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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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Liang X, Xiao Z, Wu J, Ma X, Zhao Q, Ding D. Serum TRPA1 mediates the association between olfactory function and cognitive function. Front Aging Neurosci 2024; 16:1411031. [PMID: 38915349 PMCID: PMC11194420 DOI: 10.3389/fnagi.2024.1411031] [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: 04/02/2024] [Accepted: 05/24/2024] [Indexed: 06/26/2024] Open
Abstract
Background Olfactory dysfunction was associated with poorer cognition. However, the association between transient receptor potential cation channel subfamily A member 1 (TRPA1) and cognitive function have not been studied. This study aimed to evaluate the mediation effect of TRPA1 on the association between olfactory and cognitive function among Chinese older adults. Methods We recruited 121 participants with cognitive impairment (CI) and 135 participants with normal cognition (NC) from a memory clinic and the "Shanghai Aging Study." Olfactory identification of each participant was measured by the Sniffin' Sticks Screening Test 12 (SSST-12). Serum TRPA1 were quantified using the Enzyme-Linked Immunosorbent Assay. The mediation effects of TRPA1 on the association between olfactory function and cognitive function were explored using mediation analysis. Results The CI group had a significantly higher proportion of the high level of serum TRPA1 (58.7%) than the NC group (42.2%) (p = 0.0086). After adjusted for gender, age, and years of education, mediation analysis verified that TRPA1 partially mediated the association between SSST-12 and Mini Mental State Examination (MMSE). It also verified that TRPA1 partially mediated the association between the identification of peppermint and MMSE. Conclusion Our study emphasizes the mediation role of TRPA1 in the relationship between olfactory and cognitive function among older adults. Further research is necessary to explore the mechanism of TRPA1 on the relationship between olfactory and cognitive decline.
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Affiliation(s)
- Xiaoniu Liang
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxu Xiao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Jie Wu
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoxi Ma
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
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Arruda JFDL, Silva LD, Brisson RT, Micheli GDC, Lima MASDD, Rosso ALZD, Fernandes RDCL. Performance of a cost-effective olfactory test to evaluate hyposmia in Parkinson's disease patients. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-6. [PMID: 38811023 DOI: 10.1055/s-0044-1787139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
BACKGROUND Parkinson's disease (PD) causes motor and non-motor symptoms such as hyposmia, which is evaluated through olfactory tests in the clinical practice. OBJECTIVE To assess the feasibility of using the modified Connecticut Chemosensory Clinical Research Center (mCCCRC) olfactory test and to compare its performance with the Sniffin' Sticks-12 (SS-12, Burghart Messtechnik GmbH, Wedel, Germany) test. METHODS A transversal case-control study in which the patients were divided into the PD group (PDG) and the control group (CG). The cost and difficulty in handling substances to produce the mCCCRC test kits were evaluated. Sociodemographic characteristics, smoking habits, past coronavirus disease 2019 (COVID-19) infections, self-perception of odor sense, and cognition through the Montreal Cognitive Assessment (MoCA) were also evaluated. The PDG was scored by part III of the Unified Parkinson's Disease Rating Scale (UPDRS-III) and the Hoehn and Yahr Scale (H&Y) scale. Correlations were assessed through the Spearman rank correlation coefficient test (ρ, or rho). RESULTS The mCCCRC test was easily manufactured and handled at a cost ten times lower compared with the SS-12. The groups (PDG: n = 34; CG: n = 38) were similar in terms of age, sex, level of schooling, smoking habits, and history of COVID-19. The tests results showed moderate correlation (rho = 0.65; p < 0.0001). The CG presented better cognitive performance and scored better in both tests (p < 0.0001). There was a tendency for a negative correlation with age, but good correlation with the MoCA (p = 0.0029). The results of the PDG group showed no correlation with olfactory results and motor performance or disease duration. The self-perception of hyposmia was low in both groups. CONCLUSION The mCCCRC is an easy-to-apply and inexpensive method that demonstrated a similar performance to that of the SS-12 in evaluating olfaction in PD patients and healthy controls.
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Affiliation(s)
- Josevânia Fulgêncio de Lima Arruda
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Liene Duarte Silva
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Rodrigo Tavares Brisson
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Gabriel de Castro Micheli
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Marco Antônio Sales Dantas de Lima
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Ana Lucia Zuma de Rosso
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
| | - Rita de Cássia Leite Fernandes
- Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil
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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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Xiao Z, Wu W, Ma X, Wu J, Liang X, Cao Y, Zhao Q, Ding D. Olfactory function, neurofilament light chain, and cognitive trajectory: A 12-year follow-up of the Shanghai Aging Study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12485. [PMID: 37800096 PMCID: PMC10549963 DOI: 10.1002/dad2.12485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/08/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023]
Abstract
This study aimed to determine whether blood neurofilament light chain (NfL) modifies the association of olfactory dysfunction (OD) with long-term cognitive decline. A total of 1125 non-demented older adults in the Shanghai Aging Study were evaluated for baseline olfaction (12-item Sniffin' Sticks Smell Test) and cognitive trajectory by a 12-year follow-up. Baseline blood NfL was quantified using Single Molecular Array assay, and dichotomized into low and high levels based on the median value of concentration. The Mini-Mental State Examination (MMSE) and Telephone Interview for Cognitive Status-40 were used to assess participants' cognitive function. Cognitive decline was ascertained when dementia was diagnosed or documented in the medical record during follow-up, or the MMSE declining rate (slope) was 1.0 SD larger than the group mean. OD participants presented a steeper trajectory of MMSE score (p interaction = 0.004) and a high risk of cognitive decline (adjusted HR [95% CI], 1.82 [1.11, 2.98]) only in those with high NfL. Participants with combined OD and high NfL showed the highest risk of cognitive decline (adjusted HR, 2.43 [1.20, 4.92]). OD, especially in combination with high blood NfL concentration, may be able to identify individuals who later incur cognitive deterioration.
