. Olfactory identification was measured using a 12-item Sniffin’ Sticks test. Beta and logistic regressions were used to elucidate the association between olfactory identification and cognition, and the effects of brain regions atrophy in this association. Results Dementia was diagnosed in 41 (6.4%) individuals (mean age = 64.8 years), and mild cognitive impairment (MCI) in 157 (24.3%) individuals (mean age = 64.4 years). Olfactory identification was associated with MMSE and MoCA (both P < 0.001) and specific cognitive domains (memory, executive function, visuospatial function, and language; all P < 0.05). Higher olfactory identification was associated with lower likelihood of MCI and dementia (P < 0.05). The amygdala volume was significantly related to olfactory identification, MMSE, MoCA, and language, and could attenuate the association between olfactory identification and cognitive function. Conclusion The association between olfactory identification and cognition can be partly attributable to differences in amygdala volume, suggesting that the amygdala could be a shared neural substrate that links olfactory identification and cognitive function. Limitations of this study include that all these results were based on a cross-sectional study.
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Novotny D, Stögmann E, Lehrner J. Long-term Olfactory Functions in Patients with Subjective Cognitive Decline and Mild Cognitive Impairment. CHEMOSENS PERCEPT 2022. [DOI: 10.1007/s12078-022-09298-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Abstract
Introduction
Olfactory function is known to be impaired in patients with Alzheimer’s disease (AD) as well as in subjective cognitive decline (SCD) and mild cognitive impairment (MCI), which are generally considered at-risk states for developing AD. The aim of the study at hand was to identify predictors of self-reported olfaction capability (SOC), self-reported capability of perceiving specific odors (SRP), olfaction-related quality of life (ORQ), and odor identification (OIT) in patients with SCD, naMCI, and aMCI.
Methods
The sample consisted of 33 patients with SCD, 88 with naMCI, and 43 with aMCI who consulted the Department of Neurology, Medical University of Vienna, due to memory complaints between January 2001 and May 2018. Olfactory function was assessed objectively by means of the Sniffin’ Sticks odor identification test (OIT) and subjectively by means of the ASOF-scores SOC, SRP, and ORQ at two to three points in time, with an average time interval of 39 months between the first and second examination, and 24 months between the second and third examination. Linear mixed models were used in order to identify clinical and demographic variables as predictors of mean SOC, SRP, ORQ, and OIT throughout the observation period.
Results
There was a statistically significant — albeit small — time-related decline of SOC and ORQ in the SCD group but not in other groups. Throughout the observation period, estimated ORQ was significantly higher in the SCD group than in the naMCI and estimated OIT was significantly higher in the naMCI group than in the aMCI group after adjusting for time of measurement and other covariates. Positive relationships between OIT and all three ASOF-scores, negative relationships between BDI-II and SOC and ORQ, and a positive relationship between WST-IQ and SRP were identified.
Conclusion
There is a statistically significant, albeit small, time-related decline of uncertain clinical relevance in subjective measures of olfactory capability and olfaction-related quality of life in patients with SCD.
Implications
In all subgroups, objectively measured odor-identification scores have a significant impact on subjective scores over time. The study at hand confirms previous observations regarding the negative influence of depression on subjective perception of olfactory capabilities known from cross-sectional studies.
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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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Suzumura S, Kanada Y, Osawa A, Sugioka J, Maeda N, Nagahama T, Shiramoto K, Kuno K, Kizuka S, Sano Y, Mizuguchi T, Kandori A, Kondo I. Assessment of finger motor function that reflects the severity of cognitive function. FUJITA MEDICAL JOURNAL 2022; 7:122-129. [PMID: 35111556 PMCID: PMC8761821 DOI: 10.20407/fmj.2020-013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/20/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We conducted a finger tapping movement test using a finger tapping device with magnetic sensors (UB-2) and performed multiple regression analyses using a number of finger movements parameters to estimate the severity of cognitive impairment. METHODS The subjects of this study were 64 patients, including 44 diagnosed with Alzheimer's disease (AD) (mean age: 73.8±7.0 years) and 20 diagnosed with mild cognitive impairment (MCI) (mean age: 76.7±4.2 years). For the finger-tapping movement tasks, we tested single-hand (left and right) tapping, simultaneous tapping of both hands, and alternate tapping between hands. After measurement, multiple regression analysis adjusted for age and sex was performed to predict the Mini-Mental State Examination (MMSE) score from the calculated hand parameters. RESULTS Relatively high standardized partial regression coefficients were observed for the following two parameters: standard deviation (SD) of distance rate of velocity peak in extending movement and the SD of contact duration. The coefficients of determination (R2) ranged between 0.1 to 0.28. CONCLUSIONS Our results suggest the possibility that these parameters may be used to assess cognitive function. We shall obtain large-scale data from older people to examine the possibility of these parameters to be used as an early diagnostic tool for dementia patients.
