Abstract
Olfactory impairment is associated with dementia and is a potential early biomarker of cognitive decline. We developed a novel olfactory threshold test called Sniff Bubble using rose odor-containing beads made with 2-phenylethyl alcohol. We aimed to define cut-off scores for this tool to help identify cognitive decline among elderly people. In total, 162 elderly people (mean age ± SD: 73.04 ± 8.73 years) were administered olfactory threshold and neurocognitive tests. For analyses, we divided the participants into two groups based on cognitive functioning, namely cognitive decline (n = 44) and normal cognition (n = 118) groups. The Sniff Bubble and YSK olfactory function test for olfactory threshold and the Structured Clinical Interview for DSM-5 Disorders-Clinician Version and Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease assessment packet for neurocognitive functioning were used. We used K-means cluster analyses and receiver operating characteristic (ROC) analyses to identify the most appropriate cut-off value. We established a positive correlation between the Sniff Bubble and neurocognitive function test scores (r = 0.431, p < 0.001). We defined the cut-off score, using the ROC curve analyses for Sniff Bubble scores, at 3 and higher with an area under the curve of 0.759 (p < 0.001). The Sniff Bubble test can adequately detect cognitive decline in elderly people and may be used clinically as the first step in the screening process.
Highlights
Dementia is a major health and economic burden that affected approximately 47 million patients worldwide in 2015, and this number is estimated to nearly double every 20 years (65.7 million in 2030 and 154 million in 2050) [1, 2]
We developed an odor threshold test for use as a dementia screening tool that takes less than 5 min to administer, is easy to use in the elderly, and can be used cross-culturally
The exclusion criteria were as follows: (a) any past or current neurologic or psychiatric diseases other than mild cognitive impairment (MCI) and dementia based on the Structured Clinical Interview for DSM-5 Disorders-Clinician Version (SCID-5-CV) [23]; (b) any past or current diagnosis of dementia other than Alzheimer’s disease dementia; (c) head trauma or stroke history; (d) acute rhinitis or sinusitis, active asthma, or a history of obstructive nasal disease or nasal sinus surgery; (e) communication difficulties resulting from severe hearing impairment or aphasia; and (f) failing to understand the study protocol and objectives
Summary
Dementia is a major health and economic burden that affected approximately 47 million patients worldwide in 2015, and this number is estimated to nearly double every 20 years (65.7 million in 2030 and 154 million in 2050) [1, 2]. Dementia is currently incurable, early screening offers several advantages. It informs and facilitates quicker decision-making and planning by patients with dementia and their caregivers. Pharmacological treatment, including cholinesterase inhibitors or the N-methyl-D-aspartate receptor antagonist (memantine), contributes toward slowing dementia progression [3].
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