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Affiliation(s)
- Zhenxu Xiao
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological DisordersHuashan HospitalFudan UniversityShanghaiChina
| | - Wanqing Wu
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological DisordersHuashan HospitalFudan UniversityShanghaiChina
| | - Xiaoxi Ma
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological DisordersHuashan HospitalFudan UniversityShanghaiChina
| | - Jie Wu
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological DisordersHuashan HospitalFudan UniversityShanghaiChina
| | - Xiaoniu Liang
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological DisordersHuashan HospitalFudan UniversityShanghaiChina
| | - Yang Cao
- Clinical Epidemiology and BiostatisticsSchool of Medical SciencesFaculty of Medicine and HealthÖrebro UniversityÖrebroSweden
- Unit of Integrative EpidemiologyInstitute of Environmental MedicineKarolinska InstituteStockholmSweden
| | - Qianhua Zhao
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological DisordersHuashan HospitalFudan UniversityShanghaiChina
- MOE Frontiers Center for Brain ScienceFudan UniversityShanghaiChina
| | - Ding Ding
- Institute of NeurologyHuashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological DisordersHuashan HospitalFudan UniversityShanghaiChina
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6
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Camara G, Alotaibi M, Lessard-Beaudoin M, Busch K, Gendron L, Graham RK. Specific olfactory deficit patterns observed in seniors and associated with cognitive decline. Prog Neuropsychopharmacol Biol Psychiatry 2023; 126:110775. [PMID: 37120003 DOI: 10.1016/j.pnpbp.2023.110775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/01/2023]
Abstract
Olfactory dysfunction is a common symptom in neurodegenerative disorders and is regarded as a potential early predictor of impending cognitive decline. This study was undertaken in order to determine if olfactory dysfunction observed in the elderly is due to a general loss of smell or the inability to detect specific odours, and if misidentification of odours correlates with cognitive scores. Seniors for the Olfactory Response and Cognition in Aging (ORCA) sub-study were recruited from the Quebec Nutrition and Successful Aging (NuAge) cohort. The University of Pennsylvania smell identification test (UPSIT) was performed to measure olfactory function and the telephone Mini Mental State Examination (t-MMSE) and the French version of the Telephone Interview for Cognitive Status Modified (F-TICS-m) for cognitive status. The results demonstrate that seniors exhibit specific olfactory loss and had severe difficulty in particular in identifying lemon, pizza, fruit punch, cheddar cheese and lime. Furthermore, there was a significant difference in the ability to detect certain odours between the sexes. Results also showed that misidentification of certain scents was associated with cognitive scores, and when the sexes were assessed separately sex-specific misidentification of cognitive-associated odours was observed. The relationship between the cognitive scores and scent misidentification suggests that impending cognitive decline may be highlighted by the inability to smell specific odours. Our study provides additional support for the testing of olfactory function in the elderly and suggests that loss of smell for particular scents may become a useful diagnostic tool.
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Affiliation(s)
- Gemma Camara
- Research Centre on Aging CIUSSS de l'Estrie - CHUS, Canada; Dept of Pharmacology and Physiology, University of Sherbrooke, Sherbrooke, Canada
| | - Majed Alotaibi
- Medical Genomics Research Department, King Abdullah International Medical Research Center, United States of America; King Saud Bin Abdulaziz University for Health and Science, Riyadh, Kingdom of Saudi Arabia
| | - Melissa Lessard-Beaudoin
- Research Centre on Aging CIUSSS de l'Estrie - CHUS, Canada; Dept of Pharmacology and Physiology, University of Sherbrooke, Sherbrooke, Canada
| | - Kate Busch
- Research Centre on Aging CIUSSS de l'Estrie - CHUS, Canada
| | - Louis Gendron
- Dept of Pharmacology and Physiology, University of Sherbrooke, Sherbrooke, Canada
| | - Rona K Graham
- Research Centre on Aging CIUSSS de l'Estrie - CHUS, Canada; Dept of Pharmacology and Physiology, University of Sherbrooke, Sherbrooke, Canada.