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Affiliation(s)
- Shota Suzumura
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yoshikiyo Kanada
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Aiko Osawa
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Junpei Sugioka
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Natsumi Maeda
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Taishi Nagahama
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Kenta Shiramoto
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Katsumi Kuno
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Shiori Kizuka
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yuko Sano
- Center for Technology Innovation - Artificial Intelligence, Research and Development Group, Hitachi Ltd., Kokubunji, Tokyo, Japan
| | - Tomohiko Mizuguchi
- Optronics Innovation Dept., Optronics Division, Maxell, Ltd., Yokohama, Kanagawa, Japan
| | - Akihiko Kandori
- Center for Exploratory Research, Research & Development Group, Hitachi Ltd., Kokubunji, Tokyo, Japan
| | - Izumi Kondo
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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36
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Nogi S, Uchida K, Maruta J, Kurozumi H, Akada S, Shiba M, Inoue K. Utility of olfactory identification test for screening of cognitive dysfunction in community-dwelling older adults. PeerJ 2022; 9:e12656. [PMID: 35036144 PMCID: PMC8697762 DOI: 10.7717/peerj.12656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022] Open
Abstract
Background There is a need for a large-scale screening test that can be used to detect dementia in older individuals at an early stage. Olfactory identification deficits have been shown to occur in the early stages of dementia, indicating their usefulness in screening tests. This study investigated the utility of an olfactory identification test as a screening test for mild cognitive dysfunction in community-dwelling older people. Methods The subjects were city-dwelling individuals aged over 65 years but under 85 years who had not been diagnosed with dementia or mild cognitive impairment. The Japanese version of the Mild Cognitive Impairment Screen was used to evaluate cognitive function. Based on the results, the subjects were divided into two groups: healthy group and cognitively impaired group. Olfactory identification abilities based on the Japanese version of the University of Pennsylvania Smell Identification Test were compared between the groups. Results There were 182 participants in total: 77 in the healthy group and 105 in the cognitively impaired group. The mean olfactory identification test score of the cognitively impaired group was significantly lower than that of the healthy group. The cognitive impairment test score was significantly correlated with the olfactory identification test score. Conclusions Cross-sectional olfactory identification deficits at baseline in community-dwelling older adults reflected cognitive dysfunction. Assessing olfactory identification ability might be useful as a screening test for mild cognitive dysfunction in community-dwelling older people.
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Affiliation(s)
- Satoshi Nogi
- Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kentaro Uchida
- Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Jumpei Maruta
- Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan.,Medical Center for Dementia, Osaka City Kosaiin Hospital, Osaka, Japan
| | - Hideo Kurozumi
- Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Satoshi Akada
- Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masatsugu Shiba
- Medical Statistics, Osaka City University Graduate School of Medicine and Faculty of Medicine, Osaka, Japan
| | - Koki Inoue
- Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan.,Center for Brain Science, Osaka City University Graduate School of Medicine and Faculty of Medicine, Osaka, Japan
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Yamamoto K, Shiota S, Yoshiiwa A, Chishima T, Takigami S, Miyazaki E. Cognitive Function and Olfactory Impairment in Community-Dwelling Older Adults Attending a Salon. J Prim Care Community Health 2022; 13:21501319221117793. [PMID: 35950638 PMCID: PMC9380213 DOI: 10.1177/21501319221117793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Early detection, treatment, and care are important for the prevention of
dementia. Though olfactory impairment has been reported to be associated
with mild cognitive impairment (MCI), there are few reports involving
community-dwelling older adults with no difficulty in daily life in
Japan. Objective: This study aimed to identify the frequency of MCI in community-dwelling
elderly people attending community salons in a city with a high aging
population, and to determine the usefulness of a pocket olfactory
discrimination test. Methods: We recruited 268 independent older adults attending community salons. The
Japanese version of the MCI Screen was used to evaluate cognitive function,
defining MCI as <49.8 out of 100 scores of the memory performance index
(MPI). The Japanese version of the University of Pennsylvania Smell
Identification Test (UPSIT-J) was used for olfactory discrimination and the
number of correct answers out of 4 questions was noted. Results: Of the salon participants, 138 (51.5%) were classified as having MCI. As the
number of correct answers on the olfactory test decreased, the percentage of
participants with MCI increased. The MPI score of the low UPSIT score group
was significantly lower than that of the high UPSIT score group. Conclusions: This study revealed that approximately half of the elderly local residents
living without daily problems were suspected of having MCI. The UPSIT-J-4 is
a simple olfactory identification test, and can be used at any time and any
place. It is useful for screening cognitive function via olfactory
identification in a salon-like setting.
