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Decline of gustatory sensitivity with the progression of Alzheimer's disease

Published online by Cambridge University Press:  01 October 2015

Mariko Sakai
Affiliation:
Department of Clinical Rehabilitation, Osaka Prefecture University Graduate School of Comprehensive Rehabilitation, Habikino-City, Japan Department of Rehabilitation, Saiseikai Ibaraki Hospital, Ibaraki-City, Japan
Manabu Ikeda
Affiliation:
Department of Neuropsychiaty, Faculty of Life Sciences, Kumamoto University, Kumamoto-City, Japan
Hiroaki Kazui
Affiliation:
Department of Phychiatry, Osaka University Graduate School of Medicine, Suita-City, Japan
Kazue Shigenobu
Affiliation:
Department of Psychiatry, Asakayama Hospital, Sakai-City, Japan
Takashi Nishikawa*
Affiliation:
Department of Clinical Rehabilitation, Osaka Prefecture University Graduate School of Comprehensive Rehabilitation, Habikino-City, Japan
*
Correspondence should be address to: Takashi Nishikawa, Department of Clinical Rehabilitation, Osaka Prefecture University Graduate School of Comprehensive Rehabilitation, 3-7-30 Habikino, Habikino-City, Osaka 583-8555, Japan. Phone: +81-72-950-2111; Fax: +81-72-950-2129. Email: [email protected].

Abstract

Background:

Patients with Alzheimer's disease (AD) manifest various impairments in eating behavior. However, few previous studies have directly investigated the gustatory function of AD patients, and results have been inconsistent.

Methods:

Thirty-two AD patients (Clinical Dementia Rating (CDR) 0.5/1/2, respectively 11/15/6 patients) and 22 normal control participants were examined to measure detection and recognition thresholds of the four elemental tastes (sweet, salty, sour, and bitter), and their ability to discriminate between tastes. Effects of demographic and clinical factors (age, sex, histories of alcohol and tobacco consumption, and CDR grade) on gustatory threshold were examined using ordinal logistic regression analysis. Performance was compared between AD and control groups.

Results:

Total threshold values (the sum of threshold grades for the four tastes) for detection and recognition of tastes were significantly higher in the AD group. Detection thresholds for sweet, salty, and bitter, and recognition thresholds for sweet and sour, were also significantly higher in the AD group. Ordinal logistic regression analysis revealed that CDR grade was the only factor that significantly affected both total threshold values. Regarding taste discrimination, there were no significant differences between the AD group and control group.

Conclusions:

These findings suggest that progression of dementia severity accompanies gustatory decline. Although it seemingly paradoxical, weight loss and preference for sweet tastes are frequently, often simultaneously, observed in AD. Gustatory dysfunction may be partially involved in these symptoms. Thus, the nutritional care of patients with AD could be improved by making the taste of meals stronger, while controlling calorie and mineral intake.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Bozeat, S, Gregory, C. A., Lambon Ralph, M. A. and Hodges, J. R. (2000). Which neuropsychiatic and behavioural features distinguish frontal and temporal variants of frontotemporal dementia from Alzheimer's disease? Journal of Neurology, Neurosurgery & Psychiatry, 69, 178186.CrossRefGoogle Scholar
Cullen, P. (1997). Eating disorders in dementia. International Journal of Geriatric Psychiatry, 12, 559562.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082316.Google Scholar
Folstein, M. F., Fostein, S. E. and McHugh, P. R. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Gillet-Guyonnet, S. et al. (2000). Weight loss in Alzheimer disease. The American Journal of Clinical Nutrition, 71, 637S642S.Google Scholar
Hirono, N. et al. (1997). Japanese version of the Neuropsychiatric Inventory –a scoring system for neuropsychiatric disturbance in dementia patients. No To Shinkei, 49, 266271. Japanese.Google Scholar
Hughes, C. P., Berg, L., Danziger, W. L., Coben, L. A. and Martin, R. L. (1982). A new clinical scale for the staging of dementia. The British Journal of Psychiatry, 140, 566572.Google Scholar
Ikeda, M., Brown, J., Holland, A. J., Fukuhara, R. and Hodges, J. R. (2002). Changes in appetite, food preference, and eating habits in frontotemporal dementia and Alzheimer's disease. Journal of Neurology, Neurosurgery & Psychiatry, 73, 371376.CrossRefGoogle ScholarPubMed
Ikeda, M. and Hodges, J. R. (2013). Disorders of appetite, eating and swallowing in the dementias. In Shaker, R., Postma, G. N., Belafsky, P. C. and Easterling, C., (eds.), Principles of Deglutition: A Multidisciplinary Text for Swallowing and its Disorders (pp. 411421). New York: Springer.Google Scholar
Japanese WAIS-III Publication Committee (2006). Japanese Wechsler Adult Intelligence Scale-Third Edition. Nihon Bunka Kagakusya, Tokyo, 2006.Google Scholar
Johnson, D. K., Wilkins, C. H. and Morris, J. C. (2006). Accelerated weight loss may precede diagnosis in Alzheimer disease. Archives of Neurology, 63, 13121317.Google Scholar
Koss, E., Wiffenbach, J. M., Haxby, J. V. and Friedland, R. P. (1988). Olfactory detection and identification performance are dissociated in early Alzheimer's disease. Neurology, 38, 12281232.CrossRefGoogle ScholarPubMed
Kovács, T. (2004). Mechanisms of olfactory dysfunction in aging and neurodegenerative disorders. Ageing Research Reviews, 3, 215232.Google Scholar
Kugino, K., Kaneko, M. and Akiyoshi, T. (1997). Studies on the taste perspective threshold for 4 basic taste qualities at various sites of lingual surface. Fukuoka Igakuzasshi, 88, 331336. Japanese.Google Scholar
Landis, B. N. et al. (2009). “Taste Strips” – A rapid, lateralized, gustatory bedside identification test based on impregnated filter papers. Journal of Neurology, 256, 242248.Google Scholar
Lang, C. J. G., Leuschner, T., Ulrich, K., Stössel, C., Heckmann, J. G. and Hummel, T. (2006). Taste in dementing diseases and Parkinsonism. Journal of the Neurological Sciences, 248, 177184.Google Scholar
McKeith, I. G. et al. (2005). Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology, 65, 18631872.Google Scholar
McKhann, G., Drachmann, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of the department of health and human services task force on Alzheimer's disease. Neurology, 34, 939944.Google Scholar
Mori, E., Mitani, Y. and Yamadori, A. (1985). Usefulness of Japanese version of the mini-mental state test in neurological patients. Japanese Journal of Neuropsychiatry, 1, 8290.Google Scholar
Müeller, C. et al. (2003). Quantitative assessment of gustatory function in a clinical context using impregnated “taste strips”. Rhinology, 41, 26.Google Scholar
Neary, D. et al. (1998). Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology, 51, 15461554.Google Scholar
Ogawa, H. (1994). Gustatory cortex of primates: anatomy and physiology. Neurosciences Research, 20, 113.CrossRefGoogle ScholarPubMed
Onoda, K., Kobayakawa, T., Ikeda, M., Saito, S. and Kida, A. (2003). Laterality of the human primary gustatory area studied by MEG. Chemical Sensitivity, 30, 657666.Google Scholar
Román, G. C. et al. (1993). Diagnostic criteria for research studies: report of the NIND- AIREN international workshop. Neurology, 43, 250260.Google Scholar
Sawada, M. (2005). A study of measurements of and factors influencing threshold levels of taste perception. Kokubyo Gakkai Zasshi, 72, 2841. Japanese.Google Scholar
Schiffman, S. S., Clark, C. M. and Warwick, Z. S. (1990). Gustatory and olfactory dysfunction in dementia: not specific to Alzheimer's disease. Neurobiology of Aging, 11, 597600.Google Scholar
Schiffman, S. S., Graham, B. G., Sattely-Miller, E. A., Zervakis, J. and Welsh-Bohmer, K. (2002). Taste, smell and neuropsychological performance of individuals at familial risk for Alzheimer's disease. Neurobiology of Aging, 23, 397404.Google Scholar
Shinagawa, S. et al. (2009). Characteristics of abnormal eating behavior in frontotemporal lobar degeneration: a cross-cultural survey. Journal of Neurology, Neurosurgery & Psychiatry, 80, 14131414.Google Scholar
Steinbach, S. et al. (2010). Taste in mild cognitive impairment and Alzheimer's disease. Journal of Neurology, 257, 238246.Google Scholar
Stewart, R. et al. (2005). A 32-year prospective study of change in body weight and incident dementia: the Honolulu-Asia Aging study. Archives of Neurology, 62, 5560.Google Scholar
Tomita, H., Ikeda, M. and Okuda, Y. (1986). Basis and practice of clinical taste examination. Auris Nasus Larynx (Tokyo), 13 (Suppl. I), 1–15.Google Scholar
Welge-Lüssen, A. (2009). Ageing, neurodegeneration, and olfactory and gustatory loss. B-ENT, 5, 129132.Google Scholar