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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: 23] [Impact Index Per Article: 23.0] [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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Wang MC, Chiou JM, Chen YC, Chen JH. Association Between Olfactory Dysfunction and Cognitive Impairment in Dementia-Free Older Adults: A Prospective Cohort Study in Taiwan. J Alzheimers Dis 2023; 96:1477-1488. [PMID: 37980657 PMCID: PMC10741368 DOI: 10.3233/jad-230319] [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] [Accepted: 09/27/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Previous studies assessing olfactory function and cognition have mostly been cross-sectional, and few have investigated the Asian geriatric population. OBJECTIVE To examine the relationships of olfaction with global or domain-specific cognitive function in Taiwanese community-dwelling older adults. METHODS This cohort study (2015-2019) is part of the Taiwan Initiative for Geriatric Epidemiological Research. The Taiwanese version of the Montreal Cognitive Assessment (MoCA-T) and a battery of neuropsychological tests were assessed at baseline and at a two-year follow-up. The cross-culture modified Sniffin' Sticks Identification Test (SSIT) was utilized to measure olfactory function. Generalized linear mixed models were used to examine the association of olfaction with cognitive performance over two years. RESULTS Data were collected from 376 participants (55.1% women), with a mean age of 75.6 years. A one-point decrease in the SSIT score (worsening of olfaction) was associated with worse global cognition (MoCA-T: βˆ= -0.13), memory (βˆ= -0.08 to -0.06), and verbal fluency (βˆ= -0.07). Compared with an SSIT score ≥ 11 (normosmia), an SSIT score < 8 (anosmia) was associated with worse global cognition (MoCA-T: βˆ= -0.99), memory (βˆ= -0.48 to -0.42), executive function (Trail Making Test A: βˆ= -0.36), attention (digit span backward: βˆ= -0.34), and verbal fluency (βˆ= -0.45). After stratified analyses, the associations remained in older adults ≥ 75 years, males, and non-carriers of apolipoprotein E ɛ4 in terms of global cognition, memory, and verbal fluency. CONCLUSIONS Odor identification deficits were associated with poor global or domain-specific cognitive function in a four-year cohort of community-dwelling older adults. Cognitive assessments should be conducted in dementia-free elderly individuals with impaired odor identification.
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Affiliation(s)
- Mu-Cyun Wang
- Department of Geriatrics and Gerontology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jeng-Min Chiou
- Institute of Statistics and Data Science, National Taiwan University, Taipei, Taiwan
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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9
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Song J, Xu J, Yuan W, Li R, Guo H, Gao H, Gu C, Feng W, Ma Y, Guo H, Sun Z, Zheng L. A potential biomarker of cognitive impairment: The olfactory dysfunction and its genes expression. Ann Clin Transl Neurol 2022; 9:1884-1897. [PMID: 36300915 PMCID: PMC9735362 DOI: 10.1002/acn3.51680] [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: 07/06/2022] [Revised: 09/09/2022] [Accepted: 10/01/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Accumulation evidence has reported that olfactory impairment may be an essential clinical marker and predictor of mild cognitive impairment or Alzheimer's disease. METHOD Participants were enrolled in the population-based, prospective study in Fuxin county, Liaoning province, China between 2019 and 2021. An inverse probability weighting logistic regression and mixed-effect models were performed to explore the association between dysosmia and cognition and rate of change in cognition, respectively. Besides, we utilized the Robust Rank Aggregation method to integrated three eligible datasets from the Gene Expression Omnibus to identify differential expressed genes. RESULTS A total of 4695 participants were enrolled and 4221 of those were eligible for our cross-sectional study. The mean (SD) age was 59.93(9.78) years, 64.8% were men. Over a 2-year follow-up, of the 2088 participants who completed follow-up, 1559 participants were eligible for our longitude cohort study. We observed an association between dysosmia and an increased risk of cognitive impairment (OR, 0.47, [95% CI, 0.35-0.64]; p < 0.001). The OR (95% CI) for cognition in females with dysosmia was higher than (OR, 0.73[0.51, 1.05], p = .007) that for males with dysosmia (OR, 0.25[0.15, 0.42], p < 0.001; P for interaction <0.001). Dysosmia was also associated with more rapid decline in calculation ability (p < 0.001). Besides, several DEGs were identified, which are mainly associated with olfactory transduction, detection of chemical stimulus involved in sensory perception of smell, sensory perception of smell, olfactory receptor activity and odorant binding. INTERPRETATION These findings proved novel insight into identifying olfactory dysfunction as potential biomarker for diagnosis of cognitive impairment.