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Affiliation(s)
- Kyoko Yamamoto
- Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
| | - Seiji Shiota
- Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
| | - Aoi Yoshiiwa
- Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
| | | | | | - Eishi Miyazaki
- Oita University Faculty of Medicine, Yufu-shi, Oita, Japan
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Huang X, Aihemaitijiang S, Ye C, Halimulati M, Wang R, Zhang Z. Development of the cMIND Diet and Its Association with Cognitive Impairment in Older Chinese People. J Nutr Health Aging 2022; 26:760-770. [PMID: 35934820 DOI: 10.1007/s12603-022-1829-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Cognitive impairment commonly occurs among older people worldwide. Although the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet was associated with better cognitive function and lower risk of cognitive impairment, it could not be applied to older Chinese due to the traditional dietary characteristics in China. We aimed to develop the Chinese version of the MIND (cMIND) diet and verify its association with cognitive impairment among older Chinese individuals. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS We included a total of 11,245 participants from the Chinese Longitudinal Healthy Longevity Study (CLHLS) follow-up survey in 2018. The mean age of the participants at study baseline was 84.06 (±11.46) years. MEASUREMENTS We established the cMIND diet based on current evidence in the diet-cognition field, combined with Chinese dietary characteristics. The verification of its association with cognitive impairment was conducted using the data from the CLHLS follow-up survey. Adherence to the cMIND diet was assessed by the cMIND diet score, which was calculated from a food frequency questionnaire. Cognitive impairment was identified by the Mini-Mental State Examination. Instrumental activities of daily living (IADL) disability was defined according to the self-reported performance of eight activities. RESULTS The cMIND diet comprised 11 brain-healthy food groups and 1 unhealthy food group. The median cMIND diet score of all participants was 4.5 (from a total of 12 points) and the prevalence of cognitive impairment was 15.2%. Compared with the lowest tertile, the highest tertile score was associated with lower odds of cognitive impairment (odds ratio (OR)=0.60, 95% confidence interval (CI): 0.51-0.72) and IADL disability (OR=0.86, 95% CI: 0.75-0.98) in the full-adjusted model. CONCLUSION We developed the cMIND diet that was suitable for older Chinese individuals, and our results suggested that higher adherence to the cMIND diet was associated with reduced odds of cognitive impairment and IADL disability. In view of the limitations of cross-sectional design in the study, further research is clearly warranted.
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Affiliation(s)
- X Huang
- Zhaofeng Zhang, Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China, Email Address:
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Touliou K, Maglaveras N, Bekiaris E. Olfactory Decline in Older Adults with Mild Cognitive Impairment with and without Comorbidities. Diagnostics (Basel) 2021; 11:diagnostics11122228. [PMID: 34943465 PMCID: PMC8700609 DOI: 10.3390/diagnostics11122228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/08/2021] [Accepted: 11/24/2021] [Indexed: 12/03/2022] Open
Abstract
Over the past two decades, several studies have measured olfactory performance in Mild Cognitive Impairment (MCI). Deficits are observed in multiple olfactory domains, including odour detection threshold, identification, discrimination, and memory. In this study, the psychophysiological Sniffin’ Sticks smell screening test was administered to examine olfactory functioning in 145 older adults with MCI, a group with MCI and chronic comorbid conditions, and a healthy age-matched comparison group. We hypothesised that olfactory performance will deteriorate in the two MCI groups compared to the control group, even after assessing the known contributions of age and gender. The higher olfactory deterioration in the group with the MCI and the comorbidities in the first year disappeared in the second. This could mean that early consideration of the potential effect of other comorbidities that might affect olfaction should be taken and addressed, as they could easily mask the effect of cognitive decline and/or contribute to it. This study also found higher deterioration in smell identification in participants with MCI, as has been found repeatedly in similar research. Olfactory identification seems to be a more robust marker for discriminating people with MCI and without, and even discriminating between those with MCI and having other health problems.
