Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, Illinois.
Department of Psychology, Northeastern Illinois University, Chicago, Illinois.
J Am Geriatr Soc. 2018 Jan;66(1):140-144. doi: 10.1111/jgs.15048. Epub 2017 Sep 25.
To investigate the relationship between olfactory dysfunction and subsequent diagnosis of dementia.
Longitudinal study of a population representative of U.S. older adults.
Home interviews (National Social Life, Health, and Aging Project).
Men and women aged 57 to 85 (N = 2,906).
Objective odor identification ability was measured at baseline using a validated five-item test. Five years later, the respondent, or a proxy if the respondent was too sick to interview or had died, reported physician diagnosis of dementia. The association between baseline olfactory dysfunction and an interval dementia diagnosis was tested using multivariate logistic regression, controlling for age, sex, race and ethnicity, education, comorbidities (modified Charlson Comorbidity Index), and cognition at baseline (Short Portable Mental Status Questionnaire).
Older adults with olfactory dysfunction had more than twice the odds of having developed dementia 5 years later (odds ratio = 2.13, 95% confidence interval = 1.32-3.43), controlling for the above covariates. Having more odor identification errors was associated with greater probability of an interval dementia diagnosis (P = .04, 1-degree of freedom linear-trend test).
We show for the first time in a nationally representative sample that home-dwelling older adults with normal cognition and difficulty identifying odors face higher odds of being diagnosed with dementia 5 years later, independent of other significant risk factors. This validated five-item odor identification test is an efficient, low-cost component of the physical examination that can provide useful information while assessing individuals' risk of dementia. Use of such testing may provide an opportunity for early interventions to reduce the attendant morbidity and public health burden of dementia.
研究嗅觉功能障碍与随后痴呆诊断之间的关系。
对美国老年人群进行的一项具有代表性的纵向研究。
家庭访谈（国家社会生活、健康和老龄化项目）。
年龄在 57 岁至 85 岁的男性和女性（N=2906）。
在基线使用经过验证的五项测试测量客观气味识别能力。五年后，受访者或如果受访者病得无法接受采访或已经死亡，则由代理人报告医生诊断为痴呆。使用多变量逻辑回归测试基线嗅觉功能障碍与间隔期痴呆诊断之间的关联，同时控制年龄、性别、种族和民族、教育、合并症（改良 Charlson 合并症指数）以及基线认知（简短便携精神状态问卷）。
基线嗅觉功能障碍的老年人在 5 年内发生痴呆的几率是没有嗅觉功能障碍的老年人的两倍多（优势比=2.13，95%置信区间=1.32-3.43），同时控制了上述协变量。识别气味错误的次数越多，间隔期痴呆诊断的可能性就越大（P=0.04，自由度为 1 的线性趋势检验）。
我们首次在具有代表性的全国性样本中表明，认知正常但识别气味困难的居家老年人大脑中痴呆的诊断几率在 5 年内增加了两倍以上，这与其他重要危险因素无关。这项经过验证的五项嗅觉识别测试是体检的一个有效、低成本的组成部分，可以在评估个体痴呆风险的同时提供有用的信息。使用这种测试可能为早期干预提供机会，以降低痴呆的发病和公共卫生负担。