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Affiliation(s)
- Jiayi Song
- School of Public HealthChina Medical UniversityShenyang110122China,Ministry of Education‐Shanghai Key Laboratory of Children's Environmental Health, School of Public HealthShanghai Jiao Tong University School of MedicineShanghai200025China
| | - Jiahui Xu
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Wei Yuan
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Ruixue Li
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Hui Guo
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Hanshu Gao
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Cuiying Gu
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Wenjing Feng
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public HealthChina Medical UniversityNo.77 Puhe RoadShenyangLiaoning Province110122China,Institute of Health Sciences, China Medical UniversityNo.77 Puhe RoadShenyangLiaoning Province110122China
| | - Haiqiang Guo
- Department of Health StatisticsChina Medical UniversityShenyang110122China
| | - Zhaoqing Sun
- Department of CardiologyShengjing Hospital of China Medical UniversityShenyang110004P. R. China
| | - Liqiang Zheng
- Ministry of Education‐Shanghai Key Laboratory of Children's Environmental Health, School of Public HealthShanghai Jiao Tong University School of MedicineShanghai200025China
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10
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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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11
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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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12
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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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13
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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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14
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Shen ZX, Sun YM, Gu HH, Zhang Y, Shen ZW, Liang XN, Ding D, Wang J. Association between anxiety symptoms and atrial fibrillation in a community cohort of Chinese older adults: a case-control study. BMC Cardiovasc Disord 2021; 21:471. [PMID: 34592933 PMCID: PMC8485515 DOI: 10.1186/s12872-021-02278-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/20/2021] [Indexed: 12/16/2022] Open
Abstract
Background The association between anxiety and atrial fibrillation (AF) remains unclear. Moreover, this association has rarely been studied in Chinese individuals aged 60 years or older. This study investigated the association between anxiety and AF in a community-based case-control study of older adult residents in urban China. Methods The cases and controls were from a community-based study conducted in the Jingansi community in Shanghai, China, between January 2010 and December 2012. A total of 3622 residents aged 60 years or older without severe vision, hearing, or speaking impairments were eligible to participate in the physical examinations and questionnaire survey. AF was assessed based on a previous physician’s diagnosis, electrocardiogram, ambulatory electrocardiogram, or echocardiogram. Anxiety was evaluated using the Zung Self-Rating Anxiety Scale (ZSAS). Using the AF group as a reference, the control group consisted of randomly selected age- and sex-matched individuals in a 1:5 ratio (case:control = 1:5). The association between anxiety and AF in the AF group and the multifactor-matched control group was explored using logistic regression. Results In the AF and control groups, after adjusting for a history of coronary heart disease, valvular heart disease, hypertension, stroke, hyperlipidemia, and diabetes, as well as depression score, ZSAS scores (odds ratio 1.07; 95% confidence interval 1.02–1.12; p = 0.003), and anxiety symptoms (odds ratio 3.94; 95% confidence interval 1.06–14.70; p = 0.041) were associated with AF. Conclusions Anxiety symptoms were associated with AF in a Chinese older population. This suggests that older adults who have anxiety symptoms may need psychological intervention or treatment in daily life and care.
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Affiliation(s)
- Zhu-Xia Shen
- Department of Cardiology, Jing'an District Centre Hospital of Shanghai, Fudan University, 259 Xikang Rd, Shanghai, 200040, China
| | - Yu-Min Sun
- Department of Cardiology, Jing'an District Centre Hospital of Shanghai, Fudan University, 259 Xikang Rd, Shanghai, 200040, China
| | - Hui-Hui Gu
- Department of Cardiology, Jing'an District Centre Hospital of Shanghai, Fudan University, 259 Xikang Rd, Shanghai, 200040, China
| | - Yan Zhang
- Department of Cardiology, Jing'an District Centre Hospital of Shanghai, Fudan University, 259 Xikang Rd, Shanghai, 200040, China
| | - Zhi-Wen Shen
- Department of Cardiology, Jing'an District Centre Hospital of Shanghai, Fudan University, 259 Xikang Rd, Shanghai, 200040, China
| | - Xiao-Niu Liang
- Department of Neurology, Huashan Hospital, WHO Collaborating Center for Research and Training in Neurosciences, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ding Ding
- Department of Neurology, Huashan Hospital, WHO Collaborating Center for Research and Training in Neurosciences, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jun Wang
- Department of Cardiology, Jing'an District Centre Hospital of Shanghai, Fudan University, 259 Xikang Rd, Shanghai, 200040, China.
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15
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Parvand M, Rankin CH. Is There a Shared Etiology of Olfactory Impairments in Normal Aging and Neurodegenerative Disease? J Alzheimers Dis 2021; 73:1-21. [PMID: 31744002 DOI: 10.3233/jad-190636] [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: 12/19/2022]
Abstract
As we age, our olfactory function declines. In addition to occurring in normal aging, more rapid decrement of olfactory decline has been associated with several neurodegenerative diseases including Alzheimer's disease (AD) and Parkinson's disease (PD). It has been argued that since olfactory deficits occur less frequently or are absent in diseases such as progressive supranuclear palsy, corticobasal degeneration, and multiple system atrophy, olfactory deficits can be used for differential diagnoses of AD and PD. The purpose of this review is to provide a survey of current knowledge about the molecular bases and differential patterns of olfactory deficits present in normal aging, AD, and PD. As substantial research has been conducted in this area, the majority of the content of this review focuses on articles published in the past decade. We hypothesize that olfactory deficits in normal aging, AD, and PD may have different underlying causes, and propose the use of model organisms with small, tractable nervous systems and/or easy to manipulate genomes to further investigate the cellular mechanisms responsible for these deficits.