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Affiliation(s)
- Katerina Touliou
- Center for Research and Technology Hellas, Hellenic Institute of Transportation, 57001 Thessaloniki, Greece; (K.T.); (E.B.)
| | - Nicos Maglaveras
- Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, Medical School, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece
- Correspondence:
| | - Evangelos Bekiaris
- Center for Research and Technology Hellas, Hellenic Institute of Transportation, 57001 Thessaloniki, Greece; (K.T.); (E.B.)
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40
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Yan Y, Aierken A, Wang C, Song D, Ni J, Wang Z, Quan Z, Qing H. A potential biomarker of preclinical Alzheimer's disease: The olfactory dysfunction and its pathogenesis-based neural circuitry impairments. Neurosci Biobehav Rev 2021; 132:857-869. [PMID: 34810025 DOI: 10.1016/j.neubiorev.2021.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/26/2021] [Accepted: 11/07/2021] [Indexed: 01/24/2023]
Abstract
The olfactory dysfunction can signal and act as a potential biomarker of preclinical AD. However, the precise regulatory mechanism of olfactory function on the neural pathogenesis of AD is still unclear. The impairment of neural networks in olfaction system has been shown to be tightly associated with AD. As key brain regions of the olfactory system, the olfactory bulb (OB) and the piriform cortex (PCx) have a profound influence on the olfactory function. Therefore, this review will explore the mechanism of olfactory dysfunction in preclinical AD in the perspective of abnormal neural networks in the OB and PCx and their associated brain regions, especially from two aspects of aberrant oscillations and synaptic plasticity damages, which help better understand the underlying mechanism of olfactory neural network damages related to AD.
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Affiliation(s)
- Yan Yan
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, 100081, China
| | - Ailikemu Aierken
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, 100081, China
| | - Chunjian Wang
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, 100081, China
| | - Da Song
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, 100081, China
| | - Junjun Ni
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, 100081, China
| | - Zhe Wang
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, The National Clinical Research Center for Geriatric Disease, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhenzhen Quan
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, 100081, China.
| | - Hong Qing
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing, 100081, China.
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Su MW, Ni JN, Cao TY, Wang SS, Shi J, Tian JZ. The Correlation Between Olfactory Test and Hippocampal Volume in Alzheimer's Disease and Mild Cognitive Impairment Patients: A Meta-Analysis. Front Aging Neurosci 2021; 13:755160. [PMID: 34744696 PMCID: PMC8564359 DOI: 10.3389/fnagi.2021.755160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 09/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Previous studies have reported that olfactory identification deficits may be the earliest clinical features of Alzheimer's disease (AD). However, the association between odor identification and hippocampal atrophy remains unclear. Objective: This meta-analysis quantified the correlation between odor identification test scores and hippocampal volume in AD. Method: A search of the PUBMED, EMBASE, and WEB OF SCIENCE databases was conducted from January 2003 to June 2020 on studies with reported correlation coefficients between olfactory identification score and hippocampal volume in patients with amnestic AD or mild cognitive impairment (MCI). The quality of the studies was assessed using the Newcastle-Ottawa quality assessment scale (NOS). Pooled r-values were combined and computed in R studio. Results: Seven of 627 original studies on AD/MCI using an olfactory identification test (n = 902) were included. A positive correlation was found between hippocampal volume and olfactory test scores (r = 0.3392, 95% CI: 0.2335–0.4370). Moderator analysis showed that AD and MCI patients were more profoundly correlated than normal controls (AD: r = 0.3959, 95% CI: 0.2605–0.5160; MCI: r = 0.3691, 95% CI: 0.1841–0.5288; NC: r = 0.1305, 95% CI: −0.0447–0.2980). Age difference and patient type were the main sources of heterogeneity in this analysis. Conclusion: The correlation appears to be more predominant in the cognitive disorder group (including MCI and AD) than in the non-cognitive disorder group. Age is an independent factor that affects the severity of the correlation during disease progression. The mildness of the correlation suggests that olfactory tests may be more accurate when combined with other non-invasive examinations for early detection. Systematic Review Registration:https://inplasy.com/, identifier INPLASY202140088.
