Abstract
The Sniffin’ Sticks Olfactory Identification Test is a tool for measurement of olfactory performance developed in Germany and validated in several countries. This research aims to develop the Spanish version of the Sniffin’ Sticks Olfactory Identification Test and obtain normative values for the Spanish population. The parameters are free recall and subjective intensity of odorants are included. The influence of possible demographic covariates such as sex, age, smoking, or educational level are analyzed, and the items that best discriminate are studied. In addition, the internal structure validity of the blue and purple versions is studied as a parallel measure, and a cultural adaptation of the purple version is carried out. For this, three independent samples of normosmic healthy volunteers were studied. To obtain normative values, the sample was of 417 participants (18–89 years). For the internal structure validity study of both versions, the sample was 226 (18–70 years), and for familiarity of the purple version, the sample was 75 participants (21–79 years). Results indicated that men and women and smokers and non-smokers perform equally. However, differences were found as age progresses, being more pronounced after 60 years old in all three measurements of the identification test. This research also provides the items that best discriminate in the blue version and a cultural adaptation for the purple version. In conclusion, the Sniffin’ Sticks Odor Identification Test is a suitable tool for olfactory assessment in the Spanish population. The instrument has been expanded with two new scores, and normative data as a function of age are provided. Its parallel version also seems appropriate for testing, as items have been culturally adapted and evidence of internal structure validity for both versions is reported.
Highlights
IntroductionOlfactory tests are necessary tools for adequate assessment of olfactory function [1].The use of olfactory assessment tests has become more relevant in recent years, due to clinical and research findings that indicate the existence of olfactory alterations derived from traumatic injuries as brain injury [2,3], in surgical or medical procedures for the treatment of some diseases such as larynx tumors requiring partial or total laryngectomy [4], treatment with radiotherapy [5], or pathologies with alterations of the sense of smell such as arterial hypertension [6], liver disease [7,8], diabetes mellitus [9,10], rhinitis, sinusitis [11,12], autoimmune diseases [13,14], inflammatory diseases [15], anxiety [16,17], major depression [18,19,20,21], schizophrenia [22], autism [23], and neurodegenerative diseases [24,25], such as frontotemporal dementia [26,27,28], amyotrophic lateral sclerosis [29], Parkinson’s disease [30,31,32,33], or Alzheimer’s disease [33,34,35,36].There is full consensus that the sense of smell gradually decreases with age, especially after the age of 60 [37,38,39,40,41,42,43], not so when talking about sex, which effects are controversial [44,45,46,47,48,49,50]
The use of olfactory assessment tests has become more relevant in recent years, due to clinical and research findings that indicate the existence of olfactory alterations derived from traumatic injuries as brain injury [2,3], in surgical or medical procedures for the treatment of some diseases such as larynx tumors requiring partial or total laryngectomy [4], treatment with radiotherapy [5], or pathologies with alterations of the sense of smell such as arterial hypertension [6], liver disease [7,8], diabetes mellitus [9,10], rhinitis, sinusitis [11,12], autoimmune diseases [13,14], inflammatory diseases [15], anxiety [16,17], major depression [18,19,20,21], schizophrenia [22], autism [23], and neurodegenerative diseases [24,25], such as frontotemporal dementia [26,27,28], amyotrophic lateral sclerosis [29], Parkinson’s disease [30,31,32,33], or Alzheimer’s disease [33,34,35,36]
Other authors have worked on modifications regarding the number of verbal descriptors of the recognition task, finding that increasing the number of descriptors makes it more difficult to identify odors [89]; in the development of self-administrated versions, the results suggest that odor identification with the Sniffin’ Sticks can be administered by the subjects themselves [90], or in systems that provide a more accurate interpretation of the results in the subjects random responses in the odor recognition task [91]
Summary
Olfactory tests are necessary tools for adequate assessment of olfactory function [1].The use of olfactory assessment tests has become more relevant in recent years, due to clinical and research findings that indicate the existence of olfactory alterations derived from traumatic injuries as brain injury [2,3], in surgical or medical procedures for the treatment of some diseases such as larynx tumors requiring partial or total laryngectomy [4], treatment with radiotherapy [5], or pathologies with alterations of the sense of smell such as arterial hypertension [6], liver disease [7,8], diabetes mellitus [9,10], rhinitis, sinusitis [11,12], autoimmune diseases [13,14], inflammatory diseases [15], anxiety [16,17], major depression [18,19,20,21], schizophrenia [22], autism [23], and neurodegenerative diseases [24,25], such as frontotemporal dementia [26,27,28], amyotrophic lateral sclerosis [29], Parkinson’s disease [30,31,32,33], or Alzheimer’s disease [33,34,35,36].There is full consensus that the sense of smell gradually decreases with age, especially after the age of 60 [37,38,39,40,41,42,43], not so when talking about sex, which effects are controversial [44,45,46,47,48,49,50]. There is no consensus on whether education level has an influence on olfactory assessment tests [51,52,53,54] nor regarding smoking habits [55,56,57]. Olfactory capacity is evaluated through tests that measure threshold and discrimination and identification of odors. The olfactory threshold represents the level of odor detection at low concentration, meaning the least detectable concentrations of odorant that can be perceived, whereas discrimination is the non-verbal distinction of different odors, while identification refers to the ability to name or associate an odor [20,39,42,44]
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