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Ann Neurol. 2015 Sep;78(3):401-11. doi: 10.1002/ana.24447. Epub 2015 Jul 3.

Olfactory identification deficits and increased mortality in the community.

Author information

1
Division of Geriatric Psychiatry, Department of Psychiatry, Columbia University, New York, NY.
2
Division of Biostatistics, New York State Psychiatric Institute and Columbia University, New York, NY.
3
Department of Neurology, Gertrude H. Sergievsky Center, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY.
4
Smell and Taste Center, University of Pennsylvania, Philadelphia, PA.

Abstract

OBJECTIVE:

To examine the association between odor identification deficits and future mortality in a multiethnic community cohort of older adults.

METHODS:

Participants were evaluated with the 40-item University of Pennsylvania Smell Identification Test (UPSIT). Follow-up occurred at 2-year intervals with information on death obtained from informant interviews and the National Death Index.

RESULTS:

During follow-up (mean = 4.1 years, standard deviation = 2.6), 349 of 1,169 (29.9%) participants died. Participants who died were more likely to be older (p < 0.001), be male (p < 0.001), have lower UPSIT scores (p < 0.001), and have a diagnosis of dementia (p < 0.001). In a Cox model, the association between lower UPSIT score and mortality (hazard ratio [HR] = 1.07 per point interval, 95% confidence interval [CI] = 1.05-1.08, p < 0.001) persisted after controlling for age, gender, education, ethnicity, language, modified Charlson medical comorbidity index, dementia, depression, alcohol abuse, head injury, smoking, body mass index, and vision and hearing impairment (HR = 1.05, 95% CI = 1.03-1.07, p < 0.001). Compared to the fourth quartile with the highest UPSIT scores, HRs for mortality for the first, second, and third quartiles of UPSIT scores were 3.81 (95% CI = 2.71-5.34), 1.75 (95% CI = 1.23-2.50), and 1.58 (95% CI = 1.09-2.30), respectively. Participant mortality rate was 45% in the lowest quartile of UPSIT scores (anosmia) and 18% in the highest quartile of UPSIT scores.

INTERPRETATION:

Impaired odor identification, particularly in the anosmic range, is associated with increased mortality in older adults even after controlling for dementia and medical comorbidity.

PMID:
26031760
PMCID:
PMC4546561
DOI:
10.1002/ana.24447
[Indexed for MEDLINE]
Free PMC Article

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