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帕金森病嗅觉功能障碍的认知。

Awareness of olfactory dysfunction in Parkinson's disease.

机构信息

Faculty of Psychology, University of Vienna.

Department of Neurology.

出版信息

Neuropsychology. 2019 Jul;33(5):633-641. doi: 10.1037/neu0000544. Epub 2019 Apr 4.

Abstract

OBJECTIVE

Olfactory impairment is a very common symptom in Parkinson's disease (PD). However, individuals often overestimate their ability to smell. Hyposmia and metacognitive errors are also related to aging, depression, male gender and cognitive impairment. The current study investigated the awareness of olfactory functioning in PD and the influence of additional factors.

METHOD

A sample of 124 nondemented PD patients and 154 elderly controls was assessed with the Sniffin' Sticks Odor Identification Test (OIT) and the Subjective Olfactory Capability (SOC) domain of the Assessment of Self-Reported Olfactory Functioning and Olfaction-Related Quality of Life, additional to measures of depressive symptoms, verbal memory and executive functioning. Olfactory awareness groups were formed by means of the cut-offs of the OIT and the SOC.

RESULTS

Significant correlations between the OIT and the SOC were moderate in participants with PD and small in controls. Of all PD patients, 52% overrated their sense of smell while 27% correctly identified themselves as being hyposmic, as opposed to corresponding 6% and 1% of healthy elderly. Overrating and aware of being hyposmic participants with PD showed worse executive functions than PD patients who were objectively and subjectively normosmic.

CONCLUSIONS

The findings imply that, although people with PD are aware of hyposmia to some extent, the majority is affected by overestimation of the ability to smell, making self-reported functioning an unreliable source of information. Moreover, reduced odor identification and impaired executive functioning might underlie the same pathological changes within the brain and could serve as a marker for cognitive impairment in PD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

摘要

目的

嗅觉障碍是帕金森病(PD)非常常见的症状。然而,个体通常会高估自己的嗅觉能力。嗅觉减退和元认知错误也与衰老、抑郁、男性性别和认知障碍有关。本研究调查了 PD 患者嗅觉功能的意识及其受其他因素的影响。

方法

评估了 124 名非痴呆 PD 患者和 154 名老年对照组的嗅觉能力,使用了嗅棒嗅觉识别测试(OIT)和主观嗅觉能力(SOC)域,以及抑郁症状、言语记忆和执行功能的测量。通过 OIT 和 SOC 的截止值形成嗅觉意识组。

结果

PD 患者和对照组的 OIT 和 SOC 之间的相关性具有中等显著性。在所有 PD 患者中,有 52%的人高估了自己的嗅觉,而 27%的人正确地认为自己嗅觉减退,而健康老年人中相应的比例分别为 6%和 1%。与客观和主观嗅觉正常的 PD 患者相比,高估嗅觉和意识到嗅觉减退的 PD 患者的执行功能更差。

结论

这些发现意味着,尽管 PD 患者在某种程度上意识到嗅觉减退,但大多数人受到嗅觉能力高估的影响,使得自我报告的功能成为不可靠的信息来源。此外,嗅觉识别能力下降和执行功能受损可能是大脑内相同的病理变化的基础,并可作为 PD 认知障碍的标志物。

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