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Smell identification function in early-onset Alzheimer’s disease and mild cognitive impairment

Published online by Cambridge University Press:  15 October 2018

Latha Velayudhan*
Affiliation:
Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neurosciences, London, UK Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Centre for Medicine, Leicester, UK
Frances Wilson-Morkeh
Affiliation:
Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Centre for Medicine, Leicester, UK
Emily Penney
Affiliation:
Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Centre for Medicine, Leicester, UK
Amala Jovia Maria Jesu
Affiliation:
Evington Centre, Leicestershire Partnership NHS Trust, Leicester, UK
Sarah Baillon
Affiliation:
Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Centre for Medicine, Leicester, UK Evington Centre, Leicestershire Partnership NHS Trust, Leicester, UK
Traolach Brugha
Affiliation:
Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Centre for Medicine, Leicester, UK
*
Correspondence should be addressed to: Latha Velayudhan, Consultant Psychiatrist and Senior Clinical Lecturer, Department of Old Age Psychiatry, PO Box 70, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK. Phone: 0044 207848 0508. Email: [email protected]; [email protected]

Abstract

Little is known about olfactory identification (OI) function in early-onset Alzheimer’s disease (EOAD) and early-onset mild cognitive impairment (eoMCI) with age of onset <65 years. We aimed to study OI in EOAD compared with eoMCI and age-matched healthy controls (HC). Nineteen EOAD subjects with mild to moderate dementia, 17 with eoMCI, and 21 HC recruited as a convenience sample from memory services were assessed for cognition, behavioral symptoms, and activities for daily living. The OI was tested using the University of Pennsylvania smell identification test (UPSIT). EOAD participants performed worse compared with eoMCI and HC on cognitive tests and OI (p < 0.001). Although eoMCI had poorer cognitive scores compared to HC, they were similar in their OI function. OI correlated with attention (r = 0.494, p = 0.031), executive functions (r = 0.508, p = 0.026), and praxis (r = 0.455, p = 0.05) within the EOAD group. OI impairment was significantly associated with the diagnosis of EOAD versus eoMCI, but not with eoMCI when compared with HC. OI could potentially be useful in differentiating EOAD from eoMCI. Studies with late-life MCI patients showing OI impairment relative to HC may be attributed to a different disease process. Independent replication in a larger sample is needed to validate these findings.

Type
Brief Report
Copyright
© International Psychogeriatric Association 2018 

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Footnotes

*

Consultant Psychiatrist, South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Lichfield, UK

