1991 年海湾战争老兵患海湾战争病/慢性多症状病后的嗅觉和认知能力下降。
Olfactory and cognitive decrements in 1991 Gulf War veterans with gulf war illness/chronic multisymptom illness.
机构信息
Departments of Radiology & Biomedical Imaging and Psychiatry & Behavioral Science, University of Calfiornia, 505 Parnassus Avenue, San Francisco, CA, 94143, USA.
San Francisco Veterans Affairs Health Care System, 4150 Clement Street, San Francisco, CA, 94121, USA.
出版信息
Environ Health. 2024 Jan 30;23(1):14. doi: 10.1186/s12940-024-01058-2.
BACKGROUND
Gulf War illness (GWI)/Chronic Multisymptom Illness (CMI) is a disorder related to military service in the 1991 Gulf War (GW). Prominent symptoms of GWI/CMI include fatigue, pain, and cognitive dysfunction. Although anosmia is not a typical GWI/CMI symptom, anecdotally some GW veterans have reported losing their sense smell shortly after the war. Because olfactory deficit is a prodromal symptom of neurodegenerative diseases like Parkinson's and Alzheimer's disease, and because we previously reported suggestive evidence that deployed GW veterans may be at increased risk for Mild Cognitive Impairment (MCI) and dementia, the current study examined the relationship between olfactory and cognitive function in deployed GW veterans.
METHODS
Eighty deployed GW veterans (mean age: 59.9 ±7.0; 4 female) were tested remotely with the University of Pennsylvania Smell Identification Test (UPSIT) and the Montreal Cognitive Assessment (MoCA). Veterans also completed self-report questionnaires about their health and deployment-related exposures and experiences. UPSIT and MoCA data from healthy control (HC) participants from the Parkinson's Progression Markers Initiative (PPMI) study were downloaded for comparison.
RESULTS
GW veterans had a mean UPSIT score of 27.8 ± 6.3 (range 9-37) and a mean MoCA score of 25.3 ± 2.8 (range 19-30). According to age- and sex-specific normative data, 31% of GW veterans (vs. 8% PPMI HCs) had UPSIT scores below the 10th percentile. Nearly half (45%) of GW veterans (vs. 8% PPMI HCs) had MoCA scores below the cut-off for identifying MCI. Among GW veterans, but not PPMI HCs, there was a positive correlation between UPSIT and MoCA scores (Spearman's ρ = 0.39, p < 0.001). There were no significant differences in UPSIT or MoCA scores between GW veterans with and without history of COVID or between those with and without Kansas GWI exclusionary conditions.
CONCLUSIONS
We found evidence of olfactory and cognitive deficits and a significant correlation between UPSIT and MoCA scores in a cohort of 80 deployed GW veterans, 99% of whom had CMI. Because impaired olfactory function has been associated with increased risk for MCI and dementia, it may be prudent to screen aging, deployed GW veterans with smell identification tests so that hypo- and anosmic veterans can be followed longitudinally and offered targeted neuroprotective therapies as they become available.
背景
海湾战争病（GWI）/慢性多症状疾病（CMI）是与 1991 年海湾战争（GW）期间的军事服役相关的疾病。GWI/CMI 的突出症状包括疲劳、疼痛和认知功能障碍。尽管嗅觉丧失不是典型的 GWI/CMI 症状，但有传闻称，一些海湾战争退伍军人在战后不久就失去了嗅觉。由于嗅觉缺陷是帕金森病和阿尔茨海默病等神经退行性疾病的前驱症状，并且我们之前报告的证据表明，部署的 GW 退伍军人可能患轻度认知障碍（MCI）和痴呆症的风险增加，因此当前研究检查了嗅觉和认知功能在部署的 GW 退伍军人中的关系。
方法
80 名部署的 GW 退伍军人（平均年龄：59.9 ± 7.0；4 名女性）通过宾夕法尼亚大学嗅觉识别测试（UPSIT）和蒙特利尔认知评估（MoCA）进行远程测试。退伍军人还完成了关于他们的健康和与部署相关的暴露和经历的自我报告问卷。为了进行比较，从帕金森病进展标志物倡议（PPMI）研究的健康对照组（HC）参与者中下载了 UPSIT 和 MoCA 数据。
结果
GW 退伍军人的 UPSIT 平均得分为 27.8 ± 6.3（范围为 9-37），MoCA 平均得分为 25.3 ± 2.8（范围为 19-30）。根据年龄和性别特定的标准数据，31%的 GW 退伍军人（与 8%的 PPMI HC 相比）的 UPSIT 得分低于第 10 百分位。将近一半（45%）的 GW 退伍军人（与 8%的 PPMI HC 相比）的 MoCA 得分低于识别 MCI 的截止值。在 GW 退伍军人中，但在 PPMI HC 中，UPSIT 和 MoCA 得分之间存在正相关关系（Spearman's ρ=0.39，p<0.001）。在有和没有 COVID 病史的 GW 退伍军人之间以及在有和没有堪萨斯州 GWI 排除条件的 GW 退伍军人之间，UPSIT 或 MoCA 评分均无显着差异。
结论
我们在 80 名部署的 GW 退伍军人队列中发现了嗅觉和认知功能障碍的证据，并且 UPSIT 和 MoCA 评分之间存在显着相关性，其中 99%的退伍军人患有 CMI。由于嗅觉功能障碍与 MCI 和痴呆症的风险增加有关，因此对嗅觉识别测试进行老化、部署的 GW 退伍军人进行嗅觉筛查可能是谨慎的，以便对嗅觉减退和嗅觉丧失的退伍军人进行纵向随访，并在可用时为他们提供有针对性的神经保护治疗。
Zotero 插件