Clinic of Neurology an Neurosurgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Med Sci Monit. 2023 May 27;29:e940363. doi: 10.12659/MSM.940363.
BACKGROUND Olfactory impairment is an early symptom of Alzheimer disease (AD). However, it is rarely assessed in clinical practice. This study aimed to assess the identification and discrimination of specific odors in patients with early-stage AD using the Sniffin' Sticks test and determine the items that would be most valuable in the diagnosis of early-stage AD in order to create a brief test of olfactory dysfunction. MATERIAL AND METHODS Three groups of participants were enrolled, including 30 patients with mild cognitive impairment due to AD (MCI-AD group), 30 with mild dementia due to AD (MD-AD group), and 30 older participants with normal cognition (NC group). All participants underwent cognitive (Clinical Dementia Rating, Mini-Mental State Examination, Alzheimer's Disease Assessment Scale-Cognitive Subscale, and verbal fluency tests) and olfactory (Burghart Sniffin' Sticks odor identification and odor discrimination tests) assessments. RESULTS The MD-AD group scored significantly lower than the MCI-AD group and the MCI-AD group scored significantly lower than the NC group in both the odor identification (P<0.001) and discrimination (P<0.05) tasks. The shortened versions of the odor identification and discrimination tasks showed good diagnostic properties in differentiating patients with AD from the NC participants (receiver operating characteristic [ROC] area under the curve [AUC]=0.912 and 0.954, respectively) and differentiating patients with MCI-AD from the NC participants (ROC AUC=0.871 and 0.959, respectively). CONCLUSIONS The brief versions of olfactory tests, containing selected items that were found to differ the most between cognitively normal participants and early-stage AD patients, have good diagnostic qualities and can aid clinicians in screening for early-stage AD.
背景:嗅觉障碍是阿尔茨海默病(AD)的早期症状。然而,在临床实践中很少对其进行评估。本研究旨在使用嗅棒测试评估早期 AD 患者对特定气味的识别和辨别能力,并确定最有助于早期 AD 诊断的项目,以创建一个简短的嗅觉功能障碍测试。
材料和方法:本研究纳入了三组参与者,包括 30 名轻度认知障碍(AD 型)患者(MCI-AD 组)、30 名轻度痴呆(AD 型)患者(MD-AD 组)和 30 名认知正常的老年人(NC 组)。所有参与者均接受认知(临床痴呆评定量表、简易精神状态检查、阿尔茨海默病评估量表认知分量表和词语流畅性测试)和嗅觉(Burghart 嗅棒嗅觉识别和嗅觉辨别测试)评估。
结果:MD-AD 组在嗅觉识别(P<0.001)和辨别(P<0.05)任务中的得分均显著低于 MCI-AD 组,而 MCI-AD 组的得分又显著低于 NC 组。嗅觉识别和辨别测试的缩短版本在区分 AD 患者和 NC 参与者方面具有良好的诊断性能(受试者工作特征曲线下面积[ROC AUC]分别为 0.912 和 0.954),并在区分 MCI-AD 患者和 NC 参与者方面具有良好的诊断性能(ROC AUC 分别为 0.871 和 0.959)。
结论:包含在认知正常参与者和早期 AD 患者之间差异最大的选定项目的简短嗅觉测试版本具有良好的诊断质量,可以帮助临床医生筛查早期 AD。
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