D P Devanand1, Seonjoo Lee2, Jennifer Manly2, Howard Andrews2, Nicole Schupf2, Richard L Doty2, Yaakov Stern2, Laura B Zahodne2, Elan D Louis2, Richard Mayeux2. 1. From the Division of Geriatric Psychiatry, Department of Psychiatry (D.P.D.), Department of Neurology and the Gertrude H. Sergievsky Center and the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (J.M., H.A., N.S., Y.S., L.B.Z., E.D.L., R.M.), College of Physicians and Surgeons, Columbia University, New York; Division of Biostatistics (S.L.), New York State Psychiatric Institute and Columbia University, New York; and University of Pennsylvania (R.L.D.), Philadelphia. dpd3@columbia.edu. 2. From the Division of Geriatric Psychiatry, Department of Psychiatry (D.P.D.), Department of Neurology and the Gertrude H. Sergievsky Center and the Taub Institute for Research on Alzheimer's Disease and the Aging Brain (J.M., H.A., N.S., Y.S., L.B.Z., E.D.L., R.M.), College of Physicians and Surgeons, Columbia University, New York; Division of Biostatistics (S.L.), New York State Psychiatric Institute and Columbia University, New York; and University of Pennsylvania (R.L.D.), Philadelphia.
Abstract
OBJECTIVE: To determine the predictive utility of baseline odor identification deficits for future cognitive decline and the diagnosis of Alzheimer disease (AD) dementia. METHODS: In a multiethnic community cohort in North Manhattan, NY, 1,037 participants without dementia were evaluated with the 40-item University of Pennsylvania Smell Identification Test (UPSIT). In 757 participants, follow-up occurred at 2 years and 4 years. RESULTS: In logistic regression analyses, lower baseline UPSIT scores were associated with cognitive decline (relative risk 1.067 per point interval; 95% confidence interval [CI] 1.040, 1.095; p < 0.0001), and remained significant (relative risk 1.065 per point interval; 95% CI 1.034, 1.095; p < 0.0001) after including covariates. UPSIT, but not Selective Reminding Test-total immediate recall, predicted cognitive decline in participants without baseline cognitive impairment. During follow-up, 101 participants transitioned to AD dementia. In discrete time survival analyses, lower baseline UPSIT scores were associated with transition to AD dementia (hazard ratio 1.099 per point interval; 95% CI 1.067, 1.131; p < 0.0001), and remained highly significant (hazard ratio 1.072 per point interval; 95% CI 1.036, 1.109; p < 0.0001) after including demographic, cognitive, and functional covariates. CONCLUSIONS: Impairment in odor identification was superior to deficits in verbal episodic memory in predicting cognitive decline in cognitively intact participants. The findings support the cross-cultural use of a relatively inexpensive odor identification test as an early biomarker of cognitive decline and AD dementia. Such testing may have the potential to select/stratify patients in treatment trials of cognitively impaired patients or prevention trials in cognitively intact individuals.
OBJECTIVE: To determine the predictive utility of baseline odor identification deficits for future cognitive decline and the diagnosis of Alzheimer disease (AD) dementia. METHODS: In a multiethnic community cohort in North Manhattan, NY, 1,037 participants without dementia were evaluated with the 40-item University of Pennsylvania Smell Identification Test (UPSIT). In 757 participants, follow-up occurred at 2 years and 4 years. RESULTS: In logistic regression analyses, lower baseline UPSIT scores were associated with cognitive decline (relative risk 1.067 per point interval; 95% confidence interval [CI] 1.040, 1.095; p < 0.0001), and remained significant (relative risk 1.065 per point interval; 95% CI 1.034, 1.095; p < 0.0001) after including covariates. UPSIT, but not Selective Reminding Test-total immediate recall, predicted cognitive decline in participants without baseline cognitive impairment. During follow-up, 101 participants transitioned to AD dementia. In discrete time survival analyses, lower baseline UPSIT scores were associated with transition to AD dementia (hazard ratio 1.099 per point interval; 95% CI 1.067, 1.131; p < 0.0001), and remained highly significant (hazard ratio 1.072 per point interval; 95% CI 1.036, 1.109; p < 0.0001) after including demographic, cognitive, and functional covariates. CONCLUSIONS: Impairment in odor identification was superior to deficits in verbal episodic memory in predicting cognitive decline in cognitively intact participants. The findings support the cross-cultural use of a relatively inexpensive odor identification test as an early biomarker of cognitive decline and AD dementia. Such testing may have the potential to select/stratify patients in treatment trials of cognitively impairedpatients or prevention trials in cognitively intact individuals.
