Change in Odor Identification Impairment is Associated with Improvement with Cholinesterase Inhibitor Treatment in Mild Cognitive Impairment

Devanand, Devangere P.; Lentz, Cody; Chunga, Richard E; Ciarleglio, Adam; Scodes, Jennifer; Andrews, Howard; Schofield, Peter R.; Stern, Yaakov; Huey, Edward D.; Bell, Karen L.; Pelton, Gregory H.

doi:10.3233/jad-170497

Cited by 11 publications

(10 citation statements)

References 31 publications

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“…The association was not found in analyses excluding patients with improved CDR. Overall, the negative findings in this sample of 100 participants with MCI do not replicate other findings in much smaller samples [20]. The evaluation of olfactory function with atropine challenge, and the change in odor identification during the first 8 weeks, cannot be recommended for potential clinical use in predicting improvement in memory with CheI treatment.…”

Section: Discussioncontrasting

confidence: 58%

“…In our pilot study of 37 patients with amnestic MCI who received donepezil for a year, atropine nasal spray challenge at baseline induced a shortterm odor identification decline on the University of Pennsylvania Smell Identification Test (UPSIT) that was associated with weakly significant longer term improvement in episodic verbal memory but not in other measures [20]. In that sample, improvement in odor identification over 8 weeks tended to predict longer term cognitive improvement [20].…”

Section: Introductionmentioning

confidence: 87%

“…Participants were recruited from the Memory Disorders Clinic at NYSPI and the Behavioral Neurology practice at Columbia University Medical Center (CUMC), and by advertising in local media. Inclusion/Exclusion criteria were essentially the same as in the published pilot study [20]. Inclusion criteria were age 55-95 years and diagnosis of amnestic MCI based on the presence of subjective memory complaints, score >1.5 SD below standardized norms on the Wechsler Memory Scale-III Logical Memory combined Story A + B immediate recall or delayed recall scores, or the Free and Cued Selective Reminding Test (FC-SRT) immediate or delayed recall score [21], and without functional impairment consistent with dementia.…”

Section: Participantsmentioning

confidence: 99%

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Odor Identification Impairment and Change with Cholinesterase Inhibitor Treatment in Mild Cognitive Impairment

Devanand

Liu

Chunga

et al. 2020

JAD

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Background: Anticholinergic challenge can induce odor identification impairment that indicates Alzheimer's disease (AD) pathology, and short-term change in odor identification impairment with cholinesterase inhibitor (CheI) treatment may predict longer term cognitive outcomes. Objective: In patients with mild cognitive impairment (MCI) treated prospectively with donepezil, a CheI, for 52 weeks, to determine if 1) acute decline in odor identification ability with anticholinergic challenge can predict cognitive improvement, and 2) change in odor identification over 8 weeks can predict cognitive improvement. Methods: MCI was diagnosed clinically without AD biomarkers. At baseline, the University of Pennsylvania Smell identification Test (UPSIT) was administered before and after an anticholinergic atropine nasal spray challenge. Donepezil was started at 5 mg daily, increased to 10 mg daily if tolerated, and this dose was maintained for 52 weeks. Main outcomes were ADAS-Cog total score and Selective Reminding Test (SRT) total immediate recall score measured at baseline, 26 and 52 weeks. Results: In 100 study participants, mean age 70.14 (SD 9.35) years, atropine-induced decrease in UPSIT score at baseline was not associated with change in ADAS-Cog or SRT scores over 52 weeks. Change in UPSIT score from 0 to 8 weeks did not show a significant association with change in the ADAS-Cog or SRT measures over 52 weeks.

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Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 87%

Section: Participantsmentioning

confidence: 99%

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Odor Identification Impairment and Change with Cholinesterase Inhibitor Treatment in Mild Cognitive Impairment

Devanand

Liu

Chunga

et al. 2020

JAD

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“…Currently, CI is the most common and least treatable of all geriatric diseases. Most CI drugs are used for the treatment of Alzheimer's disease (AD); however, their efficacy remains uncertain, and unpleasant side effects limit the application of these drugs, which mainly include cholinesterase inhibitors, glutamate receptor blockers, calcium ion antagonists, and neuron protectants [4–6].…”

Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Sagacious Confucius’ Pillow Elixir on Cognitive Function in Senescence-Accelerated P8 Mice (SAMP8) via the NLRP3/Caspase-1 Pathway

Hou

Li²,

Chen

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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Sagacious Confucius’ Pillow Elixir (SCPE) is a traditional Chinese medicine that is mainly used for cognitive impairment in aging; however, the underlying mechanisms remain unclear. Aging is one of the most important pathogenic factors leading to inflammation and pyroptosis in the hippocampus, which may be a potential mechanism in elderly patients with cognitive impairment. Here, we examined whether SCPE could improve cognitive impairment in SAMP8 mice by reducing hippocampal inflammation and pyroptosis. Seven-month-old senescence-accelerated P8 mice (SAMP8) received SCPE (2.3 g/kg/day; 4.6 g/kg/day; 9.2 g/kg/day) for 28 days. Cognitive function and morphometric examinations were performed followed by water maze testing, hematoxylin-eosin staining, Congo red staining, toluidine blue staining, and TUNEL analysis of hippocampal CA1 and CA3 regions. Escape latency increased and times across platforms decreased in SAMP8 mice; however, both of them were normalized by SCPE after 28 days. Aging caused significant pyroptosis in hippocampal CA1 and CA3 regions, as evidenced by neuronal degeneration and necrosis, amyloid deposition, and decreased Nissl body amounts after cognitive impairment, which were greatly improved by SCPE. SCPE reduced serum IL-1β, IL-6, IL-18, and TNF-α levels and reduced hippocampal NLRP3, ASC, caspase-1, GSDM-D, IL-1β, IL-6, IL-18, and Aβ expression. Thus, SCPE exerts an antipyroptotic effect in aging, mainly by suppressing the NLRP3/caspase-1 signaling pathway.

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“…The following putative moderators of cognitive improvement were examined in exploratory analyses: apolipoprotein E e4 genotype; impaired odor identification, which is known to be associated with the transition from MCI to Alzheimer disease (AD) 22,23 and therefore may predict cognitive improvement on donepezil 24,25 ; hippocampal and entorhinal cortical atrophy on magnetic resonance imaging (MRI) 26–28 ; and hyperintensities on MRI. 29,30…”

Section: Introductionmentioning

confidence: 99%

Donepezil Treatment in Patients With Depression and Cognitive Impairment on Stable Antidepressant Treatment: A Randomized Controlled Trial

Devanand

Pelton

D’Antonio

et al. 2018

The American Journal of Geriatric Psychiatry

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Change in Odor Identification Impairment is Associated with Improvement with Cholinesterase Inhibitor Treatment in Mild Cognitive Impairment

Cited by 11 publications

References 31 publications

Odor Identification Impairment and Change with Cholinesterase Inhibitor Treatment in Mild Cognitive Impairment

Odor Identification Impairment and Change with Cholinesterase Inhibitor Treatment in Mild Cognitive Impairment

Beneficial Effects of Sagacious Confucius’ Pillow Elixir on Cognitive Function in Senescence-Accelerated P8 Mice (SAMP8) via the NLRP3/Caspase-1 Pathway

Donepezil Treatment in Patients With Depression and Cognitive Impairment on Stable Antidepressant Treatment: A Randomized Controlled Trial

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