Long-Term Test–Retest Reliability of the UPSIT in Cognitively Intact Older Adults

Abstract

<jats:title>Abstract</jats:title> <jats:p>The objective of this study was to determine the long-term test–retest reliability of the University of Pennsylvania Smell Identification Test (UPSIT), and its individual items, in cognitively intact older adults. A community sample of older adults received a neuropsychological test battery, including the 12-item, 6-trial Selective Reminding Test (SRT). The UPSIT was administered at baseline and follow-up that occurred between 1 and 4 years after baseline. UPSIT scores of participants who were cognitively intact and did not decline cognitively were examined for test–retest reliability. In 92 older adults with mean age 77.6 years followed for 2.79 (standard deviation [SD] 0.69) years, mean UPSIT score declined from 30.29 (SD 5.83) to 27.80 (SD 5.50). In linear mixed models that adjusted for time, age, sex, and education, intraclass correlation coefficients for UPSIT were 0.65, SRT delayed recall 0.59, and SRT total immediate recall 0.49. Among 4 possible response combinations, the largest proportion of participants had correct responses at both visits for 35 out of 40 items. Consistency of item responses ranged from 50% to 90% across the 2 time points. The long-term test–retest reliability of the UPSIT was moderately strong without practice effects over long periods of time in older adults. These results provide indirect support to prior findings on odor identification impairment predicting cognitive decline and dementia, and suggest potential use of olfactory testing as a biomarker in prevention and treatment trials of cognitive enhancers.</jats:p>

The Human Brain Representation of Odor Identification in Amnestic Mild Cognitive Impairment and Alzheimer's Dementia of Mild Degree

“…Importantly, OI ability is shown to predict both a later diagnosis of MCI in healthy older adults and conversion from MCI to dementia ( 8 , 9 ). Hence, OI testing can be used as an inexpensive and non-invasive supplement in the clinical evaluation of suspected AD ( 1 , 10 ). OI's utility as a clinical tool and biomarker of dementia risk depends on a better understanding of the neuronal correlates underlying OI impairment in the early symptomatic phase of Alzheimer's disease.…”

Odor identification predicts the transition of patients with isolated RBD: A retrospective study

“…Repeated evaluations of the UPSIT score may distinguish between diseases based on the severity of odors identification dysfunction, which is less affected by the learning effect. 36 In a previous study by Iranzo et al, serial UPSIT-J scores did not change over time. 37 In another study, 38 olfaction and color vision declined as long as 5 years before diagnosis, with only a slight decline in preclinical stages.…”

“…UPSIT is a widely used tool for the assessment of olfaction that has been reported to have a high test‐retest reliability at 2‐week intervals (r = 0.95) and 6‐month intervals ( r = 0.92) in young and middle‐aged adults with intact cognition. Repeated evaluations of the UPSIT score may distinguish between diseases based on the severity of odors identification dysfunction, which is less affected by the learning effect 36 . In a previous study by Iranzo et al., serial UPSIT‐J scores did not change over time 37 .…”

Odor identification impairment and cholinesterase inhibitor treatment in Alzheimer's disease

“…In the absence of a waitlist or placebo control for the treatment portion of the study, changes in cognitive test performance may be due in part to practice effects. Although practice effects likely influenced cognitive test performance as seen by the increase in SRT indices in the first 8 weeks, practice effects are generally absent for odor identification tests over short‐term 35 and long‐term 36 follow‐up. There was no objective measure of olfactory functioning as an anosmic‐based exclusionary criteria.…”