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Affiliation(s)
- Mahraz Parvand
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Catharine H Rankin
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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16
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Xiao Z, Wu W, Zhao Q, Zhang J, Hong Z, Ding D. Sensory impairments and cognitive decline in older adults: A review from a population-based perspective. AGING AND HEALTH RESEARCH 2021. [DOI: 10.1016/j.ahr.2020.100002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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17
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Ding D, Liang X, Xiao Z, Wu W, Zhao Q, Cao Y. Can dementia be predicted using olfactory identification test in the elderly? A Bayesian network analysis. Brain Behav 2020; 10:e01822. [PMID: 32864870 PMCID: PMC7667339 DOI: 10.1002/brb3.1822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/13/2020] [Accepted: 08/12/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Previous studies suggest that olfactory dysfunction is associated with cognitive decline or dementia. OBJECTIVE To find a potential association between the olfactory identification (OI) and dementia onset, and build a prediction model for dementia screening in the older population. METHODS Nine hundred and forty-seven participants from the Shanghai Aging Study were analyzed. The participants were dementia-free and completed OI test using the Sniffin' Sticks Screening Test-12 at baseline. After an average of 4.9-year follow-up, 75 (8%) of the participants were diagnosed with incident dementia. Discrete Bayesian network (DBN) and multivariable logistic regression (MLR) models were used to explore the dependencies of the incident dementia on the baseline demographics, lifestyles, and OI test results. RESULTS In DBN analysis, odors of orange, cinnamon, peppermint, and pineapple, combined with age and Mini-mental State Examination (MMSE), achieved a high predictive ability for incident dementia, with an area under the receiver operating characteristic curve (AUC) larger than 0.8. The odor cinnamon showed the highest AUC of 0.838 (95% CI: 0.731-0.946) and a high accuracy of 0.867. The DBN incorporating age, MMSE, and one odor test had an accuracy (0.760-0.872 vs. 0.835) comparable to that of the MLR model and revealed the dependency between the variables. CONCLUSION The DBN using OI test may have predictive ability comparable to MLR analysis and suggest potential causal relationship for further investigation. Identification of odor cinnamon might be a useful indicator for dementia screening and deserve further investigation.
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Affiliation(s)
- Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoniu Liang
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxu Xiao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Wanqing Wu
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
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18
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Ding D, Xiao Z, Liang X, Wu W, Zhao Q, Cao Y. Predictive Value of Odor Identification for Incident Dementia: The Shanghai Aging Study. Front Aging Neurosci 2020; 12:266. [PMID: 33005146 PMCID: PMC7479092 DOI: 10.3389/fnagi.2020.00266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/03/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the value of odors in the olfactory identification (OI) test and other known risk factors for predicting incident dementia in the prospective Shanghai Aging Study. METHODS At baseline, OI was assessed using the Sniffin' Sticks Screening Test 12, which contains 12 different odors. Cognition assessment and consensus diagnosis were conducted at both baseline and follow-up to identify incident dementia. Four different multivariable logistic regression (MLR) models were used for predicting incident dementia. In the no-odor model, only demographics, lifestyle, and medical history variables were included. In the single-odor model, we further added one single odor to the first model. In the full model, all 12 odors were included. In the stepwise model, the variables were selected using a bidirectional stepwise selection method. The predictive abilities of these models were evaluated by the area under the receiver operating characteristic curve (AUC). The permutation importance method was used to evaluate the relative importance of different odors and other known risk factors. RESULTS Seventy-five (8%) incident dementia cases were diagnosed during 4.9 years of follow-up among 947 participants. The full and the stepwise MLR model (AUC = 0.916 and 0.914, respectively) have better predictive abilities compared with those of the no- or single-odor models. The five most important variables are Mini-Mental State Examination (MMSE) score, age, peppermint detection, coronary artery disease, and height in the full model, and MMSE, age, peppermint detection, stroke, and education in the stepwise model. The combination of only the top five variables in the stepwise model (AUC = 0.901 and sensitivity = 0.880) has as a good a predictive ability as other models. CONCLUSION The ability to smell peppermint might be one of the useful indicators for predicting dementia. Combining peppermint detection with MMSE, age, education, and history of stroke may have sensitive and robust predictive value for dementia in older adults.