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Affiliation(s)
- Ming-Wan Su
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jing-Nian Ni
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tian-Yu Cao
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Shuo-Shi Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Shi
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jin-Zhou Tian
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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42
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Wang Q, Chen B, Zhong X, Zhou H, Zhang M, Mai N, Wu Z, Huang X, Haehner A, Chen X, Auber LA, Peng Q, Hummel T, Ning Y. Olfactory Dysfunction Is Already Present with Subjective Cognitive Decline and Deepens with Disease Severity in the Alzheimer's Disease Spectrum. J Alzheimers Dis 2021; 79:585-595. [PMID: 33361601 DOI: 10.3233/jad-201168] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Odor identification dysfunction occurs early in Alzheimer's disease (AD) and is considered a preclinical symptom along with subjective cognitive decline (SCD). Nevertheless, whether subjects with SCD are co-symptomatic with odor identification dysfunction remains unclear. OBJECTIVE To compare the degree of odor identification dysfunction and assess the relation between odor identification and cognitive performance in the AD spectrum (including SCD, mild cognitive impairment (MCI), and AD). METHODS Patients (84 SCD, 129 MCI, 52 AD) and 35 controls underwent the Sniffin' Sticks Screen 16 test and comprehensive neuropsychological examination. RESULTS Odor identification scores were progressively lower moving from normal older adult to SCD, MCI, and AD. Additionally,the proportion of odor identification dysfunction were increasingly higher in the AD spectrum (p for trend <0.001), but no significant difference was found in the proportion of subjective olfactory dysfunction. No significant correlation was found between odor identification and cognition in the normal older adults and SCD subjects, but odor identification correlated with global cognition in the MCI (r = 0.199, p = 0.033) and in the AD (r = 0.300, p = 0.036) patients. Multiple linear regression showed that odor identification dysfunction was most strongly associated with memory among different cognitive subdomains and was most strongly associated with immediate verbal recall among different memory subdomains. CONCLUSION Odor identification dysfunction is already present with SCD and deepens with disease severity in the AD spectrum, and it may contribute to predicting cognitive decline and identifying SCD subjects who are at risk of developing AD.
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Affiliation(s)
- Qiang Wang
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China.,Department of Geriatric Psychiatry, The Second People's Hospital of Dali Bai Autonomous Prefecture, Dali, Yunnan Province, China
| | - Ben Chen
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Xiaomei Zhong
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Huarong Zhou
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Min Zhang
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Naikeng Mai
- Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Zhangying Wu
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Xingxiao Huang
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Germany
| | - Xinru Chen
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Lavinia Alberi Auber
- Department of Medicine, University of Fribourg, Fribourg, Switzerland.,Swiss Integrative Center of Human Health, Fribourg, Switzerland
| | - Qi Peng
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Germany
| | - Yuping Ning
- Memory Clinic, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China.,The first School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
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43
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Jobin B, Zahal R, Bussières EL, Frasnelli J, Boller B. Olfactory Identification in Subjective Cognitive Decline: A Meta-Analysis. J Alzheimers Dis 2021; 79:1497-1507. [PMID: 33459721 DOI: 10.3233/jad-201022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Recently, subjective cognitive decline (SCD) has been considered to be one of the first signs of Alzheimer's disease (AD). Since this potential early marker is sensitive but not specific to AD, combining it with other markers could ensure higher accuracy when predicting which persons with SCD will convert to AD. Since olfactory dysfunction is observable in both AD and mild cognitive impairment (MCI), it is a promising marker that could help improve the early diagnosis of AD. OBJECTIVE The aim of this meta-analysis was to verify whether the presence of SCD is associated with a decrease in olfactory identification ability. METHODS We collected articles from the following databases: PsychNet, PubMed, Ebsco, and ProQuest using the keywords: "SCD", "subjective cognitive decline", "subjective cognitive impairment", "subjective memory impairment", "subjective memory decline", "cognitive complaints", "memory complaints", "cognitive concerns", "memory concerns", "olfac*" and "smell". We included articles according to the following criteria: 1) participants aged 50 and over; 2) presence of an SCD group or a conceptual equivalent; 3) presence of a healthy control group with the same age range; and 4) assessment of olfactory identification ability. RESULTS Five studies met the inclusion criteria. Small and homogeneous effects were observed for olfactory identification alteration in individuals with SCD relative to controls (g = -0.16, 95% CI [-0.46, 0.14]). CONCLUSION Despite the low number of studies included, the findings suggest that odor identification is slightly altered in SCD compared to healthy older adults. This alteration in individuals with SCD could be an early marker of AD.