Authors: Kejal Kantarci; M L Senjem; V J Lowe; H J Wiste; S D Weigand; B J Kemp; A R Frank; M M Shiung; B F Boeve; D S Knopman; R C Petersen; C R Jack Journal: AJNR Am J Neuroradiol Date: 2010-03-18 Impact factor: 3.825
Authors: Matthias H Tabert; Xinhua Liu; Richard L Doty; Michael Serby; Diana Zamora; Gregory H Pelton; Karen Marder; Mark W Albers; Yaakov Stern; D P Devanand Journal: Ann Neurol Date: 2005-07 Impact factor: 10.422
Authors: Joseph L Price; Daniel W McKeel; Virginia D Buckles; Catherine M Roe; Chengjie Xiong; Michael Grundman; Lawrence A Hansen; Ronald C Petersen; Joseph E Parisi; Dennis W Dickson; Charles D Smith; Daron G Davis; Frederick A Schmitt; William R Markesbery; Jeffrey Kaye; Roger Kurlan; Christine Hulette; Brenda F Kurland; Roger Higdon; Walter Kukull; John C Morris Journal: Neurobiol Aging Date: 2009-04-18 Impact factor: 4.673
Authors: Claire Murphy; Carla R Schubert; Karen J Cruickshanks; Barbara E K Klein; Ronald Klein; David M Nondahl Journal: JAMA Date: 2002-11-13 Impact factor: 56.272
Authors: S Cosentino; N Scarmeas; E Helzner; M M Glymour; J Brandt; M Albert; D Blacker; Y Stern Journal: Neurology Date: 2008-04-09 Impact factor: 9.910
Authors: Michael L Alosco; Johnny Jarnagin; Yorghos Tripodis; Michael Platt; Brett Martin; Christine E Chaisson; Christine M Baugh; Nathan G Fritts; Robert C Cantu; Robert A Stern Journal: J Neurotrauma Date: 2016-08-11 Impact factor: 5.269
Authors: Matthew R Woodward; Muhammad Ubaid Hafeez; Qianya Qi; Ahmed Riaz; Ralph H B Benedict; Li Yan; Kinga Szigeti Journal: Am J Geriatr Psychiatry Date: 2018-04-19 Impact factor: 4.105
Authors: Matthew E Growdon; Aaron P Schultz; Alexander S Dagley; Rebecca E Amariglio; Trey Hedden; Dorene M Rentz; Keith A Johnson; Reisa A Sperling; Mark W Albers; Gad A Marshall Journal: Neurology Date: 2015-05-01 Impact factor: 9.910
Authors: Davangere P Devanand; Seonjoo Lee; Jennifer Manly; Howard Andrews; Nicole Schupf; Arjun Masurkar; Yaakov Stern; Richard Mayeux; Richard L Doty Journal: Ann Neurol Date: 2015-07-03 Impact factor: 10.422
Authors: Davangere P Devanand; Gregory H Pelton; Kristina D'Antonio; Adam Ciarleglio; Jennifer Scodes; Howard Andrews; Julia Lunsford; John L Beyer; Jeffrey R Petrella; Joel Sneed; Michaela Ciovacco; Pudugramam Murali Doraiswamy Journal: Am J Geriatr Psychiatry Date: 2018-06-28 Impact factor: 4.105
Authors: Thomas Polak; Martin J Herrmann; Laura D Müller; Julia B M Zeller; Andrea Katzorke; Matthias Fischer; Fabian Spielmann; Erik Weinmann; Leif Hommers; Martin Lauer; Andreas J Fallgatter; Jürgen Deckert Journal: J Neural Transm (Vienna) Date: 2017-09-01 Impact factor: 3.575
Authors: Alefiya Dhilla Albers; Josephine Asafu-Adjei; Mary K Delaney; Kathleen E Kelly; Teresa Gomez-Isla; Deborah Blacker; Keith A Johnson; Reisa A Sperling; Bradley T Hyman; Rebecca A Betensky; Lloyd Hastings; Mark W Albers Journal: Ann Neurol Date: 2016-11-23 Impact factor: 10.422