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Affiliation(s)
- Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxu Xiao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoniu Liang
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Wanqing Wu
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
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19
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Turana Y, Lipnicki DM, Handajani YS, Sani TP, Widayanti JR, Suswanti I, Kochan NA, Brodaty H, Sachdev PS. Factors associated with odour identification in older Indonesian and white Australian adults. Aging Clin Exp Res 2020; 32:215-221. [PMID: 31755024 PMCID: PMC7519881 DOI: 10.1007/s40520-019-01419-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/12/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Among older adults, olfactory dysfunction is associated with cognitive impairment, lower quality of life, and increased mortality. While age is a risk factor for olfactory dysfunction, other risk factors are less well understood, and may vary between ethno-regional groups. This study investigated how associations between odour identification (OI) and various risk factors, as well as cognition and language ability, differed or were similar in two distinct ethno-regional groups of older adults. METHODS This cross-sectional study used data from two cohorts: 470 Indonesians (aged 67.4 ± 7.4 years) and 819 white Australians (aged 78.7 ± 4.8 years). Univariate and multivariate analyses explored whether OI test scores were associated with age, sex, education, cholesterol levels, apolipoprotein E ε4 status, smoking, diabetes, hypertension and depression scale scores, or with Mini-Mental State Examination (MMSE) and language test performance. RESULTS Univariate analyses identified some factors associated with OI scores in both Indonesians and white Australians, including older age and smoking with lower scores, and MMSE and language test performance with higher scores. Multivariate analyses yielded different and mutually exclusive patterns of associations in the two ethno-regional groups, with language test scores significantly associated with higher OI scores in Indonesians, and age, being male, smoking, having diabetes and higher depression scale scores significantly associated with lower OI scores in white Australians. CONCLUSION Ethno-regional differences may need consideration in the attempt to fully understand associations between OI and negative outcomes like dementia and mortality, and interventions for olfactory dysfunction might need to be tailored to specific ethno-regional groups. However, the difference in mean age between cohorts is a limitation of this study, and future studies should aim to compare populations with similar age distributions.
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Affiliation(s)
- Yuda Turana
- Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jl. Pluit Raya No. 2, Jakarta, 14440, Indonesia.
- Center of Health Research, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Yvonne S Handajani
- Center of Health Research, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Tara P Sani
- Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jl. Pluit Raya No. 2, Jakarta, 14440, Indonesia
| | - Josephine R Widayanti
- Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jl. Pluit Raya No. 2, Jakarta, 14440, Indonesia
| | - Ika Suswanti
- Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jl. Pluit Raya No. 2, Jakarta, 14440, Indonesia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
- Primary Dementia Collaborative Research Centre, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
- Primary Dementia Collaborative Research Centre, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Tebrügge S, Winkler A, Gerards D, Weimar C, Moebus S, Jöckel KH, Erbel R, Jokisch M. Olfactory Function is Associated with Cognitive Performance: Results of the Heinz Nixdorf Recall Study. J Alzheimers Dis 2019; 63:319-329. [PMID: 29578482 DOI: 10.3233/jad-170863] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND There is strong evidence for an association of olfactory dysfunction and neurodegenerative diseases. Studies on the association of olfaction and cognition in the general population are rare. OBJECTIVE To evaluate gender- and age-specific associations of olfactory function and cognitive performance in a well characterized population-based study sample. METHODS At the third examination of the Heinz Nixdorf Recall study (n = 3,087), 2,640 participants (48% men; 68.2±7.2 years) underwent Sniffin' Sticks Screening Test measuring olfactory function on a scale of 0-12 points. Olfactory function was rated as anosmic, hyposmic, or normosmic (≤6, 7-10 or ≥11 points, respectively). All participants performed eight validated cognitive subtests. Age- (55-64 years, 65-74 years, 75-86 years) and gender-stratified multivariate analysis of covariance was used to evaluate group differences in cognitive performance. RESULTS Women showed better olfactory function than men (p < 0.001). For middle-aged participants, olfactory groups differed in almost all cognitive subtests. The analyses revealed no gender effects, although associations were slightly greater for women than for men. Anosmics showed the worst cognitive performance and normosmics showed the best cognitive performance. In the young- and old-aged groups, a quantitative association was found for anosmics in all subtests and for normosmics and hyposmics in almost all subtests. CONCLUSION This is the first study reporting on age-specific associations of olfactory function and cognitive performance in the general population. The association found in middle-aged participants (65-74 years) may serve as a marker to improve identification of persons at high risk for cognitive decline and dementia.
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Affiliation(s)
- Sarah Tebrügge
- Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany
| | - Angela Winkler
- Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany
| | - Diana Gerards
- Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany
| | - Christian Weimar
- Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Germany
| | - Martha Jokisch
- Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany
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21