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Affiliation(s)
- Benoît Jobin
- Department of Psychology, Université du Québec à Trois-Rivières, QC, Canada.,Research Centre of the Hôpital du Sacré-Cœur de Montréal, QC, Canada.,Research Centre of the Institut Universitaire de Gériatrie de Montréal, QC, Canada
| | - Rayane Zahal
- Research Centre of the Hôpital du Sacré-Cœur de Montréal, QC, Canada.,Department of Psychology, Université de Montréal, QC, Canada
| | - Eve-Line Bussières
- Department of Psychology, Université du Québec à Trois-Rivières, QC, Canada
| | - Johannes Frasnelli
- Research Centre of the Hôpital du Sacré-Cœur de Montréal, QC, Canada.,Department of Anatomy, Université du Québec à Trois-Rivières, QC, Canada
| | - Benjamin Boller
- Department of Psychology, Université du Québec à Trois-Rivières, QC, Canada.,Research Centre of the Institut Universitaire de Gériatrie de Montréal, QC, Canada
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El Haj M. ODor-evoked Autobiographical Memory in Alzheimer's disease? Arch Clin Neuropsychol 2021; 37:513-520. [PMID: 34491308 DOI: 10.1093/arclin/acab074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Because memory decline is the hallmark of Alzheimer's disease (AD), an important endeavor for both clinicians and researchers is to improve memory performances in AD. This can be pursued by olfactory stimulation of memory in patients with AD and by studying the effects of olfactory stimulation on autobiographical memory (i.e., memory for personal information). The effects of olfactory stimulation on autobiographical memory in patients with mild AD have been reported by recent research. We thus provide the first comprehensive overview of research on odor-evoked autobiographical memory in AD. We also establish the basis for solid theoretical analysis concerning the memory improvement reported by research on odor-evoked autobiographical memory in AD. METHOD We examined literature on odor-evoked autobiographical memories in AD and propose the "OdAMA" (Odor-evoked Autobiographical Memory in Alzheimer's disease) model. RESULTS AND DISCUSSION According to OdAMA model, odor exposure activates involuntary access to specific autobiographical memories, which promotes enhanced experience subjective of retrieval in patients with AD and improves their ability to construct not only recent and remote events but also future ones. The OdAMA model could serve as a guide for researchers and clinicians interested in odor-evoked autobiographical memory in AD.
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Affiliation(s)
- Mohamad El Haj
- Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes Université, Univ Angers, Nantes F-44000, France.,Centre Hospitalier de Tourcoing, Unité de Gériatrie, Tourcoing, France.,Institut Universitaire de France, Paris, France
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45
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Dan X, Wechter N, Gray S, Mohanty JG, Croteau DL, Bohr VA. Olfactory dysfunction in aging and neurodegenerative diseases. Ageing Res Rev 2021; 70:101416. [PMID: 34325072 PMCID: PMC8373788 DOI: 10.1016/j.arr.2021.101416] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 12/15/2022]
Abstract
Alterations in olfactory functions are proposed to be early biomarkers for neurodegeneration. Many neurodegenerative diseases are age-related, including two of the most common, Parkinson's disease (PD) and Alzheimer's disease (AD). The establishment of biomarkers that promote early risk identification is critical for the implementation of early treatment to postpone or avert pathological development. Olfactory dysfunction (OD) is seen in 90% of early-stage PD patients and 85% of patients with early-stage AD, which makes it an attractive biomarker for early diagnosis of these diseases. Here, we systematically review widely applied smelling tests available for humans as well as olfaction assessments performed in some animal models and the relationships between OD and normal aging, PD, AD, and other conditions. The utility of OD as a biomarker for neurodegenerative disease diagnosis and future research directions are also discussed.
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Affiliation(s)
- Xiuli Dan
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Noah Wechter
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Samuel Gray
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Joy G Mohanty
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Deborah L Croteau
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Vilhelm A Bohr
- Section on DNA Repair, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA; Danish Center for Healthy Aging, University of Copenhagen, 2200 Copenhagen, Denmark.
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46
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Jobin B, Boller B, Frasnelli J. Volumetry of Olfactory Structures in Mild Cognitive Impairment and Alzheimer's Disease: A Systematic Review and a Meta-Analysis. Brain Sci 2021; 11:1010. [PMID: 34439629 PMCID: PMC8393728 DOI: 10.3390/brainsci11081010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/25/2022] Open
Abstract
Olfactory decline is an early symptom of Alzheimer's disease (AD) and is a predictor of conversion from mild cognitive impairment (MCI) to AD. Olfactory decline could reflect AD-related atrophy of structures related to the sense of smell. The aim of this study was to verify whether the presence of a clinical diagnosis of AD or MCI is associated with a volumetric decrease in the olfactory bulbs (OB) and the primary olfactory cortex (POC). We conducted two systematic reviews, one for each region and a meta-analysis. We collected articles from PsychNet, PubMed, Ebsco, and ProQuest databases. Results showed large and heterogeneous effects indicating smaller OB volumes in patients with AD (k = 6, g = -1.21, 95% CI [-2.19, -0.44]) and in patients with MCI compared to controls. There is also a trend for smaller POC in patients with AD or MCI compared to controls. Neuroanatomical structures involved in olfactory processing are smaller in AD and these volumetric reductions could be measured as early as the MCI stage.
