Olfaction and Alzheimer's disease.

Disturbances in the sense of smell may be important both clinically and theoretically in Alzheimer's disease. Initial evidence of poor olfactory recognition performance in Alzheimer's and parkinsonian dementias was followed by two reports which corroborated olfactory dysfunction in Alzheimer's disease. The neuroanatomical and neurochemical bases for this disturbance are discussed. Despite an abundance of preclinical and clinical data linking olfaction with acetylcholine, a preliminary study failed to show any effect of scopolamine on olfactory thresholds. Two of the olfaction-Alzheimer's studies found significantly better performance in other demented groups (alcoholics and patients with vascular dementia), suggesting possible utility in the differential diagnostic workup. The effect of aging per se on olfactory performance cannot be assessed without rigorous control for cognitive dysfunction in sampled populations.