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J Am Geriatr Soc. 2008 Aug;56(8):1517-21. doi: 10.1111/j.1532-5415.2008.01826.x. Epub 2008 Jul 24.

Olfaction and the 5-year incidence of cognitive impairment in an epidemiological study of older adults.

Author information

1
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA. Schubert@episense.wisc.edu

Abstract

OBJECTIVES:

To determine whether odor identification ability is associated with the 5-year incidence of cognitive impairment in a large population of older adults with normal cognition at baseline and whether olfactory impairment contributes to the prediction of cognitive decline.

DESIGN:

Population-based longitudinal study.

SETTING:

Beaver Dam, Wisconsin.

PARTICIPANTS:

One thousand nine hundred twenty participants in the Epidemiology of Hearing Loss Study (mean age 66.9).

MEASUREMENTS:

Olfaction was measured using the San Diego Odor Identification Test (SDOIT). Incident cognitive impairment was defined as a Mini-Mental State Examination (MMSE) score of less than 24 or reported diagnosis of dementia or Alzheimer's disease (AD) at follow-up in participants with a MMSE score of 24 or greater and no diagnosis of dementia or AD at baseline.

RESULTS:

There was a significant association between olfactory impairment at baseline and 5-year incidence of cognitive impairment (odds ratio (OR)=6.62, 95% confidence interval (CI)=4.36-10.05). The association remained significant after adjusting for possible confounders (OR=3.72, 95% CI=2.31-5.99). The positive predictive value of the SDOIT was 15.9%, the negative predictive value was 97.2%, the sensitivity was 55.1%, and the specificity was 84.4% for 5-year incidence of cognitive impairment.

CONCLUSION:

Olfactory impairment at baseline was strongly associated with 5-year incidence of cognitive impairment as measured using the MMSE. Odor identification testing may be useful in high-risk settings, but not in the general population, to identify patients at risk for cognitive decline.

PMID:
18662205
PMCID:
PMC2587240
DOI:
10.1111/j.1532-5415.2008.01826.x
[Indexed for MEDLINE]
Free PMC Article

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