Han Soo Yoo1, Seok Jong Chung1, Yang Hyun Lee1, Byoung Seok Ye1, Young H Sohn1, Phil Hyu Lee2,3. 1. Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. 2. Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. phee@yuhs.ac. 3. Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea. phee@yuhs.ac.
Abstract
OBJECTIVE: Parkinson's disease (PD) patients are often unaware of olfactory deficits despite having hyposmia from the early stages. We aimed to evaluate whether olfactory anosognosia is a predictor of cognitive decline in PD. METHODS: In this retrospective cohort study, we recruited 77 PD patients who underwent both olfactory and neuropsychological tests and were followed-up for over 5 years. Based on the degree of olfactory dysfunction and awareness of its presence, patients were classified as normosmic patients (Normosmia group, n = 15), hyposmic patients without olfactory anosognosia (Hyposmia-OA-, n = 40), or hyposmic patients with olfactory anosognosia (Hyposmia-OA+, n = 22). We compared the rates of cognitive decline using linear mixed model and dementia conversion using a survival analysis among the groups. RESULTS: A higher proportion of patients in the Hyposmia-OA+ group had mild cognitive impairment at baseline (77.3%) and dementia converter at follow-up (50.0%). The Hyposmia-OA+ group exhibited a faster decline in frontal executive and global cognitive function than did the Normosmia and Hyposmia-OA- groups. A Kaplan-Meier analysis demonstrated that the conversion rate to dementia was significantly higher in the Hyposmia-OA+ group than in the Normosmia (P = 0.007) and Hyposmia-OA- (P = 0.038) groups. A Cox regression analysis showed that olfactory anosognosia remained a significant predictor of time to develop dementia in the Hyposmia-OA+ group compared to the Normosmia group (adjusted hazard ratio 3.30; 95% confidence interval 1.10-8.21). CONCLUSION: This study suggests that olfactory anosognosia is a predictor of cognitive decline and dementia conversion in PD.
OBJECTIVE:Parkinson's disease (PD) patients are often unaware of olfactory deficits despite having hyposmia from the early stages. We aimed to evaluate whether olfactory anosognosia is a predictor of cognitive decline in PD. METHODS: In this retrospective cohort study, we recruited 77 PDpatients who underwent both olfactory and neuropsychological tests and were followed-up for over 5 years. Based on the degree of olfactory dysfunction and awareness of its presence, patients were classified as normosmic patients (Normosmia group, n = 15), hyposmic patients without olfactory anosognosia (Hyposmia-OA-, n = 40), or hyposmic patients with olfactory anosognosia (Hyposmia-OA+, n = 22). We compared the rates of cognitive decline using linear mixed model and dementia conversion using a survival analysis among the groups. RESULTS: A higher proportion of patients in the Hyposmia-OA+ group had mild cognitive impairment at baseline (77.3%) and dementia converter at follow-up (50.0%). The Hyposmia-OA+ group exhibited a faster decline in frontal executive and global cognitive function than did the Normosmia and Hyposmia-OA- groups. A Kaplan-Meier analysis demonstrated that the conversion rate to dementia was significantly higher in the Hyposmia-OA+ group than in the Normosmia (P = 0.007) and Hyposmia-OA- (P = 0.038) groups. A Cox regression analysis showed that olfactory anosognosia remained a significant predictor of time to develop dementia in the Hyposmia-OA+ group compared to the Normosmia group (adjusted hazard ratio 3.30; 95% confidence interval 1.10-8.21). CONCLUSION: This study suggests that olfactory anosognosia is a predictor of cognitive decline and dementia conversion in PD.
Authors: Jeremy Hunt; Elizabeth J Coulson; Rajendram Rajnarayanan; Henrik Oster; Aleksandar Videnovic; Oliver Rawashdeh Journal: Mol Neurodegener Date: 2022-01-09 Impact factor: 14.195
Authors: Lian Li; Guangliang Ding; Li Zhang; Esmaeil Davoodi-Bojd; Michael Chopp; Qingjiang Li; Zheng Gang Zhang; Quan Jiang Journal: Front Aging Neurosci Date: 2022-03-10 Impact factor: 5.750
Authors: Leah C Beauchamp; David I Finkelstein; Ashley I Bush; Andrew H Evans; Kevin J Barnham Journal: J Parkinsons Dis Date: 2020 Impact factor: 5.568