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Awareness of olfactory deficits in healthy aging, amnestic mild cognitive impairment and Alzheimer's disease

Published online by Cambridge University Press:  21 January 2011

Alex Bahar-Fuchs ,
Simon Moss ,
Christopher Rowe  and
Greg Savage
Alex Bahar-Fuchs*
Affiliation:
School of Psychology and Psychiatry, Monash University, Victoria, Australia
Simon Moss
Affiliation:
School of Psychology and Psychiatry, Monash University, Victoria, Australia
Christopher Rowe
Affiliation:
Department of Nuclear Medicine, Austin Health, Heidelberg, Victoria, Australia
Greg Savage
Affiliation:
School of Psychology and Psychiatry, Monash University, Victoria, Australia Macquarie Centre for Cognitive Science, Macquarie University, Sydney, Australia
*
Correspondence should be addressed to: Alex Bahar-Fuchs, Center for PET, Department of Nuclear Medicine, Austin Health, 145 Studley Rd. Heidelberg 3084, Victoria, Australia. Phone: +61 3 9496 5718; Fax: +61 3 9457 6605. Email: [email protected].
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Abstract

Background: Olfactory dysfunction is present in early Alzheimer's disease (AD), and has now been reported in people with amnestic mild cognitive impairment (aMCI). Recent evidence suggests that unawareness of an olfactory deficit may predict which MCI patients will subsequently meet AD criteria. However, important methodological limitations challenge this suggestion. While addressing some of the limitations of previous research, this preliminary study explores unawareness of olfactory deficits as a predictive factor of future AD among people with aMCI.

Methods: Twenty-five participants with aMCI, 25 AD patients, and 22 healthy elderly participants underwent testing of olfactory identification. Subjective reports regarding perceived decline in olfactory detection and olfactory identification were also obtained. A subset of participants was reassessed 12 months later.

Results: Control participants performed better than both aMCI and AD patients on olfactory identification. Almost uniformly, participants did not report decline in either olfactory detection or identification. Prediction of olfactory identification scores from subjective reports of olfactory function was poor, and awareness of olfactory decline bore no relationship to the likelihood of aMCI patients progressing to AD by the 12-month review.

Conclusions: Treating awareness of olfactory function as a unitary construct can be misleading, and there is a poor relationship between subjective and objective measures of olfactory ability. Our preliminary data suggest that unawareness of olfactory decline does not improve the identification of patients with MCI who are more likely to be in the prodromal phase of AD. Replication in a larger cohort is needed to support these findings.