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Affiliation(s)
- Benoît Jobin
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivieres, QC G8Z 4M3, Canada;
- Research Centre of the Institut Universitaire de Gériatrie de Montréal, Montréal, QC H3W 1W5, Canada
- Research Centre of the CIUSSS du Nord-de-l’île-de-Montréal, Montréal, QC H4J 1C5, Canada;
| | - Benjamin Boller
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivieres, QC G8Z 4M3, Canada;
- Research Centre of the Institut Universitaire de Gériatrie de Montréal, Montréal, QC H3W 1W5, Canada
| | - Johannes Frasnelli
- Research Centre of the CIUSSS du Nord-de-l’île-de-Montréal, Montréal, QC H4J 1C5, Canada;
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivieres, QC G8Z 4M3, Canada
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Walker IM, Fullard ME, Morley JF, Duda JE. Olfaction as an early marker of Parkinson's disease and Alzheimer's disease. HANDBOOK OF CLINICAL NEUROLOGY 2021; 182:317-329. [PMID: 34266602 DOI: 10.1016/b978-0-12-819973-2.00030-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Olfactory impairment is a common and early sign of Parkinson's disease (PD) and Alzheimer's disease (AD), the two most prevalent neurodegenerative conditions in the elderly. This phenomenon corresponds to pathologic processes emerging in the olfactory system prior to the onset of typical clinical manifestations. Clinically available tests can establish hyposmia through odor identification assessment, discrimination, and odor detection threshold. There are significant efforts to develop preventative or disease-modifying therapies that slow down or halt the progression of PD and AD. Due to the convenience and low cost of its assessment, olfactory impairment could be used in these studies as a screening instrument. In the clinical setting, loss of smell may also help to differentiate PD and AD from alternative causes of Parkinsonism and cognitive impairment, respectively. Here, we discuss the pathophysiology of olfactory dysfunction in PD and AD and how it can be assessed in the clinical setting to aid in the early and differential diagnosis of these disorders.
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Affiliation(s)
- Ian M Walker
- Parkinson's Disease Research, Education and Clinical Center, Michael J. Crescenz, VA Medical Center, Philadelphia, PA, United States; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michelle E Fullard
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - James F Morley
- Parkinson's Disease Research, Education and Clinical Center, Michael J. Crescenz, VA Medical Center, Philadelphia, PA, United States; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - John E Duda
- Parkinson's Disease Research, Education and Clinical Center, Michael J. Crescenz, VA Medical Center, Philadelphia, PA, United States; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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Hsieh CH, Chen PG, Zhou B, Lin LJ, Lai JT, Shen PH. Investigation of Normative Value of Commercialized Taiwan Smell Identification Test. ALLERGY & RHINOLOGY 2021; 12:2152656721991525. [PMID: 33643679 PMCID: PMC7894691 DOI: 10.1177/2152656721991525] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background The Taiwan Smell Identification Test (TWSIT) was developed and successfully administered in Taiwanese population since 2015. However, for sanitation reason, the original liquid-jar form of this test is not appropriate. The commercialized TWSIT was then re-designed as “scratch-and-sniff” version: the TIBSIT (Top International Biotech, Taipei, Taiwan). This project aims to investigate the normative value of TIBSIT in different age groups and genders. Methods Volunteers aged 20 to 80 with no subjective smell loss were recruited in a rhinology clinic. The participants were given full instructions on using the TIBSIT. Results Two hundred and nine healthy subjects (female: male =107: 102) were enrolled into this study. The median TIBSIT score in female and male subjects is 47 and 46, respectively. Subjects were further divided into three age groups: (A) 20∼34 years (n = 77), (B) 35∼54 years (n = 77), and (C) 55∼80 years (n = 55). The TIBSIT scores at the tenth percentile value at each age group of male patients are 43, 42 and 37; while the scores at the tenth percentile value at each age group of female patients are 42, 42 and 41. TIBSIT score was significantly and inversely correlated with age (Spearman rho = − 0.20, p = 0.004.). Conclusion We established the normative values of the new TIBSIT in different age groups in Taiwan. Future nation-wide screening is needed for more sophisticated norms establishment.
