Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
J Am Geriatr Soc. 2022 Apr;70(4):1106-1116. doi: 10.1111/jgs.17586. Epub 2021 Dec 7.
Olfactory impairment is associated with dementia in clinical settings. We examined the relationship of olfactory identification function with all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) and assessed the discriminative ability of the Sniffin' Sticks Identification Test (SSIT), the self-rated Ascertain Dementia 8-item Questionnaire (AD8), and their combination for dementia detection among rural-dwelling older adults in China.
This population-based cross-sectional study included 4481 participants (age ≥ 65 years; 56.8% women; 38.1% illiteracy) living in rural communities. The 16-item SSIT was performed to assess olfactory identification function. The self-rated AD8 was administered to participants for cognitive status. We diagnosed dementia, AD, and VaD following the international criteria. Data were analyzed with logistic regression models and receiver operating characteristic curve.
Of the 4481 participants, dementia was diagnosed in 139 persons (3.1%), including 92 with AD and 42 with VaD. The SSIT score (range, 0-16) was associated with multiadjusted odds ratios of 0.83 (95% CI: 0.79-0.88) for dementia, 0.84 (0.79-0.90) for AD, and 0.79 (0.71-0.87) for VaD. The area under the curve for the discrimination between participants with and without dementia was 0.73 (95% CI: 0.69-0.77) for SSIT score ≤ 8 alone, 0.86 (0.82-0.89) for self-rated AD8 score ≥ 3 alone, and 0.89 (0.86-0.92) for their combination using a logistic model.
Olfactory impairment is a clinical marker for all-cause dementia, AD, and VaD. The smell identification test, in combination with the brief self-rated cognitive screening tool, is accurate for screening dementia among rural-dwelling Chinese older adults with no or limited education.
嗅觉障碍与临床环境中的痴呆有关。我们研究了嗅觉识别功能与全因痴呆、阿尔茨海默病（AD）和血管性痴呆（VaD）的关系，并评估了嗅探棒识别测试（SSIT）、自我评定的痴呆症 8 项问卷（AD8）及其组合在检测中国农村老年人痴呆症方面的鉴别能力。
这项基于人群的横断面研究纳入了 4481 名参与者（年龄≥65 岁；56.8%为女性；38.1%为文盲），他们居住在农村社区。使用 16 项 SSIT 评估嗅觉识别功能。向参与者发放自我评定的 AD8 以评估认知状况。我们根据国际标准诊断痴呆症、AD 和 VaD。使用逻辑回归模型和受试者工作特征曲线进行数据分析。
在 4481 名参与者中，诊断出 139 人患有痴呆症（3.1%），其中 92 人患有 AD，42 人患有 VaD。SSIT 评分（范围：0-16）与校正后痴呆症（OR：0.83，95%CI：0.79-0.88）、AD（OR：0.84，95%CI：0.79-0.90）和 VaD（OR：0.79，95%CI：0.71-0.87）的比值比呈负相关。用于区分有和无痴呆症参与者的曲线下面积（AUC）分别为 SSIT 评分≤8（AUC：0.73，95%CI：0.69-0.77）、自我评定 AD8 评分≥3（AUC：0.86，95%CI：0.82-0.89）和采用逻辑模型的两者结合（AUC：0.89，0.86-0.92）。
嗅觉障碍是全因痴呆、AD 和 VaD 的临床标志物。嗅觉识别测试与简短的自我评定认知筛查工具相结合，可准确筛查无或受教育程度有限的中国农村老年人的痴呆症。
