Pritzker School of Medicine, The University of Chicago, Illinois.
Department of Otolaryngology-Head and Neck Surgery, Beijing An Zhen Hospital, Capital Medical University, China.
J Gerontol A Biol Sci Med Sci. 2021 Feb 25;76(3):528-533. doi: 10.1093/gerona/glaa276.
Sleep-disordered breathing (SDB) is a common, underdiagnosed condition in older adults with major health consequences, including disrupted central nervous system functioning. Whether SDB may affect sensory function is unclear. We sought to address this question by comparing 2 forms of olfactory testing which measure peripheral and central olfactory processing.
We assessed SDB (survey-reported snoring frequency, nighttime apneic events, or diagnosis of sleep apnea) in the National Social Life, Health, and Aging Project, a nationally representative sample of older U.S. adults. Odor sensitivity (peripheral) and odor identification (central) were assessed with validated instruments. Logistic regression was used to test the relationship between SDB and olfaction, accounting for relevant covariates, including demographics, cognition, and comorbidity.
Twenty-nine percent of older U.S. adults reported symptoms of SDB (apneic events or nightly snoring). Of these, only 32% had been diagnosed with sleep apnea. Older adults with SDB (those who reported symptoms or have been diagnosed with sleep apnea) were significantly more likely to have impaired odor identification (odds ratio 2.13, 95% confidence interval 1.19-3.83, p = .012) in analyses that accounted for age, gender, race/ethnicity, education, cognition, comorbidities (including depression), and body mass index. Presence of SDB was not associated with impaired odor sensitivity (odds ratio 1.03, 95% confidence interval 0.75-1.43, p = .84).
SDB is highly prevalent but underdiagnosed in older U.S. adults and is associated with impaired odor identification but not odor sensitivity. These data support the concept that SDB affects pathways in the central nervous system which involve chemosensory processing.
睡眠呼吸障碍（SDB）是老年人中一种常见但诊断不足的病症，对中枢神经系统功能有严重影响。SDB 是否会影响感觉功能尚不清楚。我们通过比较两种嗅觉测试来解决这个问题，这两种测试分别测量外周和中枢嗅觉处理。
我们在全国社会生活、健康和老龄化项目中评估了 SDB（通过问卷调查报告的打鼾频率、夜间呼吸暂停事件或睡眠呼吸暂停的诊断），这是一个具有全国代表性的美国老年人样本。使用经过验证的仪器评估气味敏感性（外周）和气味识别（中枢）。使用逻辑回归测试 SDB 与嗅觉之间的关系，考虑了相关的协变量，包括人口统计学、认知和合并症。
29%的美国老年人报告有 SDB 症状（呼吸暂停事件或夜间打鼾）。其中，只有 32%的人被诊断为睡眠呼吸暂停。在考虑了年龄、性别、种族/民族、教育、认知、合并症（包括抑郁症）和体重指数等因素的分析中，有 SDB 症状（报告症状或被诊断为睡眠呼吸暂停）的老年人嗅觉识别能力明显受损（优势比 2.13，95%置信区间 1.19-3.83，p=0.012）。SDB 的存在与嗅觉敏感性受损无关（优势比 1.03，95%置信区间 0.75-1.43，p=0.84）。
SDB 在老年美国人群中非常普遍但诊断不足，与嗅觉识别受损有关，但与嗅觉敏感性无关。这些数据支持 SDB 影响涉及化学感觉处理的中枢神经系统通路的概念。