Keywords

anosognosiaolfactionawarenessinsightmild cognitive impairmentAlzheimer's disease
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 7 , September 2011 , pp. 1097 - 1106
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Albers, M. W., Tabert, M. H. and Devanand, D. P. (2006). Olfactory dysfunction as a predictor of neurodegenerative disease. Current Neurology and Neuroscience Reports, 6, 379–386.CrossRefGoogle ScholarPubMed
Bahar-Fuchs, A., Moss, S., Rowe, C. and Savage, G. (2010). Unirhinal olfactory performance in MCI and AD: evidence for asymmetry in performance. Chemical Senses (in press).Google Scholar
Clare, L. (2004a). Awareness in early-stage Alzheimer's disease: a review of methods and evidence. British Journal of Clinical Psychology, 43, 177–196.CrossRefGoogle ScholarPubMed
Clare, L. (2004b). The construction of awareness in early-stage Alzheimer's disease: a review of concepts and models. British Journal of Clinical Psychology, 43, 155–175.CrossRefGoogle ScholarPubMed
Clare, L., Wilson, B. A., Carter, G., Roth, I. and Hodges, J. R. (2004). Awareness in early-stage Alzheimer's disease: relationship to outcome of cognitive rehabilitation. Journal of Clinical and Experimental Neuropsychology, 26, 215–226.CrossRefGoogle ScholarPubMed
Crowe, M., Andel, R., Wadley, V., Cook, S., Unverzagt, F., Marsiske, M. and Ball, K. (2006). Subjective cognitive function and decline among older adults with psychometrically defined amnestic MCI. International Journal of Geriatric Psychiatry, 21, 1187–1192.CrossRefGoogle ScholarPubMed
DeBettignies, B. H., Mahurin, R. K. and Pirozzolo, F. J. (1990). Insight for impairment in independent living skills in Alzheimer's disease and multi-infarct dementia. Journal of Clinical and Experimental Neuropsychology, 12, 355–363.CrossRefGoogle ScholarPubMed
Delis, D., Kramer, J., Kaplan, E. and Ober, B. (2000). CVLT-II: California Verbal Learning Test Adult Version, 2nd edn. San Antonio: The Psychological corporation.Google Scholar
Delis, D. C., Kaplan, E. and Kramer, J. H. (2001). Delis-Kaplan Executive Function System. San Antonio, TX: The Psychological Corporation.Google Scholar
Devanand, D. P., Michaels-Marston, K. S., Liu, X., Pelton, G. and Padilla, M. (2000). Olfactory deficits in patients with mild cognitive impairment predict Alzheimer's disease at follow up. American Journal of Psychiatry, 157, 1399–1405.CrossRefGoogle ScholarPubMed
Djordjevic, J., Jones-Gotman, M., De Sousa, K. and Chertkow, H. (2007). Olfaction in patients with mild cognitive impairment and Alzheimer's disease. Neurobiology of Aging, 29, 693–706.CrossRefGoogle ScholarPubMed
Doty, R. L., Shaman, P. and Dann, M. (1984). Development of the University of Pennsylvania Smell Identification Test: a standardized microencapsulated test of olfactory function. Physiology and Behavior, 32, 489–502.CrossRefGoogle Scholar
Eibenstein, A. et al. (2005). Olfactory screening test in mild cognitive impairment. Neurological Sciences, 26, 156–160.CrossRefGoogle ScholarPubMed
Ellis, K. A. et al. (2008). P2-006: baseline data from a multi-centre, prospective longitudinal study of ageing in 1000 volunteers (the AIBL study). Alzheimer's and Dementia, 4, 367–367.CrossRefGoogle Scholar
Folstein, M. F., Folstein, 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, 189–198.CrossRefGoogle ScholarPubMed
Good, K. P., Martzke, J. S., Milliken, H. I., Honer, W. G. and Kopala, L. C. (2002). Unirhinal olfactory identification deficits in young male patients with schizophrenia and related disorders: association with impaired memory function. Schizophrenia Research, 56, 211–223.CrossRefGoogle ScholarPubMed
Luzzi, S., Snowden, S. S., Neary, D., Coccia, M., Provinciali, L. and Lambon Ralph, A. M. (2007). Distinct patterns of olfactory impairment in Alzheimer's disease, semantic dementia, frontotemporal dementia and corticobasal degeneration. Neuropsychologia, 45, 1823–1831.CrossRefGoogle ScholarPubMed
Markova, I. S. and Berrios, , , G. E. (2006). Approaches to the assessment of awareness: conceptual issues. Neuropsychological Rehabilitation, 16, 439–455.CrossRefGoogle Scholar
