Utility of olfactory identification test for screening of cognitive dysfunction in community-dwelling older adults

Suggestions on the ideal method of conducting community screenings for older adults

BACKGROUND/OBJECTIVES

Since dementia and frailty lead to a reduced quality of life and risk of needing long-term care in the older adults, we hypothesized that evaluations related to dementia and frailty would be useful and of high interest in screening for the older adults. Therefore, we conducted a community screening incorporating multiple simple evaluations related to dementia and frailty. In addition to various functional evaluations, we investigated interest in tests, thoughts on the disease, and the relationships between subjective (i.e., how one feels about oneself) and objective evaluations (i.e., the results of tests and rating scales). The purpose of this study was to examine the thoughts regarding tests and diseases and the functions that make it difficult to accurately perceive changes by oneself, and to obtain suggestions on the ideal method of community screening for the older adults.

SUBJECTS/METHODS

The participants were 86 people aged 65 and over living in Kotoura Town who participated in the community screening, for which we obtained background information and body measurements. We also assessed physical, cognitive and olfactory function, evaluated nutritional status, and we administered a questionnaire (interest in tests, thoughts on dementia and frailty, and a subjective functional evaluation).

RESULTS

Regarding interest in tests, the participants answers were highest for physical, cognitive and olfactory function, in that order (68.6%, 60.5%, and 50.0%, respectively). In the survey on thoughts on dementia and frailty, 47.6% of participants felt that people with dementia were viewed with prejudice, and 47.7% did not know about frailty. Regarding the relationship between subjective and objective evaluations, only the assessment of cognitive function did not show a correlation between both evaluations.

CONCLUSIONS

From the viewpoint of the participants' degree of interest in and the need for accurate evaluations through objective examination, the findings suggest that the assessment of physical and cognitive function may be beneficial as a screening tool for older adults. Objective evaluation is essential, particularly for assessing cognitive function. However, approximately half the participants believed people with dementia were viewed with prejudice and did not know about frailty, which may lead to barriers to testing and low interest. The importance of increasing the participation rate in community screening through disease-related educational activities was suggested.

Applicability of Sniffin' Sticks Identification Test as a Screening Tool for Olfactory Dysfunction in Northeast China

BACKGROUND Because most case of smell loss are unrecognized, a valid and reliable screening test for olfactory function is needed. The Sniffin' Sticks test is one of the most widely used olfactory tests. As olfaction can be affected by environment and social background, we investigated the regional applicability of Sniffin' Sticks identification subtest as a screening tool. MATERIAL AND METHODS Normosmic volunteers were recruited between May 2021 and August 2021. We collected data on participants' age, sex, and educational level. The Self-Reported Mini-Olfactory Questionnaire and identification test of Sniffin' Sticks test battery were used to assess their olfactory function. RESULTS A total of 688 subjects (316 male, 371 female) volunteered for the screening test. The mean age of participants was 30±7.69 years (range, 15-63 years), and the average score of all subjects was 12.7±0.81 points. The 3 least recognized items among all 16 tests were lemon (correct identification rate 5.4%), clove (correct identification rate 1.5%), and apple (correct identification rate 0.7%). For Self-Reported Mini-Olfactory Questionnaire, 48 of the 687 subjects (7%) stated that they could not recognize the smell of freshly mowed grass. CONCLUSIONS We investigated the applicability of using Sniffin' Sticks Identification test and Self-MOQ as a screening tool for olfactory dysfunction in northeast China. Most of the subjects enrolled in this study failed to reach the normative standard for their age groups in the Sniffin' Sticks test. We suggest the deletion or replacement of items with extremely low correct identification rates and that physicians who use the Sniffin's Sticks test in clinical practice test the applicability in advance to avoid misdiagnosis.

Cognitive Function and Olfactory Impairment in Community-Dwelling Older Adults Attending a Salon

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.