Ekström Ingrid, Sjölund Sara, Nordin Steven, Nordin Adolfsson Annelie, Adolfsson Rolf, Nilsson Lars-Göran, Larsson Maria, Olofsson Jonas K
Gösta Ekman Laboratory, Psychology Department, Stockholm University, Stockholm, Sweden.
Department of Psychology, Umeå University, Umeå, Sweden.
J Am Geriatr Soc. 2017 Jun;65(6):1238-1243. doi: 10.1111/jgs.14770. Epub 2017 Mar 22.
To determine whether dementia could explain the association between poor olfactory performance and mortality risk within a decade-long follow-up period.
Prospective cohort study.
Betula Study, Umeå, Sweden.
A population-based sample of adult participants without dementia at baseline aged 40 to 90 (N = 1,774).
Olfactory performance using the Scandinavian Odor-Identification Test (SOIT) and self-reported olfactory function; several social, cognitive, and medical risk factors at baseline; and incident dementia during the following decade.
Within the 10-year follow-up, 411 of 1,774 (23.2%) participants had died. In a Cox model, the association between higher SOIT score and lower mortality was significant (hazard ratio (HR) = 0.74 per point interval, 95% confidence interval (CI) = 0.71-0.77, P < .001). The effect was attenuated, but remained significant, after controlling for age, sex, education, and health-related and cognitive variables (HR = 0.92, 95% CI = 0.87-0.97, P = .001). The association between SOIT score and mortality was retained after controlling for dementia conversion before death (HR = 0.92, 95% CI = 0.87-0.97, P = .001). Similar results were obtained for self-reported olfactory dysfunction.
Poor odor identification and poor self-reported olfactory function are associated with greater likelihood of future mortality. Dementia does not attenuate the association between olfactory loss and mortality, suggesting that olfactory loss might mark deteriorating health, irrespective of dementia.
确定在长达十年的随访期内，痴呆症是否能够解释嗅觉功能不佳与死亡风险之间的关联。
前瞻性队列研究。
瑞典于默奥的桦树研究。
以人群为基础的样本，基线时年龄在40至90岁之间且无痴呆症的成年参与者（N = 1774）。
使用斯堪的纳维亚气味识别测试（SOIT）评估嗅觉功能以及自我报告的嗅觉功能；基线时的若干社会、认知和医学风险因素；以及接下来十年内的新发痴呆症情况。
在10年随访期内，1774名参与者中有411人（23.2%）死亡。在Cox模型中，较高的SOIT得分与较低的死亡率之间的关联显著（风险比（HR）=每分区间0.74，95%置信区间（CI）= 0.71 - 0.77，P <.001）。在控制了年龄、性别、教育程度以及与健康和认知相关的变量后，该效应有所减弱，但仍显著（HR = 0.92，95% CI = 0.87 - 0.97，P =.001）。在控制了死亡前的痴呆症转化情况后，SOIT得分与死亡率之间的关联依然存在（HR = 0.92，95% CI = 0.87 - 0.97，P =.001）。自我报告的嗅觉功能障碍也得到了类似结果。
气味识别能力差和自我报告的嗅觉功能不佳与未来更高的死亡可能性相关。痴呆症并未减弱嗅觉丧失与死亡率之间的关联，这表明嗅觉丧失可能标志着健康状况的恶化，与痴呆症无关。
