Department of Dementia, Dementia Center, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
Division of Dementia Research, Okinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
Sci Rep. 2024 Feb 26;14(1):4658. doi: 10.1038/s41598-024-54322-3.
A simple screening test to identify the early stages of Alzheimer's disease (AD) is urgently needed. We investigated whether odor identification impairment can be used to differentiate between stages of the A/T/N classification (amyloid, tau, neurodegeneration) in individuals with amnestic mild cognitive impairment or AD and in healthy controls. We collected data from 132 Japanese participants visiting the Toranomon Hospital dementia outpatient clinic. The odor identification scores correlated significantly with major neuropsychological scores, regardless of apolipoprotein E4 status, and with effective cerebrospinal fluid (CSF) biomarkers [amyloid β 42 (Aβ42) and the Aβ42/40 and phosphorylated Tau (p-Tau)/Aβ42 ratios] but not with ineffective biomarkers [Aβ40 and the p-Tau/total Tau ratio]. A weak positive correlation was observed between the corrected odor identification score (adjusted for age, sex, ApoE4 and MMSE), CSF Aβ42, and the Aβ42/40 ratio. The odor identification score demonstrated excellent discriminative power for the amyloidogenesis stage , according to the A/T/N classification, but was unsuitable for differentiating between the p-Tau accumulation and the neurodegeneration stages. After twelve odor species were analyzed, a version of the score comprising only four odors-India ink, wood, curry, and sweaty socks-proved highly effective in identifying AD amyloidogenesis, showing promise for the screening of preclinical AD.
我们迫切需要一种简单的筛查测试来识别阿尔茨海默病（AD）的早期阶段。我们研究了气味识别障碍是否可用于区分具有遗忘型轻度认知障碍或 AD 的个体以及健康对照者的 A/T/N 分类（淀粉样蛋白、tau、神经退行性变）的各个阶段。我们从访问 Toranomon 医院痴呆门诊的 132 名日本参与者中收集了数据。无论载脂蛋白 E4 状态如何，气味识别评分与主要神经心理学评分显著相关，与有效的脑脊液（CSF）生物标志物[淀粉样蛋白 β 42（Aβ42）和 Aβ42/40 以及磷酸化 Tau（p-Tau）/Aβ42 比值]相关，但与无效生物标志物[Aβ40 和 p-Tau/总 Tau 比值]无关。校正后的气味识别评分（校正年龄、性别、ApoE4 和 MMSE）、CSF Aβ42 和 Aβ42/40 比值之间观察到微弱的正相关。气味识别评分根据 A/T/N 分类对淀粉样蛋白形成阶段具有出色的区分能力，但不适合区分 p-Tau 积累和神经退行性变阶段。在分析了 12 种气味后，仅包含四种气味-墨水、木材、咖喱和臭袜子的评分版本在识别 AD 淀粉样蛋白形成方面非常有效，有望用于筛查临床前 AD。