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Affiliation(s)
- Ching-Hung Hsieh
- Department of Otolaryngology, Kuang Tien General Hospital, Taichung
| | - Philip G Chen
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Health San Antonio, San Antonio, Texas
| | - Bing Zhou
- Department of Otolaryngology-Head and Neck Surgery, Capital Medical University, Beijing, China
| | - Li-Jung Lin
- Graduate Institute of Sports, Leisure & Hospitality Management, National Taiwan Normal University, Taipei
| | - Jen-Tsung Lai
- Department of Otolaryngology, Kuang Tien General Hospital, Taichung
| | - Ping-Hung Shen
- Department of Otolaryngology, Kuang Tien General Hospital, Taichung.,Department of Nursing, Hung-Kuang University, Taichung
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Midorikawa M, Suzuki H, Suzuki Y, Yamauchi K, Sato H, Nemoto K, Sugano Y, Iwasaki H, Sekiya M, Yatoh S, Yahagi N, Hada Y, Arai T, Shimano H. Relationships between Cognitive Function and Odor Identification, Balance Capability, and Muscle Strength in Middle-Aged Persons with and without Type 2 Diabetes. J Diabetes Res 2021; 2021:9961612. [PMID: 34660814 PMCID: PMC8516531 DOI: 10.1155/2021/9961612] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 09/07/2021] [Indexed: 11/24/2022] Open
Abstract
AIM We investigated the relationship between cognitive function and olfactory and physical functions in middle-aged persons with and without type 2 diabetes (T2D) to examine the potential of olfactory and physical functions as biomarkers for early cognitive impairment. METHODS Enrolled were 70 T2D patients (age 40 to <65 y) and 81 age-matched control participants without diabetes. Cognitive function was assessed by the Montreal Cognitive Assessment (MoCA), Trail Making Test parts A and B (TMT-A/-B), Wisconsin Card Sorting Test (WCST), Quick Inventory of Depressive Symptomatology Self-Report (QIDS), and Starkstein Apathy Scale (SAS). Multiple linear regression analyses were performed. RESULTS Odor identification was an independent determinant shown in the results of the TMT-A in the entire participant group and was independently associated with the MoCA and TMT-B in the T2D group. Balance capability assessed with a stabilometer was independently associated with all cognitive function tests except for QISD and SAS in the entire participant group and the T2D group and was independently associated with TMT-A in the control group. Knee extension strength was independently associated with the SAS in the entire participant group and the T2D group. CONCLUSIONS Odor identification, balance capability, and knee extension strength were potential markers for cognitive decline in middle-aged persons with T2D.
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Affiliation(s)
- Manabu Midorikawa
- Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8575, Japan
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Hiroaki Suzuki
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Yasuhiro Suzuki
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba 305-8596, Japan
| | - Kazuyoshi Yamauchi
- Department of Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Hiroyuki Sato
- Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8575, Japan
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Yoko Sugano
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Hitoshi Iwasaki
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Motohiro Sekiya
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Shigeru Yatoh
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Naoya Yahagi
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Hitoshi Shimano
- Department of Internal Medicine (Endocrinology and Metabolism), Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba 305-8575, Japan
- Life Science Center of Tsukuba Advanced Research Alliance (TARA), University of Tsukuba, Tsukuba 305-8575, Japan
- Japan Agency for Medical Research and Development-Core Research for Evolutional Science and Technology (AMED-CREST), Chiyoda-ku 100-0004, Japan
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Abstract
Age-related olfactory dysfunction, or presbyosmia, is a common sensory impairment in aging adults. People in this demographic group with comorbid conditions or exposure to viral, traumatic, or environmental insults remain at the greatest risk for impairment. Several methods for assessing olfaction exist, but they are only available in special settings and require consideration of age, sex, ancestry, and cognition. Perhaps most importantly, olfactory dysfunction has been suggested as an early sign of Alzheimer's and Parkinson's disease and therefore may serve as a tool in the diagnosis and prognosis of these neurodegenerative conditions. Outside of this context, olfactory loss also impacts nutrition, safety, and social relationships, and even predicts mortality itself. This review covers the detection and manifestations of olfactory decline in aging individuals and the myriad ways in which olfactory impairment is connected to their health and well-being.
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Affiliation(s)
- Emily J Papazian
- Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA
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