Association Between Olfactory Dysfunction and Amnestic Mild Cognitive Impairment and Alzheimer Disease Dementia

Roberts, Rosebud O.; Christianson, Teresa J.H.; Kremers, Walter K.; Mielke, Michelle M.; Machulda, Mary M.; Vassilaki, Maria; Alhurani, Rabe E.; Geda, Yonas E.; Knopman, David S.; Petersen, Ronald C.

doi:10.1001/jamaneurol.2015.2952

Cited by 316 publications

(296 citation statements)

References 45 publications

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“…The NHANES 2012 prevalence of measured olfactory dysfunction among older adults (≥70 years old) was 30 %, which is considerably lower than the approximately 50 % prevalence rates reported for older adults in the Rush Memory and Aging Project [61] ( n = 481) and the Mayo Clinic Study of Aging [62] ( n = 1430), but consistent with the nationally-representative sample in the National Social Life, Health, and Aging Project [63] ( n = 1436) and the Epidemiology of Hearing Loss Study [11] ( n = 2491).…”

Section: Discussionmentioning

confidence: 99%

New chemosensory component in the U.S. National Health and Nutrition Examination Survey (NHANES): first-year results for measured olfactory dysfunction

Hoffman

Rawal

et al. 2016

Rev Endocr Metab Disord

189

274

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The U.S. NHANES included chemosensory assessments in the 2011–2014 protocol. We provide an overview of this protocol and 2012 olfactory exam findings. Of the 1818 NHANES participants aged ≥40 years, 1281 (70.5 %) completed the exam; non-participation mostly was due to time constraints. Health technicians administered an 8-item, forced-choice, odor identification task scored as normosmic (6–8 odors identified correctly) versus olfactory dysfunction, including hyposmic (4–5 correct) and anosmic/severe hyposmic (0–3 correct). Interviewers recorded self-reported smell alterations (during past year, since age 25, phantosmia), histories of sinonasal problems, xerostomia, dental extractions, head or facial trauma, and chemosensory-related treatment and changes in quality of life. Olfactory dysfunction was found in 12.4 % (13.3 million adults; 55 % males/45 % females) including 3.2 % anosmic/severe hyposmic (3.4 million; 74 % males/26 % females). Selected age-specific prevalences were 4.2 % (40–49 years), 12.7 % (60–69 years), and 39.4 % (80+ years). Among adults ≥70 years, misidentification rates for warning odors were 20.3 % for smoke and 31.3 % for natural gas. The highest sensitivity (correctly identifying dysfunction) and specificity (correctly identifying normosmia) of self-reported olfactory alteration was among anosmics/severe hyposmics (54.4 % and 78.1 %, respectively). In age- and sex-adjusted logistic regression analysis, risk factors of olfactory dysfunction were racial/ethnic minority, income-to-poverty ratio ≤ 1.1, education

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Section: Discussionmentioning

confidence: 99%

New chemosensory component in the U.S. National Health and Nutrition Examination Survey (NHANES): first-year results for measured olfactory dysfunction

Hoffman

Rawal

et al. 2016

Rev Endocr Metab Disord

189

274

View full text Add to dashboard Cite

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“…The preclinical stage of Alzheimer’s disease is known as mild cognitive impairment, and its prompt diagnosis might have prognostic and therapeutic implications 61. CSERPs demonstrated significant delays in clinically normal E4 allele carriers of the apolipoprotein gene, that is, at high risk of developing Alzheimer’s disease, in contrast to non-carriers 59.…”

Section: Chemosensory Event-related Potentialsmentioning

confidence: 99%

Clinical evoked potentials in neurology: a review of techniques and indications

Lascano

Lalive

Hardmeier

et al. 2017

J Neurol Neurosurg Psychiatry

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Evoked potentials (EPs) are a powerful and cost-effective tool for evaluating the integrity and function of the central nervous system. Although imaging techniques, such as MRI, have recently become increasingly important in the diagnosis of neurological diseases, over the past 30 years, many neurologists have continued to employ EPs in specific clinical applications. This review presents an overview of the recent evolution of 'classical' clinical applications of EPs in terms of early diagnosis and disease monitoring and is an extension of a previous review published in this journal in 2005 by Walsh and collaborators. We also provide an update on emerging EPs based on gustatory, olfactory and pain stimulation that may be used as clinically relevant markers of neurodegenerative disorders such as Parkinson's disease, Alzheimer's disease and cortical or peripheral impaired pain perception. EPs based on multichannel electroencephalography recordings, known as high-density EPs, help to better differentiate between healthy subjects and patients and, moreover, they provide valuable spatial information regarding the site of the lesion. EPs are reliable disease-progression biomarkers of several neurological diseases, such as multiple sclerosis and other demyelinating disorders. Overall, EPs are excellent neurophysiological tools that will expand standard clinical practice in modern neurology.

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“…5 In addition, several studies have reported that olfactory deficits in cognitively normal older adults are associated with increased risk for cognitive decline and dementia. [6][7][8] Thus, olfactory testing may be a useful screen to identify risk of neurodegenerative disease. Because most previous studies have been limited to white older adults, potential race differences in the olfaction-dementia relationship remain unexplored, despite previously reported race differences in olfaction 9 and dementia risk.…”

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confidence: 99%

Olfaction and risk of dementia in a biracial cohort of older adults

et al. 2017

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Objective: Prior studies indicate that olfactory function may be an early marker for cognitive impairment, but the body of evidence has been largely restricted to white populations. Methods:We studied 2,428 community-dwelling black and white older adults (baseline age 70-79 years) without dementia enrolled in the Health, Aging, and Body Composition (Health ABC) study. Olfaction was measured as odor identification (OI) with the 12-item Cross Cultural Smell Identification Test in year 3. We defined incident dementia over 12 years on the basis of hospitalization records, prescription for dementia medication, or 1.5-SD decline in race-stratified global cognition score. We assessed dementia risk associated with OI score (by tertile) using Cox proportional hazards models. All analyses were stratified by race.Results: Poorer OI in older adults without dementia was associated with increased risk of dementia. After adjustment for demographics, medical comorbidities, and lifestyle characteristics, white participants in the poor or moderate OI tertile had greater risk of dementia (adjusted hazard ratio [HR] 3.34, 95% confidence interval [CI] 2.45-4.54; and HR 1.84, 95% CI 1.33-2.54, respectively) compared to those in the good tertile of function. Among blacks, worse OI was associated with an increased risk of dementia, but the magnitude of the effect was weaker (p for interaction 5 0.04) for the poor OI tertile (adjusted HR 2.03, 95% CI 1.44-2.84) and for the moderate tertile (adjusted HR 1.42, 95% CI 0.97-2.10). There was no interaction between OI and APOE e4 and risk of dementia.Conclusions: While the magnitude of the association was stronger in whites, we found that poor OI was associated with increased risk of dementia among both black and white older adults. Olfactory testing may be a simple, inexpensive, and highly sensitive method of identifying older adults at risk for developing dementia, particularly when combined with other early markers.

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Association Between Olfactory Dysfunction and Amnestic Mild Cognitive Impairment and Alzheimer Disease Dementia

Cited by 316 publications

References 45 publications

New chemosensory component in the U.S. National Health and Nutrition Examination Survey (NHANES): first-year results for measured olfactory dysfunction

New chemosensory component in the U.S. National Health and Nutrition Examination Survey (NHANES): first-year results for measured olfactory dysfunction

Clinical evoked potentials in neurology: a review of techniques and indications

Olfaction and risk of dementia in a biracial cohort of older adults

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