Kim Jin Kook, Cho Jae Hoon
Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University College of Medicine, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2025 Aug;18(3):264-270. doi: 10.21053/ceo.2024.00345. Epub 2025 Mar 17.
Many studies have reported that patients with anosmia exhibit an increased incidence of dementia later in life. However, most of these studies have focused exclusively on individuals aged 65 or older, leaving a gap in research on middle-aged subjects (40-65 years).
We conducted a retrospective cohort study using Korea's National Health Insurance claims data. The study targeted participants aged 40 years and above by randomly selecting 40% of individuals who underwent the 2009 national health check-up. The cohort was divided into two groups: the anosmia group (n=8,023), comprising individuals diagnosed with anosmia between 2006 and 2008, and the control group (n=2,680,534), consisting of the remaining participants. Subsequently, we followed the participants to monitor the occurrence of Alzheimer and vascular dementia from 2011 to 2020.
After adjusting for various factors, the incidence of Alzheimer dementia was significantly higher in the anosmia group compared to the control group (hazard ratio [HR], 1.15; 95% CI, 1.04-1.28). Stratification by age revealed that the risk of developing dementia was significantly elevated in anosmia patients under 65 years (HR, 1.28; 95% CI, 1.07-1.54), whereas no significant increase was observed in those over 65 years (HR, 1.10; 95% CI, 0.97-1.24). Vascular dementia was not statistically associated with anosmia.
A diagnosis of anosmia in middle age increases the risk of developing Alzheimer dementia, while no such increase is observed in older individuals.
许多研究报告称,嗅觉丧失患者在晚年患痴呆症的几率会增加。然而,这些研究大多只关注65岁及以上的个体,在中年受试者(40 - 65岁)的研究方面存在空白。
我们利用韩国国民健康保险索赔数据进行了一项回顾性队列研究。该研究针对40岁及以上的参与者,通过随机选择2009年全国健康检查参与者的40%。队列分为两组:嗅觉丧失组(n = 8023),包括2006年至2008年间被诊断为嗅觉丧失的个体;对照组(n = 2680534),由其余参与者组成。随后,我们对参与者进行随访,以监测2011年至2020年期间阿尔茨海默病和血管性痴呆的发生情况。
在对各种因素进行调整后,嗅觉丧失组的阿尔茨海默病痴呆发病率显著高于对照组(风险比[HR],1.15;95%置信区间,1.04 - 1.28)。按年龄分层显示,65岁以下嗅觉丧失患者患痴呆症的风险显著升高(HR,1.28;95%置信区间,1.07 - 1.54),而65岁以上患者未观察到显著增加(HR,1.10;95%置信区间,0.97 - 1.24)。血管性痴呆与嗅觉丧失无统计学关联。
中年时被诊断为嗅觉丧失会增加患阿尔茨海默病痴呆的风险,而老年个体中未观察到这种增加。