McKhann, G., Drachman, 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 Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Meyers, J. and Meyers, K. (1995). Rey Complex Figure Test and Recognition Trial. Odessa: Psychological Assessment Resources Inc.Google Scholar
Morgan, C. D., Nordin, S. and Murphy, C. (1995). Odor identification as an early marker for Alzheimer's disease: impact of lexical functioning and detection sensitivity. Journal of Clinical and Experimental Neuropsychology, 17, 793–803.CrossRefGoogle ScholarPubMed
Naylor, E. and Clare, L. (2008). Awareness of memory functioning, autobiographical memory and identity in early-stage dementia. Neuropsychological Rehabilitation, 18, 590–606.CrossRefGoogle ScholarPubMed
Nordin, S., Monsch, A. U. and Murphy, C. (1995). Unawareness of smell loss in normal aging and Alzheimer's disease: discrepancy between self-reported and diagnosed smell sensitivity. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 50, P187–192.CrossRefGoogle ScholarPubMed
Peters, M. J., Hummel, T., Kratzsch, T., Lotsch, J., Skarke, C. and Frolich, L. (2003). Olfactory function in Mild Cognitive Impairment and Alzheimer's disease: an investigation using psychophysical and electrophysiological techniques. American Journal of Psychiatry, 160, 1995–2002.CrossRefGoogle ScholarPubMed
Petersen, R. C. et al. (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58, 1985–1992.CrossRefGoogle ScholarPubMed
Pike, K. E. et al. (2007). Beta-amyloid imaging and memory in non-demented individuals: evidence for preclinical Alzheimer's disease. Brain, 130, 2837–2844.CrossRefGoogle ScholarPubMed
Roberts, J. L., Clare, L. and Woods, R. T. (2009). Subjective memory complaints and awareness of memory functioning in mild cognitive impairment: a systematic review. Dementia and Geriatric Cognitive Disorders, 28, 95–109.CrossRefGoogle ScholarPubMed
Rowe, C. C. et al. (2007). Imaging beta-amyloid burden in aging and dementia. Neurology, 68, 1718–1725.CrossRefGoogle ScholarPubMed
Salmon, E. et al. (2006). Neural correlates of anosognosia for cognitive impairment in Alzheimer's disease. Human Brain Mapping, 27, 588–597.CrossRefGoogle ScholarPubMed
Saxton, J. et al. (2000). Normative data on the Boston Naming Test and two equivalent 30-item short forms. Clinical Neuropsychology, 14, 526–534.CrossRefGoogle ScholarPubMed
Serby, M. J. (2001). Olfactory deficit in Alzheimer's disease? American Journal of Psychiatry, 158, 1534; author reply, 1534–1535.CrossRefGoogle ScholarPubMed
Serby, M., Larson, P. and Kalkstein, D. (1991). The nature and course of olfactory deficits in Alzheimer's disease. American Journal of Psychiatry, 148, 357–360.Google ScholarPubMed
Starkstein, S. E. et al. (1997). Prospective longitudinal study of depression and anosognosia in Alzheimer's disease. British Journal of Psychiatry, 171, 47–52.CrossRefGoogle ScholarPubMed
Szeszko, P. R., Bates, J., Robinson, D., Kane, J. and Bilder, R. M. (2004). Investigation of unirhinal olfactory identification in antipsychotic-free patients experiencing a first-episode schizophrenia. Schizophrenia Research, 67, 219–225.CrossRefGoogle ScholarPubMed
Tabert, M. H. et al. (2005). A 10-item smell identification scale related to risk for Alzheimer's disease. Annals of Neurology, 58, 155–160.CrossRefGoogle ScholarPubMed
Wagner, M. T., Spangenberg, K. B., Bachman, D. L. and O'Connell, P. (1997). Unawareness of cognitive deficit in Alzheimer disease and related dementias. Alzheimer's Disease and Associated Disorders, 11, 125–131.CrossRefGoogle ScholarPubMed
Warner, M. D., Peabody, C. A., Flattery, J. J. and Tinklenberg, J. R. (1986). Olfactory deficits and Alzheimer's disease. Biological Psychiatry, 21, 116–118.CrossRefGoogle ScholarPubMed
Wechsler, D. (1997). WAIS-III Administration and Scoring Manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Winblad, B. et al. (2004). Mild cognitive impairment–beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256, 240–246.CrossRefGoogle Scholar
Yaffe, K., Petersen, R. C., Lindquist, K., Kramer, J. and Miller, B. (2006). Subtype of mild cognitive impairment and progression to dementia and death. Dementia and Geriatric Cognitive Disorders, 22, 312–319.CrossRefGoogle ScholarPubMed