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Ghosh A, Torraville SE, Mukherjee B, Walling SG, Martin GM, Harley CW, Yuan Q. An experimental model of Braak's pretangle proposal for the origin of Alzheimer's disease: the role of locus coeruleus in early symptom development. ALZHEIMERS RESEARCH & THERAPY 2019; 11:59. [PMID: 31266535 PMCID: PMC6607586 DOI: 10.1186/s13195-019-0511-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 06/06/2019] [Indexed: 12/22/2022]
Abstract
Background The earliest brain pathology related to Alzheimer’s disease (AD) is hyperphosphorylated soluble tau in the noradrenergic locus coeruleus (LC) neurons. Braak characterizes five pretangle tau stages preceding AD tangles. Pretangles begin in young humans and persist in the LC while spreading from there to other neuromodulatory neurons and, later, to the cortex. While LC pretangles appear in all by age 40, they do not necessarily result in AD prior to death. However, with age and pretangle spread, more individuals progress to AD stages. LC neurons are lost late, at Braak stages III–IV, when memory deficits appear. It is not clear if LC hyperphosphorylated tau generates the pathology and cognitive changes associated with preclinical AD. We use a rat model expressing pseudohyperphosphorylated human tau in LC to investigate the hypothesis that LC pretangles generate preclinical Alzheimer pathology. Methods We infused an adeno-associated viral vector carrying a human tau gene pseudophosphorylated at 14 sites common in LC pretangles into 2–3- or 14–16-month TH-Cre rats. We used odor discrimination to probe LC dysfunction, and we evaluated LC cell and fiber loss. Results Abnormal human tau was expressed in LC and exhibited somatodendritic mislocalization. In rats infused at 2–3 months old, 4 months post-infusion abnormal LC tau had transferred to the serotonergic raphe neurons. After 7 months, difficult similar odor discrimination learning was impaired. Impairment was associated with reduced LC axonal density in the olfactory cortex and upregulated β1-adrenoceptors. LC infusions in 14–16-month-old rats resulted in more severe outcomes. By 5–6 months post-infusion, rats were impaired even in simple odor discrimination learning. LC neuron number was reduced. Human tau appeared in the microglia and cortical neurons. Conclusions Our animal model suggests, for the first time, that Braak’s hypothesis that human AD originates with pretangle stages is plausible. LC pretangle progression here generates both preclinical AD pathological changes and cognitive decline. The odor discrimination deficits are similar to human odor identification deficits seen with aging and preclinical AD. When initiated in aged rats, pretangle stages progress rapidly and cause LC cell loss. These age-related outcomes are associated with a severe learning impairment consistent with memory decline in Braak stages III–IV. Electronic supplementary material The online version of this article (10.1186/s13195-019-0511-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abhinaba Ghosh
- Division of Biomedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada
| | - Sarah E Torraville
- Division of Biomedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada.,Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St. John's, NL, A1B 3X9, Canada
| | - Bandhan Mukherjee
- Division of Biomedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada
| | - Susan G Walling
- Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St. John's, NL, A1B 3X9, Canada
| | - Gerard M Martin
- Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St. John's, NL, A1B 3X9, Canada
| | - Carolyn W Harley
- Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St. John's, NL, A1B 3X9, Canada.
| | - Qi Yuan
- Division of Biomedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada.
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22
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The Association of Olfactory Dysfunction, Frailty, and Mortality Is Mediated by Inflammation: Results from the InCHIANTI Study. J Immunol Res 2019; 2019:3128231. [PMID: 30915369 PMCID: PMC6402210 DOI: 10.1155/2019/3128231] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 11/29/2018] [Indexed: 12/11/2022] Open
Abstract
Background Olfactory dysfunction might unveil the association between ageing and frailty, as it is associated with declining cognitive function, depression, reduced physical performance, reduced dietary intake, and mortality; all these conditions are characterized by increased levels of inflammatory parameters. The present study is aimed at evaluating the association between olfactory dysfunction, frailty, and mortality and whether such association might be mediated by inflammation. Methods We analysed data of 1035 participants aged 65+ enrolled in the “InCHIANTI” study. Olfactory function was tested by the recognition of the smells of coffee, mint, and air. Olfactory dysfunction was defined as lack of recognition of at least two smells. Considering the items “shrinking,” “exhaustion,” “sedentariness,” “slowness,” and “weakness” included in the Fried definition, frailty was defined as the presence of at least three criteria, prefrailty of one or two, and robustness of none. Serum interleukin-6 (IL-6) was measured in duplicate by high-sensitivity enzyme-linked immunosorbent assays. Logistic regression was adopted to assess the association of frailty with olfactory function, as well as with the increasing number of olfactory deficits. Cox regression was used to test the association between olfactory dysfunction and 9-year survival. Results Olfactory dysfunction was associated with frailty, after adjusting (OR 1.94, 95% CI = 1.07-3.51; P = .028); analysis of the interaction term indicated that the association varied according to interleukin-6 levels (P for interaction = .005). Increasing levels of olfactory dysfunction were associated with increasing probability of being frail. Also, olfactory dysfunction was associated with reduced survival (HR 1.52, 95% CI = 1.16-1.98; P = .002); this association varied according to the presence of frailty (P for interaction = .017) and prefrailty status (P for interaction = .046), as well as increased interleukin-6 levels (P for interaction = .011). Conclusions Impairment of olfactory function might represent a marker of frailty, prefrailty, and consequently reduced survival in an advanced age. Inflammation might represent the possible link between these conditions.