References

Attems, J., Konig, C., Huber, M., Lintner, F. and Jellinger, K. A. (2005). Cause of death in demented and non-demented elderly inpatients; an autopsy study of 308 cases. Journal of Alzheimer’s Disease, 8, 5762. doi: 10.3233/JAD-2005-8107.CrossRefGoogle ScholarPubMed
Bucks, R. S., Ashworth, D. L., Wilcock, G. K. and Siegfried, K. (1996). Assessment of activities of daily living in dementia: development of the Bristol Activities of Daily Living Scale. Age and Ageing, 25, 113120. doi: 10.1093/ageing/25.2.113.CrossRefGoogle ScholarPubMed
Christen-Zaech, S. et al. (2003). Early olfactory involvement in Alzheimer’s disease. Canadian Journal of Neurological Sciences, 30, 2025. doi: 10.1017/S0317167100002389.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, 23082308. doi: 10.1212/WNL.44.12.2308.CrossRefGoogle ScholarPubMed
Devanand, D. P. et al. (2015). Olfactory deficits predict cognitive decline and Alzheimer dementia in an urban community. Neurology, 84, 182189. doi: 10.1212/WNL.0000000000001132.CrossRefGoogle Scholar
Djordjevic, J., Jones-Gotman, M., De Sousa, K. and Chertkow, H. (2008). Olfaction in patients with mild cognitive impairment and Alzheimer’s disease. Neurobiology of Aging, 29, 693706. doi: 10.1016/j.neurobiolaging.2006.11.014.CrossRefGoogle ScholarPubMed
Doty, R. L., Reyes, P. F. and Gregor, T. (1987). Presence of both odor identification and detection deficits in Alzheimer’s disease. Brain Research Bulletin, 18, 597600. doi: 10.1016/0361-9230(87)90129-8.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 & Behavior, 32, 489502. doi: 10.1016/0031-9384(84)90269-5.CrossRefGoogle ScholarPubMed
Ekstrom, I. et al. (2017). Smell loss predicts mortality risk regardless of dementia conversion. Journal of the American Geriatrics Society, 65, 12381243. doi: 10.1111/jgs.14770.CrossRefGoogle ScholarPubMed
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, 189198. doi: 10.1016/0022-3956(75)90026-6.CrossRefGoogle ScholarPubMed
Lafaille-Magnan, M. E. et al. (2017). Odor identification as a biomarker of preclinical AD in older adults at risk. Neurology, 89, 327335. doi: 10.1212/WNL.0000000000004159.CrossRefGoogle ScholarPubMed
Lehrner, J., Pusswald, G., Gleiss, A., Auff, E. and Dal-Bianco, P. (2009). Odor identification and self-reported olfactory functioning in patients with subtypes of mild cognitive impairment. Clinical Neuropsychologist, 23, 818830. doi: 10.1080/13854040802585030.CrossRefGoogle ScholarPubMed
Makizako, M. et al. (2014). Olfactory identification and cognitive performance in community-dwelling older adults with mild cognitive impairment. Chemical Senses, 39, 3946. doi: 10.1093/chemse/bjt052.CrossRefGoogle ScholarPubMed
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, 939939. doi: 10.1212/WNL.34.7.939.CrossRefGoogle ScholarPubMed
McKhann, G. M. et al. (2011). The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging–Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & Dementia, 7, 263269. doi: 10.1016/j.jalz.2011.03.005.CrossRefGoogle Scholar
Mesholam, R. I., Moberg, P. J., Mahr, R. N. and Doty, R. L. (1998). Olfaction in neurodegenerative disease: a meta-analysis of olfactory functioning in Alzheimer’s and Parkinson’s diseases. Archives of Neurology, 55, 8490. doi: 10.1001/archneur.55.1.84.CrossRefGoogle ScholarPubMed
Rahayel, S., Frasnelli, J. and Joubert, S. (2012). The effect of Alzheimer’s disease and Parkinson’s disease on olfaction: a meta-analysis. Behavioural Brain Research, 231, 6074. doi: 10.1016/j.bbr.2012.02.047.CrossRefGoogle ScholarPubMed
Roalf, D. R. et al. (2017). A quantitative meta-analysis of olfactory dysfunction in mild cognitive impairment. Journal of Neurology, Neurosurgery, and Psychiatry, 88, 226232. doi: 10.1136/jnnp-2016-314638.CrossRefGoogle ScholarPubMed
Rossor, M. N., Fox, N. C., Mummery, C. J., Schott, J. M. and Warren, J. D. (2010). The diagnosis of young-onset dementia. Lancet Neurology, 9, 793806. doi: 10.1016/S1474-4422(10)70159-9.CrossRefGoogle Scholar
Roth, M. et al. (1986). CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry, 149, 698709. doi: 10.1192/bjp.149.6.698.CrossRefGoogle Scholar
Schubert, C. R. et al. (2013). Odor identification and cognitive function in the Beaver Dam Offspring Study. Journal of Clinical and Experimental Neuropsychology, 35, 669676. doi: 10.1080/13803395.2013.809701.CrossRefGoogle ScholarPubMed
Stanciu, I., Larsson, M., Nordin, S., Adolfsson, R., Nilsson, L. G. and Olofsson, J. K. (2014). Olfactory impairment and subjective olfactory complaints independently predict conversion to dementia: a longitudinal, population-based study. Journal of the International Neuropsychological Society, 20, 209217. doi: 10.1017/S1355617713001409.CrossRefGoogle ScholarPubMed
Suzuki, Y. et al. (2004). Smell identification test as an indicator for cognitive impairment in Alzheimer’s disease. International Journal of Geriatric Psychiatry, 19, 727733. doi: 10.1002/gps.1161.CrossRefGoogle ScholarPubMed
Velayudhan, L., Gasper, A., Pritchard, M., Baillon, S., Messer, C. and Proitsi, P. (2015). Pattern of smell identification impairment in Alzheimer’s disease. Journal of Alzheimer’s Disease, 46, 381387. doi: 10.3233/JAD-142838.CrossRefGoogle ScholarPubMed
Velayudhan, L., Pritchard, M., Powell, J. F., Proitsi, P. and Lovestone, S. (2013). Smell identification function as a severity and progression marker in Alzheimer’s disease. International Psychogeriatrics, 25, 11571166. doi: 10.1017/S1041610213000446.CrossRefGoogle ScholarPubMed
Wesson, D. W., Wilson, D. A. and Nixon, R. A. (2010). Should olfactory dysfunction be used as a biomarker of Alzheimer’s disease? Expert Review of Neurotherapeutics, 10, 633635. doi: 10.1586/ern.10.33.CrossRefGoogle ScholarPubMed
Woodward, M. R. et al. (2017). Validation of olfactory deficit as a biomarker of Alzheimer disease. Neurology: Clinical Practice, 7, 514. doi: 10.1212/CPJ.0000000000000293.Google ScholarPubMed
World Health Organization (2015). Chapter V: mental and behavioural disorders. In International Statistical Classification of Diseases and Related Health Problems: 10th revision (ICD-10) – WHO version for 2016 (pp. F00F99). Geneva: World Health Organization.Google Scholar