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23
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Blanco S, Sanromán L, Pérez-Calvo S, Velasco L, Peñacoba C. Olfactory and cognitive functioning in patients with fibromyalgia. PSYCHOL HEALTH MED 2018; 24:530-541. [PMID: 30453770 DOI: 10.1080/13548506.2018.1549741] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Fibromyalgia is a complex syndrome characterized by chronic musculoskeletal pain. Previous research has found impaired olfactory function and cognitive deficits in patients with fibromyalgia. In non-clinical population (middle-aged and elderly populations) an association has been found between olfactory function and cognitive impairment. Therefore, olfactory impairment identification could be considered as a reliable and early marker predicting the decline of cognitive function in mild cognitive impairment, Alzheimer's disease and Parkinson's disease. Nevertheless, the relationship between cognitive and olfactory functioning has not been studied in fibromyalgia patients. The aims of the study have been to analyze the cognitive and olfactory functioning and their association in a sample of women with fibromyalgia in comparison to women without a chronic pain disease. A transversal study was conducted with fibromyalgia patients (n = 146) and women without a chronic pain disease (n = 122). Data were collected using the WAIS-III (cognitive functioning) and the CCCRC test (olfactory functioning). Descriptive analysis, Student's t test and chi-square tests were conducted. There were significant differences in perceptive organization and processing speed, and in odour identification, odour threshold and total CCCRC score; the lower scores were for fibromyalgia patients. Among the fibromyalgia patients there were significant differences in the verbal scale, the manipulative scale, the total scale and processing speed between normosmic and hyposmic patients, the lowest scores were for hyposmic patients. Although previous literature has shown that self-reports by fibromyalgia patients inform about an enhanced olfactory acuity, the current study suggests that there are deficits in olfactory functioning in these patients. Also, the relationship between olfactory and cognitive functioning in fibromyalgia patients, due to the lack of previous studies, suggests a new line of research. Taken together, these results suggest that olfactory functioning could be included in a bio-psycho-social approach of fibromyalgia patients, because of the association with cognitive functioning.
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Affiliation(s)
- Sheila Blanco
- a Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing , Rey Juan Carlos University , Alcorcón (Madrid) , Spain
| | - Lucía Sanromán
- a Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing , Rey Juan Carlos University , Alcorcón (Madrid) , Spain
| | - Soledad Pérez-Calvo
- a Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing , Rey Juan Carlos University , Alcorcón (Madrid) , Spain
| | - Lilian Velasco
- a Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing , Rey Juan Carlos University , Alcorcón (Madrid) , Spain
| | - Cecilia Peñacoba
- a Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing , Rey Juan Carlos University , Alcorcón (Madrid) , Spain
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Tonacci A, Bruno RM, Ghiadoni L, Pratali L, Berardi N, Tognoni G, Cintoli S, Volpi L, Bonuccelli U, Sicari R, Taddei S, Maffei L, Picano E. Olfactory evaluation in Mild Cognitive Impairment: correlation with neurocognitive performance and endothelial function. Eur J Neurosci 2017; 45:1279-1288. [PMID: 28370677 DOI: 10.1111/ejn.13565] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 03/15/2017] [Accepted: 03/15/2017] [Indexed: 01/05/2023]
Abstract
Mild Cognitive Impairment (MCI) is an intermediate condition between normal aging and dementia, associated with an increased risk of progression into the latter within months or years. Olfactory impairment, a well-known biomarker for neurodegeneration, might be present in the condition early, possibly representing a signal for future pathological onset. Our study aimed at evaluating olfactory function in MCI and healthy controls in relation to neurocognitive performance and endothelial function. A total of 85 individuals with MCI and 41 healthy controls, matched for age and gender, were recruited. Olfactory function was assessed by Sniffin' Sticks Extended Test (Burghart, Medizintechnik, GmbH, Wedel, Germany). A comprehensive neurocognitive assessment was performed. Endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery by ultrasound. MCI individuals showed an impaired olfactory function compared to controls. The overall olfactory score is able to predict MCI with a good sensitivity and specificity (70.3 and 77.4% respectively). In MCI, olfactory identification score is correlated with a number of neurocognitive abilities, including overall cognitive status, dementia rating, immediate and delayed memory, visuospatial ability and verbal fluency. FMD was reduced in MCI (2.90 ± 2.15 vs. 3.66 ± 1.96%, P = 0.016) and was positively associated with olfactory identification score (ρs =0.219, P = 0.025). The association remained significant after controlling for age, gender, and smoking. In conclusion, olfactory evaluation is able to discriminate between MCI and healthy individuals. Systemic vascular dysfunction might be involved, at least indirectly, in olfactory dysfunction in MCI.
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Affiliation(s)
- Alessandro Tonacci
- Clinical Physiology Institute - National Research Council (IFC-CNR), Via Moruzzi 1, 56124, Pisa, Italy
| | - Rosa M Bruno
- Clinical Physiology Institute - National Research Council (IFC-CNR), Via Moruzzi 1, 56124, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lorenza Pratali
- Clinical Physiology Institute - National Research Council (IFC-CNR), Via Moruzzi 1, 56124, Pisa, Italy
| | - Nicoletta Berardi
- Neuroscience Institute, National Research Council (IN-CNR), Pisa, Italy.,Department of Neuroscience, Psychology, Drug Research and Child Health NEUROFARBA, University of Florence, Florence, Italy
| | - Gloria Tognoni
- Neurological Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Simona Cintoli
- Neurological Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Leda Volpi
- Neurological Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Neurological Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Rosa Sicari
- Clinical Physiology Institute - National Research Council (IFC-CNR), Via Moruzzi 1, 56124, Pisa, Italy
| | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lamberto Maffei
- Neuroscience Institute, National Research Council (IN-CNR), Pisa, Italy.,Laboratory of Neurobiology, Scuola Normale Superiore, Pisa, Italy
| | - Eugenio Picano
- Clinical Physiology Institute - National Research Council (IFC-CNR), Via Moruzzi 1, 56124, Pisa, Italy
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